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The Journal of Sports Medicine and Physical Fitness 2001 December;41(4):546-53

Copyright © 2002 EDIZIONI MINERVA MEDICA

lingua: Inglese

Ability of new heart rate monitors to measure normal and abnormal heart rate

Boudet G., Chaumoux A.

From the Laboratoire Performance Motrice, UFR STAPS, Université Blaise Pasal, Aubière, Cedex, France * Laboratoire de Médecine du Travail, Faculté de Médecine, Université d’Auvergne, Clermont-Ferrand, France


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Background. The extend­ed use of ­heart ­rate mon­i­tors to non spor­tive peo­ple, and old­er ­ones increas­es the ­risk to be fac­ing ­heart ­rate trou­bles. Questions ­exist ­upon the abil­ity of ­this devic­es to ­detect ­such abnor­mal­ities. The pur­pose of the inves­ti­ga­tion was to eval­u­ate the accu­ra­cy of two ­third gen­er­a­tion ­heart ­rate mon­i­tors, Accurex Plus and Vantage NV and to com­pared ­these ­data ­with ­those of an old­er one, PE 4000. Then we inves­ti­gate respons­es of ­this mon­i­tors to abnor­mal ­heart ­rate.
Methods. Experimental ­design: the ­three ­heart ­rate mon­i­tors ­were test­ed in the labor­a­to­ry, ­wired in par­allel to an ECG sim­u­la­tor ­under two ­modes: a nor­mal ­heart ­rate pro­gram (7 ­stable ­heart ­rate stag­es ­with two ­marked tran­si­tions) and an auto­mat­ic arrhyth­mia one. Measures: 1st pro­gram: val­ues gen­er­at­ed by the ECG sim­u­la­tor ­were com­pared to the val­ues pro­duced by the ­three devic­es. Particular atten­tion was ­paid to the tran­si­tion phas­es (­heart ­rate ­drop and ­heart ­rate ­fall). Results of ­heart ­rate mon­i­tors accu­ra­cy ­were ­expressed at the ­exact val­ue (devic­es val­ue=sim­u­la­tor val­ue) and at approx­i­mat­ed val­ue of ±3 ­beats . min-1 (devic­es val­ue=sim­u­la­tor val­ue ±3 ­beats . min-1); 2nd pro­gram: abnor­mal ­rhythms ­were ana­lysed ­using an ambu­la­to­ry ECG record­er (Synésis) as con­trol ­data, and com­pared to the ­data ­from the ­three devic­es. Statistics: cor­re­la­tion ­between sim­u­la­tor gen­er­at­ed ­true val­ues and HRMs ­read val­ues ­were cal­cu­lat­ed.
Results. In the 1st nor­mal ­heart ­rate pro­gram, ­with an accu­ra­cy of ­exact val­ue, Accurex Plus and Vantage NV, ­were ­more accu­rate ­than the PE 4000 (94% and 89% of val­ues respec­tive­ly ver­sus 33% for the PE4000). At ±3 ­beats . min-1, the ­three devic­es ­gave ­good ­results: ­over 98% of ­total val­ues. In tran­si­tion phas­es: the ­three devic­es ­showed a smooth­ing ­effect, ­which was strong­er in decel­er­at­ing ­heart ­rate ­than in accel­er­at­ing ­heart ­rate. In the 2nd pro­gram: iso­lat­ed ­heart ­rhythm trou­bles (miss­ing ­beat, ­pause <4 sec, ­supra-ven­tric­u­lar ectop­ic activ­ity, and ven­tric­u­lar ectop­ic activ­ity) ­were ­either not detect­ed or ­were reject­ed. Signal chang­es ­such as chang­es in QRS (ven­tric­u­lar big­em­iny) may ­cause detec­tion loss­es, and so mod­i­fy cal­cu­lat­ed ­heart ­rate. The HR sig­nal ris­ing/drop­ping ­slopes ­caused by sud­den ­heart ­rhythm dis­or­ders, ­were not­ably atten­u­at­ed, ­with a con­se­quent ­loss of HR accu­ra­cy.
Conclusions. In labor­a­to­ry ­stable ­heart ­rate con­di­tions, ­third gen­er­a­tion HRMs are ­more accu­rate ­than ear­li­er ­ones. Heart ­rate mon­i­tors are ­less accu­rate in tran­sient phas­es and ­have not ­been ­improved in ­that ­domain. The ­three HRMs ­ignore iso­lat­ed ­heart ­rate trou­bles. As expect­ed, the use­ful­ness of HRMs in detect­ing HR dis­or­ders is lim­it­ed. Nevertheless, ­these devic­es ­have ­some val­ue ­with seri­ous trou­bles, ­like ­pause, brad­y­car­dia or tach­y­car­dia, last­ing long­er ­than 4 sec, and espe­cial­ly if ­they coin­cide ­with func­tion­al symp­toms. The use of ­such ­even ­more accu­rate devic­es may con­se­quent­ly be rec­om­mend­ed to ­healthy pub­lic for ­which ­they ­were ­built.

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