Key result
HRV index pRR4% differentiates atrial fibrillation from sinus rhythm with ~95% accuracy.
Why the study?
Various heart rate variability indices have recently been used to differentiate sinus rhythm from atrial fibrillation, but their comparative effectiveness required evaluation.
Do heart rate variability indices improve the differentiation of atrial fibrillation from sinus rhythm in 60-second ECG segments?
Observational (n=63,140)
Do heart rate variability indices improve the differentiation of atrial fibrillation from sinus rhythm in 60-second ECG segments?
Effect estimate: AUC 0.972, Diagnostic OR 483
The HRV index pRR4% is highly accurate in differentiating atrial fibrillation from sinus rhythm in short 60-second ECG segments, highlighting its potential for automated AF detection in clinical practice.
pRR4% may aid automated AF detection in brief ECGs; leaves open prospective validation before clinical use.
Recently, various heart rate variability (HRV) indices have been used to differentiate normal sinus rhythm (SR) from atrial fibrillation (AF). This study compared the effectiveness of different HRV indices for detecting AF in 63,140 segments of 60-second electrocardiograms (ECGs). Exactly 31,627 SR and 31,513 AF 60-second ECGs were analyzed. Based on the receiver operating characteristic (ROC) analysis, we identified optimal cutoff values of HRV indices using Youden's criterion. Next, for each HRV index a simple threshold classifier was used to classify ECG segments as AF or SR by comparing the value of the HRV index with the cutoff value. The HRV indices were then compared for their diagnostic properties using several classification measures, including sensitivity, specificity, and accuracy. The groups of HRV parameters that demonstrated the most effective diagnostic properties were pRRx (percentage of differences between successive RR intervals greater than or equal to x ms), and pRRx% (percentage of relative RR interval differences greater than or equal to x%). The best area under curve (0.972), accuracy (95.3%) and diagnostic odds ratio (483) were found for pRR4%. This study highlights the potential of these HRV indices in detecting AF and could have significant implications for clinical practice.
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Buś et al. (2023) conducted an observational in Atrial Fibrillation (n=63,140). Heart rate variability (HRV) indices was evaluated on Detection of atrial fibrillation (AUC 0.972, Diagnostic OR 483). The HRV index pRR4% effectively differentiated atrial fibrillation from sinus rhythm, achieving an area under the curve of 0.972, 95.3% accuracy, and a diagnostic odds ratio of 483.
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