title: Repeatability of ectopic beats from 48-hr ambulatory electrocardiography: The Atherosclerosis Risk in Communities (ARIC) Study.
abstract: BACKGROUND
  The purpose of this study was to characterize the repeatability of ectopic beats, defined by premature atrial contractions (PACs) and premature ventricular contractions (PVCs), on ambulatory electrocardiogram (aECG) monitoring and evaluate the effect of length of aECG monitoring on the repeatability estimates.
  
  
  METHODS
  This analysis includes 95 randomly selected participants from the Atherosclerosis Risk in Communities Study (ARIC; 2011-2013). The participants wore a Holter monitor for two, 48-hr periods separated by a mean of 38 days following an identical, standardized protocol. We divided each 48-hr recording into 3-, 6-, 12-, and 24-hr recording periods and calculated intraclass correlation coefficients (ICCs) for PACs and PVCs and also as a percentage of the corresponding total of recorded beats per hour among these periods.
  
  
  RESULTS
  All participants had ≥1 PAC during the 48-hr recordings, and only two participants had no PVCs. ICCs were >0.83 for all indices and recording lengths ≥12 hrs. ICCs were intermediate for 6-hr recordings (range 0.80-0.83) and lower for 3-hr recordings (range 0.74-0.80). The ratio of the between- to within-participant variation increased with recording length.
  
  
  CONCLUSIONS
  Repeatability of PACs and PVCs was excellent for recording lengths of 6-24 hr and fair for 3 hr. Repeatability varies over shorter duration recordings within the 48-hr recording period, and thus the present results have implications for detection algorithms for ectopic beats and can facilitate epidemiologic and clinical applications in which knowledge of measurement variability and misclassification are needed.
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Michelle L
authors.identifier: http://orcid.org/0000-0001-7085-3154
authors.initials: ML
authors.lastname: Meyer
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Wruck
authors.affiliation: University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagenknecht
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Poon
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Whitsel
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Loehr
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications*; D018880:Atrial Premature Complexes / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D015331:Cohort Studies; D015716:Electrocardiography, Ambulatory / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D015203:Reproducibility of Results; D012306:Risk; D012307:Risk Factors; D013997:Time Factors; D018879:Ventricular Premature Complexes / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
keywords: Holter; premature atrial contractions; premature ventricular contractions; supraventricular ectopic beats; ventricular ectopic beats