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Accuracy of pulse interval timing in ambulatory blood pressure measurement

View Article: PubMed Central - PubMed

ABSTRACT

Blood pressure (BP) monitors rely on pulse detection. Some blood pressure monitors use pulse timings to analyse pulse interval variability for arrhythmia screening, but this assumes that the pulse interval timings detected from BP cuffs are accurate compared with RR intervals derived from ECG. In this study we compared the accuracy of pulse intervals detected using an ambulatory blood pressure monitor (ABPM) with single lead ECG. Twenty participants wore an ABPM for three hours and a data logger which synchronously measured cuff pressure and ECG. RR intervals were compared with corresponding intervals derived from the cuff pressure tracings using three different pulse landmarks. Linear mixed effects models were used to assess differences between ECG and cuff pressure timings and to investigate the effect of potential covariates. In addition, the maximum number of successive oscillometric beats detectable in a measurement was assessed. From 243 BP measurements, the landmark at the foot of the oscillometric pulse was found to be associated with fewest covariates and had a random error of 9.5 ms. 99% of the cuff pressure recordings had more than 10 successive detectable oscillometric beats. RR intervals can be accurately estimated using an ABPM.

No MeSH data available.


Related in: MedlinePlus

(A) An example of a cuff pressure trace obtained during the study. (B) An enlarged version of one of the pressure steps where three oscillometric pulses are clearly visible. (C) A trace with a small amount of movement artifact meaning that an oscillometric pulse cannot be identified (circled). (D) A trace with intermittent artifact throughout the entire recording.
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f2: (A) An example of a cuff pressure trace obtained during the study. (B) An enlarged version of one of the pressure steps where three oscillometric pulses are clearly visible. (C) A trace with a small amount of movement artifact meaning that an oscillometric pulse cannot be identified (circled). (D) A trace with intermittent artifact throughout the entire recording.

Mentions: Twenty healthy volunteers, aged between 24 and 61 years, were recruited. The range of valid BP measurement cycles was 9–13 and there were 243 valid BP measurement cycles in total. A total of 9677 R waves occurred during these measurement cycles. Oscillometric pulses were visible in all of the cuff pressure traces, Fig. 2. However, some cuff pressure traces were subject to artifact, Fig. 2. For the 9677 R waves, 8563 corresponding oscillometric pulses were visible meaning that for 1114 (11%) of the R waves no corresponding oscillometric pulse could be detected due to artifact. This left a total of 8093 RR and OI pairs available for analysis.


Accuracy of pulse interval timing in ambulatory blood pressure measurement
(A) An example of a cuff pressure trace obtained during the study. (B) An enlarged version of one of the pressure steps where three oscillometric pulses are clearly visible. (C) A trace with a small amount of movement artifact meaning that an oscillometric pulse cannot be identified (circled). (D) A trace with intermittent artifact throughout the entire recording.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120306&req=5

f2: (A) An example of a cuff pressure trace obtained during the study. (B) An enlarged version of one of the pressure steps where three oscillometric pulses are clearly visible. (C) A trace with a small amount of movement artifact meaning that an oscillometric pulse cannot be identified (circled). (D) A trace with intermittent artifact throughout the entire recording.
Mentions: Twenty healthy volunteers, aged between 24 and 61 years, were recruited. The range of valid BP measurement cycles was 9–13 and there were 243 valid BP measurement cycles in total. A total of 9677 R waves occurred during these measurement cycles. Oscillometric pulses were visible in all of the cuff pressure traces, Fig. 2. However, some cuff pressure traces were subject to artifact, Fig. 2. For the 9677 R waves, 8563 corresponding oscillometric pulses were visible meaning that for 1114 (11%) of the R waves no corresponding oscillometric pulse could be detected due to artifact. This left a total of 8093 RR and OI pairs available for analysis.

View Article: PubMed Central - PubMed

ABSTRACT

Blood pressure (BP) monitors rely on pulse detection. Some blood pressure monitors use pulse timings to analyse pulse interval variability for arrhythmia screening, but this assumes that the pulse interval timings detected from BP cuffs are accurate compared with RR intervals derived from ECG. In this study we compared the accuracy of pulse intervals detected using an ambulatory blood pressure monitor (ABPM) with single lead ECG. Twenty participants wore an ABPM for three hours and a data logger which synchronously measured cuff pressure and ECG. RR intervals were compared with corresponding intervals derived from the cuff pressure tracings using three different pulse landmarks. Linear mixed effects models were used to assess differences between ECG and cuff pressure timings and to investigate the effect of potential covariates. In addition, the maximum number of successive oscillometric beats detectable in a measurement was assessed. From 243 BP measurements, the landmark at the foot of the oscillometric pulse was found to be associated with fewest covariates and had a random error of 9.5 ms. 99% of the cuff pressure recordings had more than 10 successive detectable oscillometric beats. RR intervals can be accurately estimated using an ABPM.

No MeSH data available.


Related in: MedlinePlus