Commercial Photoplethysmography (PPG) sensors such as Apple Watch, Fitbit Versa and Polar series rely on the measurement of Continuous-Wave Diffuse Reflection Signal (CW-DRS) from skin to monitor heart rate. However, such techniques have poor depth sensitivity when considering photons from deep dermis where capillary vessels are found, or end-users with darker skin tones; and are prone to Source-Detector Distance (SDD). Using Monte Carlo modeling of light propagation in skin, we closely evaluate the dependence of Continuous-Wave Photoplethysmography (CW-PPG) in commercial wearables on SDD. Ultimately, we introduce the concept of Time-of-Flight PPG (TOF-PPG) which can produce outstanding accuracy over CW-PPG. Moving forward, these results will provide a valuable source for hypothesis generation for TOF-PPG artificial intelligence to correct CW-PPG without extra cost.
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