Study limitations included the single-center nature of the study and the fact that patients were recruited in the cardiology department. “PVC patients were three times more likely to have a false-positive diagnosis of AF.” “Our results indicate that the presence of sinus node dysfunction, second- or third-degree atrioventricular block, ventricular pacing rhythm, PVC, and IVCD are more frequently represented in smartwatch misdiagnosis. 10% of traces could not be manually diagnosed due to poor ECG quality (3%) or ambiguous her P-waves (7%).ĥ9 of 580 patients with SR were misclassified as AF by experts, and 5 of 154 patients with AF were misclassified as SR. Overall, cardiac electrophysiologists showed high interobserver reproducibility and high agreement in distinguishing between atrial and non-fibrillatory atrial fibrillation. Patients with IVCD (RR, 2.6) and pacing (RR, 2.47) had a higher risk of false-negative traces (missed atrial fibrillation) compared with those without abnormalities. Of these, 21 (36%) had her IVCD, 7 (12%) had a ventricular pacing rhythm, and 5 (9%) had her PAC or PVC. Premature atrial contraction (PAC) or PVC (risk ratio 2.9), sinus node dysfunction (RR, 3.71), and AV block (RR, 7.8).ĥ8 patients with atrial fibrillation were classified as SR or inconclusive by smartwatch. The sensitivity was 88% and the specificity was 98% when the unclassified ECG was excluded from the analysis. When an unclassified ECG was considered a false result, the smartwatch had a sensitivity of 69% and a specificity of 81% for AF detection. Of the 187 patients with AF, 129 were correctly diagnosed, 17 were misdiagnosed as SR, and 41 were unclassified. Seven were misdiagnosed with AF and 95 were unclassified. Of 539 patients with normal SR, 437 records were correctly diagnosed by the smartwatch. atrial flutter Also atrial tachycardiaat 3 ventricular tachycardiaand 5 of the junctional tachycardias.Īdditionally, 65 (8.9%) had sinus node dysfunction and 21 (2.9%) had secondary or 3rd degree atrioventricular block39 (5.3%) had ventricular pacing rhythm, 54 (7.4%) had premature ventricular contraction (PVC), and 132 (18%) had IVCD (right or left bundle branch block or nonspecific IVCD). Of the 734 patients enrolled (mean age 66, 58% male), 539 (73%) had normal sinus rhythm (SR), 154 (21%) had atrial fibrillation, and 33 had atrial fibrillation. To assess interobserver agreement, a second blinded electrophysiologist interpreted her 100 randomly selected traces. Smartwatch recordings were reviewed by a blinded electrophysiologist who interpreted each trace and assigned a diagnosis of ‘AF’, ‘absence of AF’, or ‘diagnosis unknown’. Unclassified recordings can be attributed to “low heart rate” (less than 50 beats/min), “high heart rate” (more than 150 beats/min), “poor recording”, or “inconclusive recording”. The smartwatch’s automatic AF detection algorithm gave a result of “no signs of AF”, “AF”, or “no checking for AF”. All participants underwent her 12-lead ECG followed by 30 seconds of his ECG tracking on the Apple Watch Series 5. Researchers tested the accuracy of the Apple Watch (Apple, Cupertino, California) in detecting atrial fibrillation in patients with various ECG abnormalities.
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