Ann -> vector containing the indices of R-peaks or artifacts. If the annotation (given by 'anntype') is something like '[', is usually a part of the signal/rhythm change and not the R-peak itself.
Anntype -> A char of the same length as Ann containing the annotated symbols. A list of symbols can be found here: http://physionet.incor.usp.br/physiobank/database/html/mitdbdir/intro.htm#symbols
Comments -> A cell array containing changes in rhythm. When a new rhythm starts, it's usually given by '(XX', where XX is the rhythm-symbol. In some other databases from Phsyionet, you can find 'XX)', meaning that the change in rhythm stops there.
I attached very basic functions that I use to get R-peaks and visualize changes in rhythm from the MIT-BIH database.