Electrocardiogram: Missed beats in presence of Ectopic beats or Premature Atrial/Ventricular Contraction beats I have been working on analyzing Electrocardiogram data. So far, i have identified Ectopic beats and Premature Atrial/Ventricular Contraction beats. I am working on identifying Missed Beat in the Electrocardiogram. The definition of Missed Beat is: " **The characteristic of a missing beat in ECG is the unexpected absence, together, of P-, QRS-, and T-waves.** " My question is, do we have to consider missed beats in presence of Ectopic or Premature beats also ?? For example, if an ECG contains premature/ectopic beats, then should the R-R interval between these beats should be compared to R-R interval between normal beats to search a missed beat ??

After developing and checking the algorithm with simulated ECG data, i found out that premature beats (as the name suggests) itself arrive prematurely i.e. their R-R peak interval is less then the R-R peak interval between normal beats.

In that case, i am considering the averaged interval between normal beats and compare it to the interval between next arriving beats. If that interval is more than twice the averaged normal interval, then i classify it as a missed beat.