1. The WATCH AF Trial: SmartWATCHes for Detection of Atrial Fibrillation.
- Author
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Dörr M, Nohturfft V, Brasier N, Bosshard E, Djurdjevic A, Gross S, Raichle CJ, Rhinisperger M, Stöckli R, and Eckstein J
- Subjects
- Aged, Aged, 80 and over, Algorithms, Case-Control Studies, Female, Humans, Male, Photoplethysmography methods, Prospective Studies, Reproducibility of Results, Sensitivity and Specificity, Atrial Fibrillation diagnosis, Electrocardiography instrumentation, Photoplethysmography instrumentation, Pulse Wave Analysis instrumentation, Wearable Electronic Devices
- Abstract
Objectives: The WATCH AF (SmartWATCHes for Detection of Atrial Fibrillation) trial compared the diagnostic accuracy to detect atrial fibrillation (AF) by a smartwatch-based algorithm using photoplethysmographic (PPG) signals with cardiologists' diagnosis by electrocardiography (ECG)., Background: Timely detection of AF is crucial for stroke prevention., Methods: In this prospective, 2-center, case-control trial, a PPG pulse wave recording using a commercially available smartwatch was obtained along with Internet-enabled mobile ECG in 672 hospitalized subjects. PPG recordings were analyzed by a novel automated algorithm. Cardiologists' diagnoses were available for 650 subjects, although 142 (21.8%) datasets were not suitable for PPG analysis, among them 101 (15.1%) that were also not interpretable by the automated Internet-enabled mobile ECG algorithm, resulting in a sample size of 508 subjects (mean age 76.4 years, 225 women, 237 with AF) for the main analyses., Results: For the PPG algorithm, we found a sensitivity of 93.7% (95% confidence interval [CI]: 89.8% to 96.4%), a specificity of 98.2% (95% CI: 95.8% to 99.4%), and 96.1% accuracy (95% CI: 94.0% to 97.5%) to detect AF., Conclusions: The results of the WATCH AF trial suggest that detection of AF using a commercially available smartwatch is in principle feasible, with very high diagnostic accuracy. Applicability of the tested algorithm is currently limited by a high dropout rate as a result of insufficient signal quality. Thus, achieving sufficient signal quality remains challenging, but real-time signal quality checks are expected to improve signal quality. Whether smartwatches may be useful complementary tools for convenient long-term AF screening in selected at-risk patients must be evaluated in larger population-based samples. (SmartWATCHes for Detection of Atrial Fibrillation [WATCH AF]:; NCT02956343)., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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