Atrial fibrillation monitoring with wrist-worn photoplethysmography-based wearables: State-of-the-art review

Early detection and diagnosis of atrial fibrillation (AF) is essential in order to prevent stroke and other severe health consequences. The challenges in diagnosing AF arise from its intermittent and asymptomatic nature. Wrist-worn devices that use monitoring based on photoplethysmography have been proposed recently as a possible solution because of their ability to monitor heart rate and rhythm for long periods of time at low cost. Long-term continuous monitoring with implantable devices has been shown to increase the percentage of detected AF episodes, but the additional value of wrist-worn devices has yet to be determined. In this review, we present the state of the art in AF detection with wrist-worn devices, discuss the potential of the technology and current knowledge gaps, and propose directions for future research. The state-of-the-art methods show excellent accuracy for AF detection. However, most of the studies were conducted in hospital settings, and more studies showing the accuracy of the technology for ambulatory long-term monitoring are needed. Objective comparison of results and methodologies among different studies currently is difficult due to the lack of adequate public datasets.