Determination of aortic valve opening time and left ventricular peak filling rate from the peripheral pulse amplitude in patients with ectopic beats

D. Zheng, John Allen, Alan Murray

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    Ectopic beats are common in patients who have heart disease and are associated with reduced peripheral pulse amplitude. This study determined the start of the peripheral pulse increase and from it the opening of the aortic valve. The left ventricular peak filling rate was also estimated from the peripheral pulse. Results were compared with published invasive and cardiac imaging data. Twenty-five subjects with ectopic beat electrocardiograms (ECGs) were studied. The ECGs and the peripheral pulses, detected optically at the right index finger by a simple photoplethysmography (PPG) technique, were recorded for subsequent analysis. Peripheral pulse amplitudes for ectopic beats, post-ectopic sinus beats and normal sinus beats were determined. Ectopic beats induced a mean 68% decrease in pulse amplitude in comparison with sinus beats (p < 0.001). In contrast, the mean pulse amplitude for post-ectopic sinus beats increased by 20% (p < 0.01). Pulse amplitude changes were comparable with the published stroke volume differences for ectopic beats and post-ectopic sinus beats. The range of shortest coupling interval (CI) for ectopic beats with observable pulses was from 373 to 531 ms, with the mean value equivalent to 55% of the mean sinus RR interval, comparable with the opening of the aortic valve. Finally, as the CI increased, the pulse amplitude increased quickly from zero. The average rate of increase was equivalent to 4.8 times the normal sinus amplitude in 1 s, equal to 50% filling in 208 ms, showing diastolic rapid filling, comparable with published left ventricular peak filling rate data. In conclusion, the effect of ectopic beat CI on peripheral pulse amplitude has been determined, providing useful information for developing a technique to determine the opening of the aortic valve and the peak filling rate non-invasively and peripherally in patients with frequent ectopic beats.
    Original languageEnglish
    Article number1411
    JournalPhysiological Measurement
    Issue number12
    Publication statusPublished - 30 Oct 2008

    Bibliographical note

    This is an author-created, un-copyedited version of an article accepted for publication/published in Physiological Measurement. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at 10.1088/0967-

    Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.


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