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Accuracy of Heart Rate Obtained by Auscultation in Atrial Fibrillation

From the Division of Cardiology (Glaus), Clinic for Small Animal Internal Medicine and the Division of Herd Health (Hässig), Department of Reproduction, Animal Hospital, University of Zurich, Winterthurerstr. 260, CH-8057 Zurich, Switzerland and the Department of Cardiology (Keene), College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27606.

The accuracy of heart rate estimation by cardiac auscultation over a 15-second period, and the influence of clinical experience on accuracy were evaluated in a dog with chronic atrial fibrillation by test subjects of varying experience. Only 30% of all test subjects provided accurate heart rate estimates. Board-certified specialists, medicine residents, and experienced nurses were significantly more accurate in their estimates than surgery residents and students. Accurate estimates were provided by 12.5% of surgery residents and students, as opposed to 64% of the other test subjects. Auscultatory estimates of heart rate in atrial fibrillation may be significantly inaccurate, and under some circumstances they may not provide a sound basis for making clinical decisions.