Quadrantal multi-scale distribution entropy analysis of heartbeat interval series based on a modified Poincaré plot

• We provide a novel measure, distribution entropy (DE), for a modified Poincaré plot.
• We propose a quadrantal multi-scale distribution entropy analysis (QMDE).
• The distinction effects of DE are different in the four quadrants of the Poincaré plot.
• In multi-scale analysis, the DE of different groups changes according to different rules.

The Poincaré plot is one of the most important approaches in human cardiac rhythm analysis. However, further investigations are still needed to concentrate on techniques that can characterize the dispersion of the points displayed by a Poincaré plot. Based on a modified Poincaré plot, we provide a novel measurement named distribution entropy (DE) and propose a quadrantal multi-scale distribution entropy analysis (QMDE) for the quantitative descriptions of the scatter distribution patterns in various regions and temporal scales. We apply this method to the heartbeat interval series derived from healthy subjects and congestive heart failure (CHF) sufferers, respectively, and find that the discriminations between them are most significant in the first quadrant, which implies significant impacts on vagal regulation brought about by CHF. We also investigate the day–night differences of young healthy people, and it is shown that the results present a clearly circadian rhythm, especially in the first quadrant. In addition, the multi-scale analysis indicates that the results of healthy subjects and CHF sufferers fluctuate in different trends with variation of the scale factor. The same phenomenon also appears in circadian rhythm investigations of young healthy subjects, which implies that the cardiac dynamic system is affected differently in various temporal scales by physiological or pathological factors.