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European Heart Journal 1980 1(6):417-427;
Copyright © 1980 by the European Society of Cardiology.
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© 1980 The European Society of Cardiology

The quality of ambulatory ECG-recordings and accuracy of semi-automatic arrythmia analysis. An evaluation of the Medilog-Pathfinder system

P. BJERREGAARD

Department of Cardiology, Aarhus Kommunehospital 8000 Aarhus C, Denmark

Received 15 July 1980; revised 18 August 1980; .

Requests for reprints to: Dr Preben Bjerregaard, Cardiologisk Afdeling, Aarhus Kommunehospital, 8000 Aarhus C, Denmark.

The quality of 269 research ambulatory ECG recordings was evaluated. Nine recordings failed for technical reasons, and 20 others had a high noise level making them unsuitable for research purposes. The remaining 240 or 89% of the recordings were considered satisfactory.

Evaluation of a semi-automatic ECG analyser (Reynolds Pathfinder) revealed an overall accuracy of QRS complex detection of 98.9% (range 84.3–100%). Except for six recordings with great variability in QRS morphology more than 95% of detected QRS events were classified as normal or aberrant. Artifacts gave rise to ≥1 false positive pause per 1000 QRS events in 23% of the recordings.

Ventricular premature beats (VPBs) detected solely by their aberrancy gave rise to a high number of false positive VPBs per recording (mean: 333, range: 4–2613). When VPBs were detected by their prematurity as well, these figures were reduced (mean: 94, range: 0–572). The number of false negative VPBs (‘missed VPBs’) was evaluated in 18 recordings with a mean of 1639 (range: 172–6660) VPBs per 24 h documented on paper. The number of VPBs missed by the computer was on average 5% (0–40%) when VPBs were detected as premature aberrant events. Only in four of these cases was this percentage significantly reduced, when VPBs were detected solely as aberrant events.

This variability in quality of ambulatory ECG recordings and performance of arrhythmia computers underscores the need for a quality control procedure, when semi-automatic analysis of ambulatory ECG recordings are used for research purposes.

Key Words: Ambulatory electrocardiography • ECG tape recorder • arrhythmia computer • semiautomatic arrhythmia analysis


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