Reliability of resting heart rate measurements in atrial fibrillation
(2026) In Journal of Electrocardiology 98.- Abstract
BACKGROUND: Heart rate (HR) control in atrial fibrillation (AF) is commonly guided by resting HR measurements, usually with 12‑lead ECG or in-office pulse palpation.
OBJECTIVES: We aimed to assess the reliability of resting HR measurements in AF patients with long-term ambulatory ECG and activity monitoring.
METHODS: We included patients who had recorded a full-disclosure ambulatory ECG with a mobile cardiac telemetry device equipped with an accelerometer (PocketECG, MEDICALgorithmics, Poland), with at least 95% AF. Resting HR samples (≤20 per individual/day) were collected as 10-s daytime (8 am to 8 pm) measurements after ≥10 min of rest. These samples were compared to each individual's mean daytime resting... (More)
BACKGROUND: Heart rate (HR) control in atrial fibrillation (AF) is commonly guided by resting HR measurements, usually with 12‑lead ECG or in-office pulse palpation.
OBJECTIVES: We aimed to assess the reliability of resting HR measurements in AF patients with long-term ambulatory ECG and activity monitoring.
METHODS: We included patients who had recorded a full-disclosure ambulatory ECG with a mobile cardiac telemetry device equipped with an accelerometer (PocketECG, MEDICALgorithmics, Poland), with at least 95% AF. Resting HR samples (≤20 per individual/day) were collected as 10-s daytime (8 am to 8 pm) measurements after ≥10 min of rest. These samples were compared to each individual's mean daytime resting HR.
RESULTS: In 832 patients (median age 77 (interquartile range (IQR) 69-83) years, 42% women) with a median registration duration of 13 days (IQR 7-22), the population mean daytime resting HR was 85 (±15) beats per minute (bpm). A single resting HR differed from the mean daytime resting HR by a mean of ±10.4% (IQR 3.6-14.4%). When the mean daytime resting HR was ≥110 bpm, 29% of resting HR samples were < 110 bpm, and when the mean daytime resting HR was 80-109 bpm,11% of samples were ≥ 110 bpm. Resting HR measurement variability decreased to 5.3% (IQR 1.9-7.5%) when four resting HR samples were averaged.
CONCLUSION: In patients with AF, a single resting HR measurement often differs substantially from the mean daytime resting HR. When a precise measurement is clinically relevant, repeated resting HR sampling or ambulatory monitoring can address this measurement imprecision.
(Less)
- author
- organization
- publishing date
- 2026-07-18
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Journal of Electrocardiology
- volume
- 98
- article number
- 154408
- publisher
- Elsevier
- external identifiers
-
- pmid:42497467
- ISSN
- 1532-8430
- DOI
- 10.1016/j.jelectrocard.2026.154408
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2026. Published by Elsevier Inc.
- id
- 6f7144b8-9459-4d8e-bafe-5f56319ad2c5
- date added to LUP
- 2026-07-27 16:47:17
- date last changed
- 2026-07-28 14:38:14
@article{6f7144b8-9459-4d8e-bafe-5f56319ad2c5,
abstract = {{<p>BACKGROUND: Heart rate (HR) control in atrial fibrillation (AF) is commonly guided by resting HR measurements, usually with 12‑lead ECG or in-office pulse palpation.</p><p>OBJECTIVES: We aimed to assess the reliability of resting HR measurements in AF patients with long-term ambulatory ECG and activity monitoring.</p><p>METHODS: We included patients who had recorded a full-disclosure ambulatory ECG with a mobile cardiac telemetry device equipped with an accelerometer (PocketECG, MEDICALgorithmics, Poland), with at least 95% AF. Resting HR samples (≤20 per individual/day) were collected as 10-s daytime (8 am to 8 pm) measurements after ≥10 min of rest. These samples were compared to each individual's mean daytime resting HR.</p><p>RESULTS: In 832 patients (median age 77 (interquartile range (IQR) 69-83) years, 42% women) with a median registration duration of 13 days (IQR 7-22), the population mean daytime resting HR was 85 (±15) beats per minute (bpm). A single resting HR differed from the mean daytime resting HR by a mean of ±10.4% (IQR 3.6-14.4%). When the mean daytime resting HR was ≥110 bpm, 29% of resting HR samples were < 110 bpm, and when the mean daytime resting HR was 80-109 bpm,11% of samples were ≥ 110 bpm. Resting HR measurement variability decreased to 5.3% (IQR 1.9-7.5%) when four resting HR samples were averaged.</p><p>CONCLUSION: In patients with AF, a single resting HR measurement often differs substantially from the mean daytime resting HR. When a precise measurement is clinically relevant, repeated resting HR sampling or ambulatory monitoring can address this measurement imprecision.</p>}},
author = {{Persson, Anders P and McIntyre, William F and Glotzer, Taya and Andrade, Jason G and Conen, David and Fedorowski, Artur and Måneheim, Alexandra and Lundeberg, Johan Economou and Juhlin, Tord and Edegran, Albin and Grotek-Cuprjak, Agnieszka and Healey, Jeff S and Engström, Gunnar and Rienstra, Michiel and Johnson, Linda S}},
issn = {{1532-8430}},
language = {{eng}},
month = {{07}},
publisher = {{Elsevier}},
series = {{Journal of Electrocardiology}},
title = {{Reliability of resting heart rate measurements in atrial fibrillation}},
url = {{http://dx.doi.org/10.1016/j.jelectrocard.2026.154408}},
doi = {{10.1016/j.jelectrocard.2026.154408}},
volume = {{98}},
year = {{2026}},
}
