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

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


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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