Real-time analysis arrhythmia accuracy and repeatability of the Hewlett-Packard ambulatory ECG instrument and two updated versions of the arrhythmia algorithm were examined in the clinical evaluation of 50 patients. Appreciable algorithm inaccuracy occurred at low densities of repetitive ventricular arrhythmias. The limitations of real-time analysis ambulatory ECG arrhythmia algorithm accuracy as disclosed by a clinical evaluation as compared to authoritative database evaluations (e.g., the American Heart Association and Massachusetts Institute of Technology) were apparent. This investigation calls into question the present concept of automatic preprocessed realtime arrhythmia analysis, and suggests that some form of operator interaction is necessary to attain practical optimum accuracy.

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