Key Points - The present systematic review is the first one that systematically compares methods of intensity zone determination derived from heart rate variability (HRVTlow/HRVThigh) with more traditional concepts derived from ventilatory measurements (VTlow/VThigh) and blood lactate concentration (LTlow/LThigh). - The findings of our data synthesis reveal that HRVTs for healthy, male adults participating in endurance-type activities show in general a high overall correlation but a very heterogeneous level of agreement with established VTs and/or LTs as the agreement strongly varies with the chosen reference method and/or HRVT approach. - HRVTlow seems a promising approach for the determination of a `lower` threshold comparable to VTlow that could be used to demarcate the boundary between moderate and heavy exercise intensity. This may also be the case for HRVThigh compared to VThigh to denote the boundary between the heavy and severe exercise domain but needs further evaluation. Limits of agreement denote potential bias on an individual level. - HRVT validation studies used very heterogeneous methodologies, which limit the comparability of results. Evidence for female athletes is scarce, and for some HRVT-approaches not available at all. Thus, more high-quality research in this direction is urgently needed
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