title: Accuracy of pulse interval timing in ambulatory blood pressure measurement.
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.
authors.affiliation: Medical Physics Department, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.|Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, NE1 7RU, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Kane
authors.affiliation: Medical Physics Department, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.|Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, NE1 7RU, UK.
authors.forename: James R
authors.initials: JR
authors.lastname: Blake
authors.affiliation: Medical Physics Department, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.|Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, NE1 7RU, UK.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: McArdle
authors.affiliation: Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, NE1 7RU, UK.|School of Engineering, University of Hull, HU6 7RX, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Langley
authors.affiliation: Medical Physics Department, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.|Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, NE1 7RU, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Sims
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D015924:Blood Pressure Monitors; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011674:Pulse