A method of determining a confidence level in a heart rate obtained from an ECG signal of a patent comprises determining a heart rate from a segment of an ECG signal, the segment having a pre-determined length, and determining a first confidence level in the determined heart rate. If the first confidence level exceeds a predetermined value, the heart rate is output. Otherwise, the method further comprises determining a set of features from the segment of the ECG signal； and classifying the segment of the ECG signal, based on one or more features selected from the determined set of features and the heart rate, into one of at least three classes: noise, an abnormal sinus rhythm and a normal sinus rhythm.
