A Narrative Review of HRV Metric Selection for Applied Monitoring: RMSSD as the Default Metric for Sport and Exercise

Heart rate variability (HRV) monitoring is commonly used in sport and exercise science to assess recovery, training adaptation, and performance readiness. However, the routine reporting of numerous HRV metrics with substantial conceptual and physiological overlap has created inconsistency regarding which indices should be prioritized for applied monitoring. This narrative review synthesizes the contemporary literature to provide practical recommendations regarding HRV metric selection in applied monitoring, with particular emphasis on whether the root mean square of successive differences between adjacent normal-to-normal intervals (RMSSD) may serve as the primary metric for routine HRV monitoring in many healthy sport and exercise populations. RMSSD demonstrates several characteristics favorable for applied monitoring, including strong physiological relevance, favorable reliability, compatibility with ultra-short recording durations, relative robustness during spontaneous breathing, computational simplicity, and suitability for longitudinal monitoring frameworks. Although additional HRV metrics remain valuable for addressing specific physiological, mechanistic, or research questions, the current evidence supports RMSSD as the primary metric for routine HRV monitoring in many sport and exercise settings.