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Reliability of resting heart rate measurements in atrial fibrillation

Persson, Anders P LU orcid ; McIntyre, William F ; Glotzer, Taya ; Andrade, Jason G ; Conen, David ; Fedorowski, Artur LU orcid ; Måneheim, Alexandra LU ; Lundeberg, Johan Economou LU orcid ; Juhlin, Tord LU and Edegran, Albin LU , et al. (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.

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publishing date
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 &lt; 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}},
}