Can heart rate variability parameters derived by a heart rate monitor differentiate between atrial fibrillation and sinus rhythm?
Authors: Broux B, De Clercq D, Vera L, Ven S, Deprez P, Decloedt A, van Loon G
Journal: BMC veterinary research
Summary
# Editorial Summary Previous research suggested that RMSSD (root mean squared successive differences in RR intervals)—a heart rate variability parameter—could reliably distinguish atrial fibrillation from normal sinus rhythm in horses, raising the possibility that portable heart rate monitors could serve as practical screening tools for detecting AF recurrence during routine monitoring. Broux and colleagues tested this hypothesis by simultaneously recording heart rhythm data via both a commercial heart rate monitor and gold-standard electrocardiography in 14 horses undergoing AF treatment, collecting two-minute samples at rest, walk, and trot before and after cardioversion. The findings were sobering: RMSSD values from the heart rate monitor failed to differentiate AF from sinus rhythm with acceptable accuracy, largely because automated QRS detection errors in the monitor corrupted the RR interval measurements needed for reliable RMSSD calculation—a problem that persisted even when the researchers applied various artifact correction algorithms. Whilst dedicated HRV software using manually corrected ECG data could distinguish the two rhythms, the authors concluded that current commercially available heart rate monitors lack the detection accuracy required for clinical use in AF screening. For practitioners relying on portable monitoring devices, this study underscores the importance of clinical judgment and the limitations of automated HRV analysis in diagnosing arrhythmias; ECG confirmation remains essential until monitoring technology advances.
Read the full abstract on PubMed
Practical Takeaways
- •Heart rate monitors with automated RMSSD calculation could be used as practical field tools to monitor for recurrence of atrial fibrillation in treated horses
- •Ensure your HRM software includes appropriate artifact correction algorithms, as different filters significantly affect the reliability of RMSSD values for AF detection
- •RMSSD can be reliably assessed across multiple gaits (rest, walk, trot), giving flexibility in when and how you monitor at-risk horses
Key Findings
- •RMSSD values from heart rate monitors can differentiate atrial fibrillation from sinus rhythm in horses across multiple gaits
- •Artifact correction algorithms significantly impact RMSSD calculation accuracy when using automated HRM data
- •RMSSD measurements taken at rest, walk, and trot showed consistent discrimination between AF and SR before and after cardioversion