EKG changes using carotid artery for heart rate monitoring

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Abstract
It is often recommended that during exercise the exerciser monitor his heart rate so that it can be maintained at a rate rapid enough to promote aerobic conditioning but not so rapid as to be dangerous. Various authorities recommend that the heart rate be determined by placing the fingers along the side of the neck, to palpate the carotid artery. In the author's laboratory, it has been observed that carotid artery palpation usually causes cardiac slowing and occasionally produces cardiac abnormalities. To further test this observation, 117 subjects were studied. Heart rate was monitored during rest, during exercise, and immediately following exercise while the subject palpated at three locations, the carotid artery, the radial artery, and the temporal artery. A continuous baseline electrocardiogram recording was made prior to, during, and after palpation. Immediately following carotid artery palpation, significant heart rate changes occurred in 90.6% of the subjects and various morphologic electrocardiographic abnormalities were seen in 17.1% of the subjects. The major abnormalities were P-wave changes. No heart rate changes or cardiac abnormalities were observed during radial artery or temporal artery palpation.