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Distinguishing atrial fibrillation from sinus rhythm using commercial pulse detection systems: The non-interventional
Christian Müller1, Ulf Hengstmann2, Michael Fuchs3
1Bayer Vital GmbH, Leverkusen, Germany.
Insights
Commercial pulse detection systems show promise for early atrial fibrillation (AFib) diagnosis. The Polar V800 and eMotion Faros 360 effectively screened for AFib, aiding stroke prevention efforts.
Area of Science:
- Cardiology
- Medical Devices
- Digital Health
Background:
- Early detection of atrial fibrillation (AFib) is crucial for preventing strokes.
- Commercial pulse detection systems (CPDSs) offer a potential tool for widespread AFib screening.
Purpose of the Study:
- To evaluate the accuracy of four CPDSs in distinguishing AFib from normal sinus rhythm.
- To compare CPDS performance against electrocardiogram (ECG) visual diagnosis using a published algorithm.
Main Methods:
- A prospective, single-centre study involving 144 cardiology patients (73 with AFib, 71 with sinus rhythm).
- Patients underwent a 5-minute pulse assessment using Polar V800, eMotion Faros 360, TomTom heart rate monitor, or Adidas miCoach Smart Run.
- A published algorithm was applied to CPDS recordings and routine ECGs for AFib detection.
Main Results:
- The Polar V800 achieved 93.3% sensitivity and 94.1% specificity for AFib detection.
- The eMotion Faros 360 showed 90.0% sensitivity and 84.2% specificity.
- Other CPDSs demonstrated 0% sensitivity, indicating inability to detect AFib accurately.
Conclusions:
- AFib screening is feasible using the Polar V800 and eMotion Faros 360, which provide RR interval data.
- CPDSs providing only pre-processed heart rate time series were not suitable for AFib detection with the applied algorithm.
- These findings support the potential of specific CPDSs for remote AFib monitoring and stroke risk reduction.
Objective:
Early diagnosis of atrial fibrillation (AFib) is a priority for stroke prevention. We sought to test four commercial pulse detection systems (CPDSs) for ability to distinguish AFib from normal sinus rhythm using a published algorithm (Zhou et al., PLoS One 2015;10:e0136544), compared with visual diagnosis by electrocardiogram inspection.
Methods:
BAYathlon was a prospective, non-interventional, single-centre study. Adult cardiology patients with documented AFib or sinus rhythm who were due to have a routine 5-min electrocardiogram were randomized to undergo a parallel 5-min pulse assessment with a Polar V800, eMotion Faros 360, TomTom heart rate monitor, or Adidas miCoach Smart Run.
Results:
144 patients (73 with AFib, 71 with sinus rhythm (based on electrocardiograms); median age: 73 years; 53.5% male) were analysed. Algorithm sensitivities (primary endpoint) and specificities for AFib when applied to CPDS recordings were 93.3% and 94.1% with the Polar V800, 90.0% and 84.2% with the eMotion Faros 360, and 0% and 100% with the other CPDSs (analysis period: 127 heart rate signals + 2 min). When applied to routine electrocardiograms, the algorithm correctly detected AFib in 71/73 patients. Different analysis periods (127 heart rate signals +1 or 3 min) only slightly changed the sensitivities with the Polar V800 and eMotion Faros 360 and had no effect on the sensitivities with the other CPDSs.
Conclusion:
AFib screening using the applied algorithm is feasible with the Polar V800 and eMotion Faros 360 (which provide RR interval data) but not with the other CPDSs (which provide pre-processed heart rate time series).ClinicalTrials.gov identifier: NCT02875106.
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