Extended cardiac monitoring in patients and the use of implantable cardiovascular electronic devices can increase detection of atrial fibrillation (AF), but the devices have limitations including short battery life and lack of immediate feedback. Can new smartphone tools that can record an electrocardiogram (ECG) strip and make an automated diagnosis overcome these limitations and facilitate timely diagnosis?
, finds that the use of these devices is challenging in patients with abnormal ECGs. Better algorithms and"Earlier studies have validated the accuracy of the Apple Watch for the diagnosis of AF in a limited number of patients with similar clinical profiles," explained lead investigator Marc Strik, MD, Ph.D., LIRYC institute, Bordeaux University Hospital, Bordeaux, France.
In approximately one in every five patients, the smartwatch ECG failed to produce an automatic diagnosis. The risk of having a false positive automated AF detection was higher for patients with premature atrial and ventricular contractions , sinus node dysfunction, and second- or third-degree atrioventricular-block. For patients in AF, the risk of having a false negative tracing was higher for patients with ventricular conduction abnormalities or rhythms controlled by an implanted pacemaker.
correctly identified 78% of the patients who were in AF and 81% who were not in AF. The electrophysiologists identified 97% of the patients who were in AF and 89% who were not.AF diagnoses from the smartwatch ECG, and the identification of patients with atrial tachycardia and atrial flutter was very poor.
In an accompanying editorial, Andrés F. Miranda-Arboleda, MD, and Adrian Baranchuk, MD, Division of Cardiology, Kingston Health Science Center, Kingston, ON, Canada, observed that this is the first"real-world" study focusing on the use of the Apple Watch as a diagnostic tool for AF.
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