Performance on heartbeat counting tasks is usually
interpreted in terms of cardiac sensitivity. We tested
the hypothesis that heartbeat counting is influenced by
beliefs about heart rates by dissociating beliefs about
heart rates and actual heart rates. In a within-subjects
design, heart rates of 50 patients with cardiac pacemakers
were set to a low (50 bpm), medium (75 bpm), or high (110
bpm) pacing rate unknown to the patients via remote control
while they performed a heartbeat tracking task. Results
showed that patients' heartbeat counting did not follow
the shifts in their actual heart rates adequately, although
their overall performance was comparable to that of young
and healthy control participants. As a result, tracking
scores decreased significantly in the high pacing rate
condition where beliefs about heart rates and actual heart
rates were most extremely dissociated. The findings suggest
that tracking scores reflect beliefs about heart rates
rather than cardiac sensitivity.