Accuracy of commercially available heart rate monitors in athletes: a prospective study
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Abstract: Endurance athletes, particularly competitive runners, are using wrist worn devices with the heart rate (HR) feature to guide their training. However, few studies have assessed the effectiveness of these at high levels of exertion. The purpose of this study was to measure the accuracy of the HR monitor feature in four watches at six different treadmill speeds. This prospective study recruited 50 healthy, athletic adults (68% male, mean age of 29, and mean BMI of 23 kg/m2). All subjects wore a three lead ECG and Polar H7 chest strap monitor and two different randomly assigned wrist worn HR monitors. These included the Apple Watch III, Fitbit Iconic, Garmin Vivosmart HR, and Tom Tom Spark 3. Once all devices were on, they were asked to run at the following speeds on a treadmill (in mph): 4, 5, 6, 7, 8, and 9 for two min. HR was assessed on all devices and agreement among measurements determined with Lin’s concordance correlation coefficient (CCC) (rc). The Polar H7 chest strap had the greatest agreement with the ECG (rc=98). This was followed by the Apple Watch III (rc=96). The Fitbit Iconic, Garmin Vivosmart HR, and Tom Tom Spark 3 all had the same level of agreement (rc=89). The Polar H7 chest strap was the most accurate, and the Apple Watch was superior among watches. For endurance athletes and their coaches, a chest strap device or Apple Watch may be the best choice for guiding workouts and performance.
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Four of the ten included studies reported statistically significant reductions in heart rate measurement accuracy in participants with darker skin tones compared to participants with lighter skin tones.
“Overall, four of the ten studies reported a significant reduction in accuracy of heart rate measurement with wearable devices in darker-skinned individuals, compared to participants with lighter skin tones.”
From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [10]
All five studies that compared manufacturers found the Apple Watch to be more accurate than the other commercial devices.
“Of those, all five found the Apple Watch to be more accurate than the other commercial devices [2, 9–12].”
From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [10]
Pasadyn et al. found that the accuracy of heart rate detection was slightly lower in non-white participants (p = 0.01).
“Pasadyn et al. similarly found that the accuracy of heart rate detection was slightly lower in non-white participants (p = 0.01) [10].”
From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [10]
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A concordance correlation coefficient to evaluate reproducibility.
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- Authors
- Pasadyn, S. R., Soudan, M., Gillinov, M., Houghtaling, P., Phelan, D., Gillinov, N., Bittel, B., & Desai, M. Y.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- Desai, Milind Y.
- Venue
- Cardiovascular Diagnosis and Therapy
- Publisher
- AME Publishing Company
- Published
- 2019-08
- Volume
- 9
- Issue
- 4
- Pages
- 379-385
- ISSN
- 2223-3652 (ISSN-L)
- 2223-3660
- PMC
- PMC6732081
- OpenAlex
- W2955237239
- Cited by
- 135
- References
- 14
- Citations by year
- 2026: 14 · 2025: 21 · 2024: 24 · 2023: 23 · 2022: 28 · 2021: 19 · 2020: 6
- FWCI
- 4.67
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Cardiovascular Diagnosis and Therapy (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- heart rate monitors, wearable devices, wrist-worn devices, chest strap, Apple Watch, Fitbit, Garmin, endurance athletes, treadmill running, measurement accuracy, training monitoring
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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