Validation and comparison of three different heart rate measuring methods during treadmill performance diagnostics

Abstract

Background: Different methods for heart rate (HR)-determination are used in routine performance diagnostics. Aim of the study was to compare different HR measurement methods during treadmill performance diagnostics. Methods: 76 athletes (28.6±14.7 years, 38% female. performed a treadmill lactate threshold test. HR during testing was simultaneously assessed by analysis of a 12-lead electrocardiogram (ECG. both automatically (aECG. and manually (mECG. and a heart rate monitor (HRM). ECGs and HRM measurements were analyzed by two diagnosticians and finally, three different HR curves (aECG, mECG, HRM. were generated and compared at different time points. ››Results: ECG-based HR detection revealed excellent reproducibility and reliability. Concerning HRM/aECG, faulty measurements were detected in 14.5%/36.8% of all athletes. However, constructions of HR/lactate curves were still possible in 84.6%/73.7% of all athletes. HR at different corresponding time points did not differ significantly between mECG and HRM/aECG (intraclass correlation coefficient >0.9/0.8 and coefficient of variation <5%/5%). In Bland-Altman analysis HRM/mECG and aECG/ mECG, mean differences were usually low (3-5 bpm). Limits of agreement were relatively high (approx.±10 bpm). Conclusions: Training areas defined by mECG may be used for home training control with HRM. If HRM measurements are used for the athlete’s training recommendations, HRs determined should be checked for plausibility and comparability with corresponding ECG measurements by physicians with appropriate expertise. Due to comparably high error susceptibility, aECG HR detection should not be used in performance diagnostics.