Heart rate monitors used by athletes — from gadget to medical equipment. A decade of own observations

Abstract

Introduction: For many years, many athletes have reported to the Centre for Sports Cardiology in Pułtusk that during endurance training, mainly running and cycling, they found unexpected increases in heart rate (HR) values observed on sports heart rate monitors (HRMs), in the vast majority of cases without the accompanying clinical symptoms. The authors have attempted to answer the question of whether the "arrhythmia" observed on HRMs is a rhythm disturbance or a mere technical artefact. The aim of the study: This article aimed to summarize the authors' observations in the field of the usefulness of HRMs for the assessment of cardiac arrhythmias in the situation of introducing new technological solutions in the modernized and enriched ones with new functions HRMs. Material and methods: Over ten years, numerous studies have been carried out and the world literature has been also analysed many times, finally describing the authors' study results and observations in numerous types of English-language articles published between 2017 and 2021. In this review article, the authors focused only on their publications from the Centre for Sports Cardiology in Pułtusk on the issues of heart rhythm disturbances observed on HRMs by endurance athletes, and on publications in which researchers from CKS participated and the articles themselves were related with the use of HRMs. Only a few references have been cited from other sources. Conclusions: The HRMs used in the past years were not significant for the treatment of asymptomatic exercise-stimulated arrhythmias. These HRMs, however, in a symptomatic arrhythmia situation, became an effective diagnostic tool confirming its occurrence. The analysis of cases and literature shows that modern sports heart rate monitors used by athletes of endurance disciplines (especially with the possibility of ECG recording) are becoming a useful, important and more and more effective diagnostic tool in the detection and final diagnosis of cardiac arrhythmias stimulated by exercise, both symptomatic and asymptomatic athletes and can significantly contribute to the increase of safety during training. It can be assumed that future HRMs will have comparable diagnostic value in detecting cardiac arrhythmias as the Holter ECG, surpassing them with the possibility of constant data transmission, ease of use and affordable price.

Sports Heart Monitors as Reliable Diagnostic Tools for Training Control and Detecting Arrhythmias in Professional and Leisure-Time Endurance Athletes: An Expert Consensus Statement

“…Athletes have long used HR monitoring digital devices for training [ 17 ]. These devices are widely known as “heart rate monitors” or HRMs [ 18 ]. Originally, these mostly included sports watches equipped with GPS, which measured HR during a workout through straps with built-in electrodes placed on the chest, which transmitted the heart’s electric field data to a receiver inside the watch [ 19 , 20 ].…”

Amateur Athlete with Sinus Arrest and Severe Bradycardia Diagnosed through a Heart Rate Monitor: A Six-Year Observation—The Necessity of Shared Decision-Making in Heart Rhythm Therapy Management

“…Despite these shortcomings, modern sports HRMs are very effective non-medical devices for identifying tachyarrhythmias, especially those that are symptomatic [ 36 ]. They can accidentally identify bradyarrhythmia [ 38 ] and some can even make ECG recordings temporarily or during the entire training session [ 14 ].…”

“…Whenever it is feasible for the person to be subjected to 1–3 days of observation, the “gold standard” is to use the Holter ECG test [ 13 ]. It is rather common for athletes to make HR assessments during exercise; specifically, HR control during training using HR monitors (HRMs) helps them to carry out their training precisely within a predetermined load range [ 14 ].…”