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Int J Cardiol. 2018 Sep 1;266:124-127. doi: 10.1016/j.ijcard.2018.02.073.

Smart watches for heart rate assessment in atrial arrhythmias.

Author information

1
Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Victoria, Australia.
2
Monash Cardiovascular Research Centre, Department of Medicine, Monash University and Monash Heart, Monash Health, Clayton, Victoria, Australia.
3
Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Victoria, Australia; Deakin University, Geelong, Victoria, Australia.
4
Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Victoria, Australia; Melbourne University, Austin Hospital Clinical School, Department of Cardiology, Heidelberg, Victoria, Australia. Electronic address: Andrew.teh@easternhealth.org.au.

Abstract

BACKGROUND:

Despite studies demonstrating the accuracy of smart watches (SW) and wearable heart rate (HR) monitors in sinus rhythm, no data exists regarding their utility in arrhythmias.

METHODS:

102 hospitalized patients were evaluated at rest using continuous electrocardiogram (ECG) monitoring with concomitant SW-HR (FitBit, FB, Apple Watch, AW) for 30 min.

RESULTS:

Across all devices, 38,616 HR values were recorded. Sinus rhythm cohort demonstrated strong agreement for both devices with a low bias (FB & AW Bias = 1 beat). In atrial arrhythmias, AW demonstrated a stronger correlation than FB (AW rs = 0.83, FB rs = 0.56, both p < 0.01) with a lower bias (Bias AW = -5 beats, FB = -18 beats). Atrial flutter demonstrated strongest agreement in both devices with a mean bias <1 beat. However, in AF, there was significant HR underestimation (Bias FB = -28 beats, AW-8 beats) with wide limits of agreement. Despite HR underestimation in AF, when SW recorded HR ≥ 100 in arrhythmias, 98% of values were within ±10-beats of ECG-HR.

CONCLUSIONS:

SW demonstrate strong agreement for HR estimation in sinus rhythm and atrial flutter but underestimates HR in AF. Tachycardic episodes recorded at rest on a SW may be suggestive of an underlying atrial tachyarrhythmia and warrant further clinical evaluation.

CLINICAL TRIAL REGISTRATION:

Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) ACTRN: 12616001374459.

KEYWORDS:

Accuracy; Arrhythmias; Atrial fibrillation; Heart rate; Smart watch

PMID:
29887428
DOI:
10.1016/j.ijcard.2018.02.073
[Indexed for MEDLINE]

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