Preejection period can be calculated using R peak instead of Q

Preejection period (PEP) is a common measure of sympathetic nervous system activation in psychophysiological research, which makes it important to measure reliably for as many participants as possible. PEP is typically calculated as the interval between the onset or peak of the electrocardiogram Q wave and the impedance cardiography B point, but the Q wave can lack clear definition and even its peak is not visible for all participants. We thus investigated the feasibility of using the electrocardiogram R wave peak (Rpeak) instead of Q because it can be consistently identified with ease and precision. Across four samples (total N = 408), young adult participants completed a variety of minimally metabolically demanding laboratory tasks after a resting baseline. Results consistently supported a close relationship between absolute levels of the Rpeak-B interval and PEP (accounting for approximately 90% of the variance at baseline and 89% during task performance, on average), but for reactivity values, Rpeak-B was practically indistinguishable from PEP (accounting for over 98% of the variance, on average). Given that using Rpeak rather than the onset or peak of Q saves time, eliminates potential subjectivity, and can be applied to more participants (i.e., those without a visible Q wave), findings suggest that Rpeak-B likely provides an adequate estimate of PEP when absolute levels are of interest and clearly does so for within-person changes.