RR interval signal quality of a heart rate monitor and an ECG Holter at rest and during exercise

Eur J Appl Physiol. 2019 Jul;119(7):1525-1532. doi: 10.1007/s00421-019-04142-5. Epub 2019 Apr 19.


This study was designed to examine the RR interval signal qualities of a Holter device and a heart rate chest belt monitor at rest and during exercise. Ten healthy individuals completed five low- to high-intensity activities while simultaneously using the medilog® AR12plus Holter monitor and the Polar H10 heart rate monitor. The RR interval signal quality was based on the quantification of the missing RR intervals and RR interval detection errors. Therefore, both measurement systems were compared against visual inspection of the raw electrocardiography signal. The missing and wrong R-wave peak detections were counted manually for both measurement systems. RR interval signal quality was defined as the relative number of correctly detected RR intervals. Overall, RR interval signal qualities of 94.6% and 99.6% were demonstrated for the medilog® AR12plus and the Polar H10. During the high-intensity activities, the RR interval signal quality of the medilog® AR12plus dropped to 89.8%, whereas the Polar H10 maintained a signal quality of 99.4%. The correlation between both systems was high (r = 0.997, p > 0.001). The excellent RR interval signal quality during low- to moderate-intensity activities in the medilog® AR12plus and during low- to high-intensity activities in the Polar H10 demonstrates both measurement systems' validity for the detection of RR intervals throughout a wide range of activities. A simple chest strap such as the Polar H10 might be recommended as the gold standard for RR interval assessments if intense activities with strong body movements are investigated.

Keywords: Gold standard; Heart rate measurement; Low- to high-intensity activities; Validity.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Electrocardiography, Ambulatory / instrumentation
  • Electrocardiography, Ambulatory / methods*
  • Electrocardiography, Ambulatory / standards
  • Exercise / physiology*
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Reference Standards
  • Reproducibility of Results