Accuracy of heart rate obtained by auscultation in atrial fibrillation

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.