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. 2022 Dec 8;6(1):e984.
doi: 10.1002/hsr2.984. eCollection 2023 Jan.

Validity and reliability of short-term heart-rate variability from disposable electrocardiography leads

Nduka C Okwose  1   2 , Sophie L Russell  1   2 , Mushidur Rahman  1   2 , Charles J Steward  1 , Amy E Harwood  1   2 , Gordon McGregor  1   2 , Srdjan Ninkovic  3 , Helen Maddock  1 , Prithwish Banerjee  1   2 , Djordje G Jakovljevic  1   2
Affiliations

Validity and reliability of short-term heart-rate variability from disposable electrocardiography leads

Nduka C Okwose et al. Health Sci Rep. .

Abstract

Background and aims: Single-use electrocardiography (ECG) leads have been developed to reduce healthcare-associated infection. This study compared the validity and reliability of short-term heart rate variability (HRV) obtained from single-use disposable ECG leads.

Methods: Thirty healthy subjects (33 ± 10 years; 9 females) underwent 5-min resting HRV assessments using disposable (single use) ECG cable and wire system (Kendall DL™ Cardinal Health) and a standard, reusable ECG leads (CardioExpress, Spacelabs Healthcare).

Results: Intraclass correlation coefficient (ICC) with 95% confidence interval (CI) between disposable and reusable ECG leads was for the time domain [R-R interval (ms); 0.99 (0.91, 1.00)], the root mean square of successive normal R-R interval differences (RMSSD) (ms); 0.91 (0.76, 0.96), the SD of normal-to-normal R-R intervals (SDNN) (ms); 0.91 (0.68, 0.97) and frequency domain [low-frequency (LF) normalized units (nu); 0.90 (0.79, 0.95), high frequency (HF) nu; 0.91 (0.80, 0.96), LF power (ms2); 0.89 (0.62, 0.96), HF power (ms2); 0.90 (0.72, 0.96)] variables. The mean difference and upper and lower limits of agreement between disposable and reusable leads for time- and frequency-domain variables were acceptable. Analysis of repeated measures using disposable leads demonstrated excellent reproducibility (ICC 95% CI) for R-R interval (ms); 0.93 (0.85, 0.97), RMSSD (ms); 0.93 (0.85, 0.97), SDNN (ms); 0.88 (0.75, 0.95), LF power (ms2); 0.87 (0.72, 0.94), and HF power (ms2); 0.88 (0.73, 0.94) with coefficient of variation ranging from 2.2% to 5% (p > 0.37 for all variables).

Conclusion: Single-use Kendall DL™ ECG leads demonstrate a valid and reproducible tool for the assessment of HRV.

Keywords: ECG; disposable leads; heart rate variability; reproducibility; validity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Bland–Altman plots with mean difference (solid line) and 95% limits of agreement (dotted lines) demonstrating the validity of heart rate variability using disposable electrocardiography leads compared to reusable electrocardiography leads. Variables include (A) R‐R Interval, (B) log‐transformed root mean square of successive normal R‐R intervals (RMSSD), (C) low‐frequency power in normalized units, and (D) high‐frequency power in normalized units.
Figure 2
Figure 2
Relationship between reusable and disposable leads: (A) R‐R Interval, (B) log‐transformed root mean square of successive normal R‐R intervals (RMSSD), (C) low‐frequency power in normalized units, and (D) high‐frequency power in normalized units.
See this image and copyright information in PMC

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