Format

Send to

Choose Destination
J Cardiovasc Electrophysiol. 2016 Jan;27(1):51-7. doi: 10.1111/jce.12842. Epub 2015 Nov 13.

PULSE-SMART: Pulse-Based Arrhythmia Discrimination Using a Novel Smartphone Application.

Author information

1
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
2
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
3
Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA.
4
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
5
Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.
6
Department of Biomedical Engineering, University of Connecticut, Stores, Connecticut, USA.

Abstract

BACKGROUND:

Atrial fibrillation (AF) is a common and dangerous rhythm abnormality. Smartphones are increasingly used for mobile health applications by older patients at risk for AF and may be useful for AF screening.

OBJECTIVES:

To test whether an enhanced smartphone app for AF detection can discriminate between sinus rhythm (SR), AF, premature atrial contractions (PACs), and premature ventricular contractions (PVCs).

METHODS:

We analyzed two hundred and nineteen 2-minute pulse recordings from 121 participants with AF (n = 98), PACs (n = 15), or PVCs (n = 15) using an iPhone 4S. We obtained pulsatile time series recordings in 91 participants after successful cardioversion to sinus rhythm from preexisting AF. The PULSE-SMART app conducted pulse analysis using 3 methods (Root Mean Square of Successive RR Differences; Shannon Entropy; Poincare plot). We examined the sensitivity, specificity, and predictive accuracy of the app for AF, PAC, and PVC discrimination from sinus rhythm using the 12-lead EKG or 3-lead telemetry as the gold standard. We also administered a brief usability questionnaire to a subgroup (n = 65) of app users.

RESULTS:

The smartphone-based app demonstrated excellent sensitivity (0.970), specificity (0.935), and accuracy (0.951) for real-time identification of an irregular pulse during AF. The app also showed good accuracy for PAC (0.955) and PVC discrimination (0.960). The vast majority of surveyed app users (83%) reported that it was "useful" and "not complex" to use.

CONCLUSION:

A smartphone app can accurately discriminate pulse recordings during AF from sinus rhythm, PACs, and PVCs.

KEYWORDS:

atrial fibrillation; detection; premature beats; smartphone; technology

PMID:
26391728
PMCID:
PMC4768310
DOI:
10.1111/jce.12842
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center