Key result
Wearable devices accurately measure exercise HR in CAD patients with >0.9 correlation.
Why the study?
Wearable devices with heart rate monitors are reported to be less accurate across different exercise intensities, prompting validation of recently commercialized devices during cardiopulmonary exercise testing in coronary artery disease.
Do recently commercialized wearable digital devices accurately measure heart rate compared to 12-lead ECG during cardiopulmonary exercise testing in patients with coronary artery disease?
Observational (n=44)
No
Do recently commercialized wearable digital devices accurately measure heart rate compared to 12-lead ECG during cardiopulmonary exercise testing in patients with coronary artery disease?
Recently commercialized wearable devices (Apple Watch 7, Galaxy Watch 4, Mobicare 200) demonstrate excellent accuracy for heart rate monitoring during high-intensity exercise in CAD patients, supporting their use in cardiac rehabilitation.
Supports wearable HR monitoring in CAD exercise testing; leaves open randomized validation before clinical adoption.
OBJECTIVE: To assess the accuracy of recently commercialized wearable devices in heart rate (HR) measurement during cardiopulmonary exercise test (CPX) under gradual increase in exercise intensity, while wearable devices with HR monitors are reported to be less accurate in different exercise intensities. METHODS: CPX was performed for patients with coronary artery disease (CAD). Twelve lead electrocardiograph (ECG) was the gold standard and Apple watch 7 (AW7), Galaxy watch 4 (GW4) and Bio Patch Mobicare 200 (MC200) were applied for comparison. Paired absolute difference (PAD), mean absolute percentage error (MAPE) and intraclass correlation coefficient (ICC) were evaluated for each device. RESULTS: Forty-four participants with CAD were included. All the devices showed MAPE under 2% and ICC above 0.9 in rest, exercise and recovery phases (MC200=0.999, GW4=0.997, AW7=0.998). When comparing exercise and recovery phase, PAD of MC200 and AW7 in recovery phase were significantly bigger than PAD of exercise phase (p<0.05). Although not significant, PAD of GW4 tended to be bigger in recovery phase, too. Also, when stratified by HR 20, ICC of all the devices were highest under HR of 100, and ICC decreased as HR increased. However, except for ICC of GW4 at HR above 160 (=0.867), all ICCs exceeded 0.9 indicating excellent accuracy. CONCLUSION: The HR measurement of the devices validated in this study shows a high concordance with the ECG device, so CAD patients may benefit from the devices during high-intensity exercise under conditions where HR is measured reliably.
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Kim et al. (2023) conducted an observational in Coronary artery disease (n=44). Wearable digital devices (Apple Watch 7, Galaxy Watch 4, Bio Patch Mobicare 200) vs. 12-lead electrocardiograph (ECG) was evaluated on Accuracy of heart rate measurement (Mean absolute percentage error and intraclass correlation coefficient). Wearable devices including Apple Watch 7, Galaxy Watch 4, and Bio Patch Mobicare 200 accurately measured heart rate during exercise testing in coronary artery disease patients, with intraclass correlation coefficients >0.9.