Abstract
Background: The Equivital (EQ02) is a multi-parameter telemetric device offering both real-time and/or retrospective, synchronized monitoring of ECG, HR, and HRV, respiration, activity, and temperature. Unlike the Holter, which is the gold standard for continuous ECG measurement, EQO2 continuously monitors ECG via electrodes interwoven in the textile of a wearable belt.Objective: To compare EQ02 with the Holter for continuous home measurement of ECG, heart rate (HR), and heart rate variability (HRV).Methods: Eighteen healthy participants wore, simultaneously for 24 h, the Holter and EQ02 monitors. Per participant, averaged HR, and HRV per 5 min from the two devices were compared using Pearson correlation, paired T-test, and Bland-Altman analyses. Accuracy and precision metrics included mean absolute relative difference (MARD).Results: Artifact content of EQ02 data varied widely between (range 1.93–56.45%) and within (range 0.75–9.61%) participants. Comparing the EQ02 to the Holter, the Pearson correlations were respectively 0.724, 0.955, and 0.997 for datasets containing all data and data with < 50 or < 20% artifacts respectively. For datasets containing respectively all data, data with < 50, or < 20% artifacts, bias estimated by Bland-Altman analysis was −2.8, −1.0, and −0.8 beats per minute and 24 h MARD was 7.08, 3.01, and 1.5. After selecting a 3-h stretch of data containing 1.15% artifacts, Pearson correlation was 0.786 for HRV measured as standard deviation of NN intervals (SDNN).Conclusions: Although the EQ02 can accurately measure ECG and HRV, its accuracy and precision is highly dependent on artifact content. This is a limitation for clinical use in individual patients. However, the advantages of the EQ02 (ability to simultaneously monitor several physiologic parameters) may outweigh its disadvantages (higher artifact load) for research purposes and/ or for home monitoring in larger groups of study participants. Further studies can be aimed at minimizing the artifacts.
Highlights
With cardiovascular diseases still representing a leading cause of death globally, continuous electrocardiography (ECG) measurement is becoming increasingly important
Data represent mean with standard deviation unless stated otherwise. *Excluding charging times
This is the first study to investigate the accuracy of Equivital EQ02 lifemonitor (EQ02) for continuous ECG measurement by comparing EQ02 with the gold standard (Holter)
Summary
With cardiovascular diseases still representing a leading cause of death globally, continuous electrocardiography (ECG) measurement is becoming increasingly important. Continuous ECG measurements yields valuable information on heart rate (HR) and its variability (HRV) that can be measured at a beat-to-beat level. Their direct clinical importance has been demonstrated in numerous studies. Even in apparently healthy individuals, HR has predictive value for sudden cardiac death (Mølgaard et al, 1991). Control of HR has become the focus of drug development for cardiovascular diseases (Routledge et al, 2002). In addition to HR, continuous measurement of heart rate variability (HRV) serves as an index of cardiac sympathetic and parasympathetic activity (Thayer et al, 2010). Unlike the Holter, which is the gold standard for continuous ECG measurement, EQO2 continuously monitors ECG via electrodes interwoven in the textile of a wearable belt
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