Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring
Abstract Background The analysis of heart rate variability (HRV) and heart rate (HR) dynamics by Holter ECG has been standardized to 24 hs, but longer‐term continuous ECG monitoring has become available in clinical practice. We investigated the effects of long‐term ECG on the assessment of HRV and H...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Annals of Noninvasive Electrocardiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/anec.12897 |
| _version_ | 1818966121976430592 |
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| author | Junichiro Hayano Emi Yuda |
| author_facet | Junichiro Hayano Emi Yuda |
| author_sort | Junichiro Hayano |
| collection | DOAJ |
| description | Abstract Background The analysis of heart rate variability (HRV) and heart rate (HR) dynamics by Holter ECG has been standardized to 24 hs, but longer‐term continuous ECG monitoring has become available in clinical practice. We investigated the effects of long‐term ECG on the assessment of HRV and HR dynamics. Methods Intraweek variations in HRV and HR dynamics were analyzed in 107 outpatients with sinus rhythm. ECG was recorded continuously for 7 days with a flexible, codeless, waterproof sensor attached on the upper chest wall. Data were divided into seven 24‐h segments, and standard time‐ and frequency‐domain HRV and nonlinear HR dynamics indices were computed for each segment. Results The intraweek coefficients of variance of HRV and HR dynamics indices ranged from 2.9% to 26.0% and were smaller for frequency‐domain than for time‐domain indices, and for indices reflecting slower HR fluctuations than faster fluctuations. The indices with large variance often showed transient abnormalities from day to day over 7 days, reducing the positive predictive accuracy of the 24‐h ECG for detecting persistent abnormalities over 7 days. Conversely, 7‐day ECG provided 2.3‐ to 6.5‐fold increase in sensitivity to detect persistent plus transient abnormalities compared with 24‐h ECG. It detected an average of 1.74 to 2.91 times as many abnormal indices as 24‐h ECG. Conclusions Long‐term ECG monitoring increases the accuracy and sensitivity of detecting persistent and transient abnormalities in HRV and HR dynamics and allows discrimination between the two types of abnormalities. Whether this discrimination improves risk stratification deserves further studies. |
| first_indexed | 2024-12-20T13:27:52Z |
| format | Article |
| id | doaj.art-0a7aa03cb49f40b3948c4af35c0db686 |
| institution | Directory Open Access Journal |
| issn | 1082-720X 1542-474X |
| language | English |
| last_indexed | 2024-12-20T13:27:52Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj.art-0a7aa03cb49f40b3948c4af35c0db6862022-12-21T19:39:12ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2022-01-01271n/an/a10.1111/anec.12897Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoringJunichiro Hayano0Emi Yuda1Heart Beat Science Lab, Co., Ltd. Sendai JapanHeart Beat Science Lab, Co., Ltd. Sendai JapanAbstract Background The analysis of heart rate variability (HRV) and heart rate (HR) dynamics by Holter ECG has been standardized to 24 hs, but longer‐term continuous ECG monitoring has become available in clinical practice. We investigated the effects of long‐term ECG on the assessment of HRV and HR dynamics. Methods Intraweek variations in HRV and HR dynamics were analyzed in 107 outpatients with sinus rhythm. ECG was recorded continuously for 7 days with a flexible, codeless, waterproof sensor attached on the upper chest wall. Data were divided into seven 24‐h segments, and standard time‐ and frequency‐domain HRV and nonlinear HR dynamics indices were computed for each segment. Results The intraweek coefficients of variance of HRV and HR dynamics indices ranged from 2.9% to 26.0% and were smaller for frequency‐domain than for time‐domain indices, and for indices reflecting slower HR fluctuations than faster fluctuations. The indices with large variance often showed transient abnormalities from day to day over 7 days, reducing the positive predictive accuracy of the 24‐h ECG for detecting persistent abnormalities over 7 days. Conversely, 7‐day ECG provided 2.3‐ to 6.5‐fold increase in sensitivity to detect persistent plus transient abnormalities compared with 24‐h ECG. It detected an average of 1.74 to 2.91 times as many abnormal indices as 24‐h ECG. Conclusions Long‐term ECG monitoring increases the accuracy and sensitivity of detecting persistent and transient abnormalities in HRV and HR dynamics and allows discrimination between the two types of abnormalities. Whether this discrimination improves risk stratification deserves further studies.https://doi.org/10.1111/anec.12897heart rate dynamicsheart rate variabilityHolter ECGlong‐term ECG monitoringday‐to‐day variationintraweek variation |
| spellingShingle | Junichiro Hayano Emi Yuda Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring Annals of Noninvasive Electrocardiology heart rate dynamics heart rate variability Holter ECG long‐term ECG monitoring day‐to‐day variation intraweek variation |
| title | Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring |
| title_full | Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring |
| title_fullStr | Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring |
| title_full_unstemmed | Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring |
| title_short | Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring |
| title_sort | enhanced detection of abnormalities in heart rate variability and dynamics by 7 day continuous ecg monitoring |
| topic | heart rate dynamics heart rate variability Holter ECG long‐term ECG monitoring day‐to‐day variation intraweek variation |
| url | https://doi.org/10.1111/anec.12897 |
| work_keys_str_mv | AT junichirohayano enhanceddetectionofabnormalitiesinheartratevariabilityanddynamicsby7daycontinuousecgmonitoring AT emiyuda enhanceddetectionofabnormalitiesinheartratevariabilityanddynamicsby7daycontinuousecgmonitoring |