Arrhythmias & electrophysiologyCohort study
High heart rate peaks from chest-strap recordings in athletes: prevalence, characteristics, and clinical relevance
- Retrospective cohort study
Authors' conclusion
Many characteristics point to true arrhythmias as the cause of HRmaxHRM recordings with paroxysmal spike morphology: they are rare, do not occur randomly across athletes, and cosegregate with clinically documented arrhythmias.
Study context
- Population
- Endurance athletes with heart rate monitor (chest-strap) training recordings57,282 sessions
- Participants
- 251 athletes
- Exposure
- Pro@Heart vs Master@Heart
- Pro@Heartn = 167
- Master@Heartn = 84
- Outcome
- Prevalence, morphology and clinical relevance of transient extreme HR spikes (sessions exceeding individual physiological maximal HR)
Main finding
As reported in the abstract
- Extreme HR values: share of sessions
- 1.0%
- Athletes with extreme HR values
- 133 (53.0%)
- Paroxysmal spikes: share of cases
- 28.1%
- Paroxysmal spikes: share of sessions
- 0.27%
- Paroxysmal spikes: share of athletes
- 23.9%
- Cumulative incidence of paroxysmal spikes after 291 sessions
- 33.8% (95% CI 26.1-41.4%)
Observational data: associations, not effects.
Further findings
Paroxysmal spikes by documented arrhythmia
P < 0.001
- Paroxysmal spikes by documented arrhythmia: 10/14 vs 50/237
Predictors (demographic, training, device) of extreme HR events (generalised linear mixed model (GLMM))
- No significant predictors identified
Paroxysmal spikes by documented arrhythmia
- Nearly all HRmaxHRM spikes preceded Holter-documented arrhythmias
Original publication
High heart rate peaks from chest-strap recordings in athletes: prevalence, characteristics, and clinical relevance. Eur J Prev Cardiol. Published 22 April 2026. doi:10.1093/eurjpc/zwag232
Summarised from the published abstract; every number is checked against it