Spatial Artifact Coherence Determines Codec Robustness in Patch-Based rPPG

Remote photoplethysmography (rPPG) achieves low heart-rate error on uncompressed benchmarks yet is deployed over compressed video channels in telehealth, neonatal ICU, and driver fatigue applications. No prior work identifies the physical quantity determining when spatial decomposition outperforms global-projection methods under codec compression. We propose Spatial Artifact Coherence (SAC), defined as the ratio of off-diagonal to diagonal energy in the 4x4 inter-patch Green-channel covariance matrix (bandpass 0.75-2.5 Hz), and the PatchPCA algorithm family (four codec-aware rPPG algorithms). We evaluate 280 subjects across three public datasets, 11 codec degradation variants (MPEG-4, H.265, H.264, JPEG, chroma subsampling), and 13 algorithms via Wilcoxon tests (BH-FDR, q < 0.05, 904 tests). SAC explains 93.8% of between-variant variance in PCA advantage (r = +0.969), with zero overlap between codec families: non-MPEG-4 variants cluster at SAC 0.10-0.18 with 84-90% PCA win rates, while MPEG-4 variants cluster at SAC 0.48-0.59 with 61% win rate and a 5.8x reduction in mean improvement. Within subjects, 78% confirm the expected pattern (p < 10^-22, dz = 0.73). Within-variant subject-level SAC correlation is r = +0.099, confirming SAC classifies codec families rather than predicting individual outcomes. MPEG-4's effect is structural (macroblock DCT geometry, not noise amplitude), governed by source codec state, not resolution. P-Hybrid is identified as the most deployment-robust algorithm. Two necessary operating conditions for PatchPCA advantage are established: SAC < 0.30 and low-to-moderate motion, directly ruling out raw-to-MPEG-4 transcoding pipelines. SAC provides a physically grounded metric for codec-aware rPPG algorithm selection in clinical remote monitoring systems.