A smartwatch algorithm using photoplethysmography-triggered ECG continuously detected atrial fibrillation with 96.9% sensitivity and 99.3% specificity compared to a 28-day ECG patch.
Observational (n=204)
Does a smartwatch algorithm using W-PPG and W-ECG accurately detect atrial fibrillation compared to a 28-day continuous ECG patch in a free-living population?
A novel smartwatch algorithm combining photoplethysmography and ECG can continuously detect atrial fibrillation with high sensitivity and specificity compared to a 28-day ECG patch.
Effect estimate: Sensitivity 96.9%, Specificity 99.3% (W-PPG triggered W-ECG)
BackgroundConsumer devices with broad reach may be useful in screening for atrial fibrillation (AF) in appropriate populations. However, currently no consumer devices are capable of continuous monitoring for AF.ObjectiveThe purpose of this study was to estimate the sensitivity and specificity of a smartwatch algorithm for continuous detection of AF from sinus rhythm in a free-living setting.MethodsWe studied a commercially available smartwatch with photoplethysmography (W-PPG) and electrocardiogram (W-ECG) capabilities. We validated a novel W-PPG algorithm combined with a W-ECG algorithm in a free-living setting, and compared the results to those of a 28-day continuous ECG patch (P-ECG).ResultsA total of 204 participants completed the free-living study, recording 81,944 hours with both P-ECG and smartwatch measurements. We found sensitivity of 87.8% (95% confidence interval CI 83.6%–91.0%) and specificity of 97.4% (95% CI 97.1%–97.7%) for the W-PPG algorithm (every 5-minute classification); sensitivity of 98.9% (95% CI 98.1%–99.4%) and specificity of 99.3% (95% CI 99.1%–99.5%) for the W-ECG algorithm; and sensitivity of 96.9% (95% CI 93.7%–98.5%) and specificity of 99.3% (95% CI 98.4%–99.7%) for W-PPG triggered W-ECG with a single W-ECG required for confirmation of AF. We found a very strong correlation of W-PPG in quantifying AF burden compared to P-ECG (r = 0.98).ConclusionOur findings demonstrate that a novel algorithm using a commercially available smartwatch can continuously detect AF with excellent performance and that confirmation with W-ECG further enhances specificity. In addition, our W-PPG algorithm can estimate AF burden. Further research is needed to determine whether this algorithm is useful in screening for AF in select at-risk patients. Consumer devices with broad reach may be useful in screening for atrial fibrillation (AF) in appropriate populations. However, currently no consumer devices are capable of continuous monitoring for AF. The purpose of this study was to estimate the sensitivity and specificity of a smartwatch algorithm for continuous detection of AF from sinus rhythm in a free-living setting. We studied a commercially available smartwatch with photoplethysmography (W-PPG) and electrocardiogram (W-ECG) capabilities. We validated a novel W-PPG algorithm combined with a W-ECG algorithm in a free-living setting, and compared the results to those of a 28-day continuous ECG patch (P-ECG). A total of 204 participants completed the free-living study, recording 81,944 hours with both P-ECG and smartwatch measurements. We found sensitivity of 87.8% (95% confidence interval CI 83.6%–91.0%) and specificity of 97.4% (95% CI 97.1%–97.7%) for the W-PPG algorithm (every 5-minute classification); sensitivity of 98.9% (95% CI 98.1%–99.4%) and specificity of 99.3% (95% CI 99.1%–99.5%) for the W-ECG algorithm; and sensitivity of 96.9% (95% CI 93.7%–98.5%) and specificity of 99.3% (95% CI 98.4%–99.7%) for W-PPG triggered W-ECG with a single W-ECG required for confirmation of AF. We found a very strong correlation of W-PPG in quantifying AF burden compared to P-ECG (r = 0.98). Our findings demonstrate that a novel algorithm using a commercially available smartwatch can continuously detect AF with excellent performance and that confirmation with W-ECG further enhances specificity. In addition, our W-PPG algorithm can estimate AF burden. Further research is needed to determine whether this algorithm is useful in screening for AF in select at-risk patients.
Avram et al. (Wed,) conducted a observational in Atrial fibrillation (n=204). Smartwatch with photoplethysmography (W-PPG) and electrocardiogram (W-ECG) algorithms vs. 28-day continuous ECG patch (P-ECG) was evaluated on Sensitivity and specificity for continuous detection of AF (Sensitivity 96.9%, Specificity 99.3% (W-PPG triggered W-ECG)). A smartwatch algorithm using photoplethysmography-triggered ECG continuously detected atrial fibrillation with 96.9% sensitivity and 99.3% specificity compared to a 28-day ECG patch.