Repeatability of ectopic beats from 48-hr ambulatory electrocardiography: The Atherosclerosis Risk in Communities (ARIC) Study

• Type of Material: Article
• Authors: Michelle L Meyer, University of North Carolina; Elsayed Z Soliman, Wake Forest School; Lisa M Wruck, Duke Clinical Research Institute; Thomas H Mosley, University of Mississippi; Lynne E Wagenknecht, Wake Forest School; Anna K Poon, University of North Carolina; Eric A Whitsel, University of North Carolina; Alvaro Alonso, Emory University; Gerardo Heiss, University of North Carolina; Laura R Loehr, University of North Carolina
• Language: English
• Date: 2017-07-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1111/anec.12426
• Title of Journal or Parent Work: Annals of Noninvasive Electrocardiology
• ISSN: 1082-720X
• Volume: 22
• Issue: 4
• Start Page: e12426
• End Page: e12426
• Grant/Funding Information: Research reported here was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under award number R01HL116900.; The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C).
• Keywords: Cardiovascular System & Cardiology; ATRIAL-FIBRILLATION; FREQUENCY; MYOCARDIAL-INFARCTION; Cardiac & Cardiovascular Systems; SPONTANEOUS VARIABILITY; HEART-DISEASE; Life Sciences & Biomedicine; premature ventricular contractions; supraventricular ectopic beats; ventricular ectopic beats; premature atrial contractions; TIME; ARRHYTHMIAS; VENTRICULAR ECTOPY; Science & Technology; STROKE; Holter
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background: The purpose of this study was to characterize the repeatability of ectopic beats, defined by premature atrial contractions (PACs) and premature ventricular contractions (PVCs), 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 (ICCs) for PACs and PVCs 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 PVCs. ICCs were >0.83 for all indices and recording lengths ≥12 hrs. ICCs 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 PACs and PVCs 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.