What is so special about 3 channel ECG devices – they deliver data which are reproducable & have the highest accuracy

Last Updated on December 12, 2023 by pg@petergamma.org

3 channel ECG devices are used by scientists to write papers on a regular basis

The information about this can be found in a paper of the Cleveland Clinic in Ohio about commercially available heart rate monitors:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732081/

Gold standard for heart rate measurement means that a device is the most accurate device on the market which is available. In the paper we mentioned above we can find that 3 lead (or 3 channels ) devices are gold standard for heart rate measurements.

In the paper it says, in order to accurately assess the heart rate:

1. The Mason-Likar electrode placement was used
2. The ECG was monitored on a Quinton Q-tel RMS (a 3 channel ECG device)
3. ECG-based heart rate was determined by visual assessment by trained research personnel.

Point 1 – 3 are the requirements for gold standard for heart rate measurements. The scientific basis for this can be found in the following paper:

Lin LI. A concordance correlation coefficient to evaluate reproducibility. Biometrics

https://pubmed.ncbi.nlm.nih.gov/2720055/

which was published in 1989 and has been cited 8461 times to this date. In this paper we can find as described above for heart rate measurements to be reproducable:

(1) the correct placement
(2) a 3 channel ECG device
(3) a trained person who checks every single ECG peak

is required. If these requirements are not full-filled, heart rate data are not reproducable and reach the higest accuracy. We can find a lot of papers which have been written with 3 channel ECG devices. Here we can find for instance the list of papers which have been written with iWorx TA 220 which is a 3 channel ECG device:

IX-TA-220 Recorder with Integrated Sensors

But neither the Polar H10 chest strap nor the 100 smartwatches Rob ter Horst tested full-fill these requirements. If these requirements are not full-filled, a validation paper is necessary to proof that the device has the required accuracy. This could be the explanation that neither the Polar H10 not the 100 smartwatches Rob ter Horst tested are used by medical doctors in the hospital where it is about life or death. These devices never have proofen that they have reached the accuracy of 3 channel ECG devices as described above.