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Canadian Journal of Cardiology

Role of Coexisting ECG Anomalies in the Accuracy of Smartwatch ECG Detection of Atrial Fibrillation

Published:October 11, 2022DOI:https://doi.org/10.1016/j.cjca.2022.08.222
      Selected smartwatches, including the Apple Watch (Apple, Cupertino, CA) series 4 and later, offer the ability to record ECG, equivalent to lead 1) and automatically diagnose AF.
      • Abu-Alrub S.
      • Strik M.
      • Ramirez F.D.
      • et al.
      Smartwatch electrocardiograms for automated and manual diagnosis of atrial fibrillation: a comparative analysis of three models.
      • Nasarre M.
      • Strik M.
      • Daniel Ramirez F.
      • et al.
      Using a smartwatch electrocardiogram to detect abnormalities associated with sudden cardiac arrest in young adults.
      • Strik M.
      • Ploux S.
      • Ramirez F.D.
      • et al.
      Smartwatch-based detection of cardiac arrhythmias beyond the differentiation between sinus rhythm and atrial fibrillation.
      Given this technology’s growing use, mass screening for AF using smartwatch-based technologies such as the Apple watch may occur in the near future. However, the accuracy of the Apple Watch for the diagnosis of AF has been validated in only a relatively limited number of patients with similar clinical profiles.
      • Seshadri Dhruv R.
      • Bittel Barbara
      • Browsky Dalton
      • et al.
      Accuracy of Apple Watch for detection of atrial fibrillation.
      ,
      • Bumgarner J.M.
      • Lambert C.T.
      • Hussein A.A.
      • et al.
      Smartwatch algorithm for automated detection of atrial fibrillation.
      Patients with various but common ECG anomalies, such as premature beats, AV block, paced rhythm, and ventricular conduction delay, were not represented in those studies. The objective of the present study was to assess the diagnostic accuracy of Apple automated diagnosis of AF in a large population of hospitalised adult patients with various ECG anomalies.
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      References

        • Abu-Alrub S.
        • Strik M.
        • Ramirez F.D.
        • et al.
        Smartwatch electrocardiograms for automated and manual diagnosis of atrial fibrillation: a comparative analysis of three models.
        Front Cardiovasc Med. 2022; 9836375
        • Nasarre M.
        • Strik M.
        • Daniel Ramirez F.
        • et al.
        Using a smartwatch electrocardiogram to detect abnormalities associated with sudden cardiac arrest in young adults.
        Europace. 2022; 24: 406-412
        • Strik M.
        • Ploux S.
        • Ramirez F.D.
        • et al.
        Smartwatch-based detection of cardiac arrhythmias beyond the differentiation between sinus rhythm and atrial fibrillation.
        Heart Rhythm. 2021; 18: 1524-1532
        • Seshadri Dhruv R.
        • Bittel Barbara
        • Browsky Dalton
        • et al.
        Accuracy of Apple Watch for detection of atrial fibrillation.
        Circulation. 2020; 141: 702-703
        • Bumgarner J.M.
        • Lambert C.T.
        • Hussein A.A.
        • et al.
        Smartwatch algorithm for automated detection of atrial fibrillation.
        J Am Coll Cardiol. 2018; 71: 2381-2388

      Linked Article

      • Atrial Fibrillation Detection by Smartwatch Devices in Patients With Underlying ECG Abnormalities: Still Not Smart Enough?
        Canadian Journal of CardiologyVol. 38Issue 11
        • Preview
          Atrial fibrillation (AF) is the most common sustained arrhythmia in adults, and it is linked with increased morbidity and mortality.1 The diagnosis of AF can be challenging owing to its paroxysmal behaviour and low burden of symptoms in some patients; however, early diagnosis is of paramount importance to reduce the risk of complications.1 Different studies have shown that extended electrocardiographic monitoring in high-risk patients,2 after stroke,3,4 or in those with cardiac implantable electronic devices5 can increase detection of AF up to 50% after 30 months of follow-up.
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