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Consumer wearable devices for evaluation of heart rate control using digoxin versus beta-blockers: the RATE-AF
Simrat K Gill1, Andrey Barsky2, Xin Guan2
1Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
Nature Medicine
|July 15, 2024
Summary
Digoxin and beta-blockers show equivalent heart rate effects in patients with atrial fibrillation. Wearable technology effectively monitors patients, offering an alternative to in-person assessments for arrhythmia management.
Area of Science:
- Cardiology
- Digital Health
- Clinical Trials
Background:
- Consumer wearables offer potential for clinical research and patient management.
- Permanent atrial fibrillation and heart failure are common comorbidities in older adults.
- Digoxin and beta-blockers are standard treatments for these conditions, but their comparative effects on heart rate require further investigation.
Purpose of the Study:
- To compare the heart rate effects of digoxin versus beta-blockers in older patients with permanent atrial fibrillation and heart failure.
- To evaluate the utility of wearable technology for monitoring heart rate and physical activity in this population.
- To assess the ability of wearable data to predict New York Heart Association functional class.
Main Methods:
- The RATE-AF trial wearables study enrolled 53 participants (mean age 75.6 years) with permanent atrial fibrillation and heart failure.
- Participants were randomized to digoxin or beta-blocker treatment and monitored using a wrist-worn wearable for 20 weeks.
- Heart rate and physical activity data were collected, and a convolutional neural network was used to analyze data and predict functional class.
Main Results:
- No significant difference in heart rate was observed between digoxin and beta-blocker groups, even after accounting for physical activity or high activity levels.
- Wearable device data predicted New York Heart Association functional class with similar accuracy (F1 score 0.56) to standard clinical measures (F1 score 0.55).
- Data demonstrated equivalent effects of digoxin and beta-blockers on heart rate at rest and during exertion.
Conclusions:
- Digoxin and beta-blockers have comparable effects on heart rate in patients with atrial fibrillation.
- Wearable technology provides a viable alternative for dynamic, remote monitoring of individuals with arrhythmia, potentially reducing the need for frequent in-person assessments.
- This study supports the integration of wearable devices into clinical practice for managing cardiovascular conditions.
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