Open AccessRepeatability of ectopic beats from 48‐hr ambulatory electrocardiography: The Atherosclerosis Risk in Communities ( ARIC ) Study
Author(s) -
Meyer Michelle L.,
Soliman Elsayed Z.,
Wruck Lisa M.,
Mosley Thomas H.,
Wagenknecht Lynne E.,
Poon Anna K.,
Whitsel Eric A.,
Alonso Alvaro,
Heiss Gerardo,
Loehr Laura R.
Publication year - 2017
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12426
Subject(s) - repeatability , medicine , premature atrial contraction , ambulatory , intraclass correlation , atherosclerosis risk in communities , cardiology , holter monitor , electrocardiography , ambulatory ecg , confidence interval , statistics , clinical psychology , psychometrics , mathematics , atrial fibrillation
Background The purpose of this study was to characterize the repeatability of ectopic beats, defined by premature atrial contractions ( PAC s) and premature ventricular contractions ( PVC s), on ambulatory electrocardiogram ( aECG ) monitoring and evaluate the effect of length of aECG monitoring on the repeatability estimates. Methods This analysis includes 95 randomly selected participants from the Atherosclerosis Risk in Communities Study ( ARIC ; 2011–2013). The participants wore a Holter monitor for two, 48‐hr periods separated by a mean of 38 days following an identical, standardized protocol. We divided each 48‐hr recording into 3‐, 6‐, 12‐, and 24‐hr recording periods and calculated intraclass correlation coefficients ( ICC s) for PAC s and PVC s and also as a percentage of the corresponding total of recorded beats per hour among these periods. Results All participants had ≥1 PAC during the 48‐hr recordings, and only two participants had no PVC s. ICC s were >0.83 for all indices and recording lengths ≥12 hrs. ICC s were intermediate for 6‐hr recordings (range 0.80–0.83) and lower for 3‐hr recordings (range 0.74–0.80). The ratio of the between‐ to within‐participant variation increased with recording length. Conclusion Repeatability of PAC s and PVC s was excellent for recording lengths of 6–24 hr and fair for 3 hr. Repeatability varies over shorter duration recordings within the 48‐hr recording period, and thus the present results have implications for detection algorithms for ectopic beats and can facilitate epidemiologic and clinical applications in which knowledge of measurement variability and misclassification are needed.