Background: Consumer smartwatches have gained attention as mobile health
(mHealth) tools able to detect atrial fibrillation (AF) using photoplethysmography (PPG) or
a short strip of electrocardiogram (ECG). PPG has limited accuracy due to the movement
artifacts, whereas ECG cannot be used continuously, is usually displayed as a single-lead
signal and is limited in asymptomatic cases.
Objective: DoubleCheck-AF is a validation study of a wrist-worn device dedicated to
providing both continuous PPG-based rhythm monitoring and instant 6-lead ECG with
no wires. We evaluated its ability to differentiate between AF and sinus rhythm (SR) with
particular emphasis on the challenge of frequent premature beats.
Methods and Results: We performed a prospective, non-randomized study of 344
participants including 121 patients in AF. To challenge the specificity of the device
two control groups were selected: 95 patients in stable SR and 128 patients in
SR with frequent premature ventricular or atrial contractions (PVCs/PACs). All ECG
tracings were labeled by two independent diagnosis-blinded cardiologists as “AF,”
“SR” or “Cannot be concluded.” In case of disagreement, a third cardiologist was
consulted. A simultaneously recorded ECG of Holter monitor served as a reference. It
revealed a high burden of ectopy in the corresponding control group: 6.2 PVCs/PACs
per minute, bigeminy/trigeminy episodes in 24.2% (31/128) and runs of ≥3 beats
in 9.4% (12/128) of patients. AF detection with PPG-based algorithm, ECG of the
wearable and combination of both yielded sensitivity and specificity of 94.2 and
96.9%; 99.2 and 99.1%; 94.2 and 99.6%, respectively. All seven false-positive PPGbased cases were from the frequent PVCs/PACs group compared to none from the
stable SR group (P < 0.001). In the majority of these cases (6/7) cardiologists were able
to correct the diagnosis to SR with the help of the ECG of the device (P = 0.012).
Conclusions: This is the first wearable combining PPG-based AF detection algorithm
for screening of AF together with an instant 6-lead ECG with no wires for manual rhythm
confirmation. The system maintained high specificity despite a remarkable amount of
frequent single or multiple premature contractions
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:85858 |
| Date | 08 June 2023 |
| Creators | Bacevicius, Justinas, Abramikas, Zygimantas, Dvinelis, Ernestas, Audzijoniene, Deimile, Petrylaite, Marija, Marinskiene, Julija, Staigyte, Justina, Karuzas, Albinas, Juknevicius, Vytautas, Jakaite, Rusne, Basyte-Bacevice, Viktorija, Bileisiene, Neringa, Solosenko, Andrius, Sokas, Daivaras, Petrenas, Anrius, Butkuviene, Monika, Paliakaite, Birute, Daukantas, Saulius, Rapalis, Anrius, Marinskis, Germanas, Jasiunas, Eugenijus, Darma, Angeliki, Marozas, Vaidotas, Aidietis, Audrius |
| Publisher | Frontiers Media S.A. |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 869730 |
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