Comparative Evaluation of Consumer Wearable Devices for Atrial Fibrillation Detection: Validation Study

Area of Science:

• Cardiology
• Biomedical Engineering
• Digital Health

Background:

• Consumer-oriented wearable devices (CWDs) like smartphones and smartwatches are increasingly used for detecting atrial fibrillation (AF).
• Existing validation studies are numerous, but a direct comparison of interdevice performance is lacking.
• These devices utilize electrocardiography (ECG) or photoplethysmography (PPG) for digital recordings.

Purpose of the Study:

• To evaluate and compare the diagnostic performance of CWDs in distinguishing between sinus rhythm and AF.
• To assess the accuracy of different CWDs in a clinical setting.

Main Methods:

• 122 participants with sinus rhythm or AF were enrolled.
• Measurements were taken using KardiaMobile 6L (handheld ECG), Apple Watch (smartwatch ECG), FibriCheck (smartphone PPG), and Preventicus (smartphone PPG).
• A 12-lead ECG served as the gold standard, with measurements performed in a random sequence.

Main Results:

• All tested devices demonstrated 100% sensitivity in detecting AF.
• Specificities for detecting sinus rhythm were high and comparable across devices (KardiaMobile 6L: 96.4%, Apple Watch: 97.8%, FibriCheck: 98.9%, Preventicus: 97.8%).
• No significant differences in performance (P=.50) or measurement quality (P=.21) were observed between devices, though participants preferred the Apple Watch.

Conclusions:

• Consumer-oriented wearable devices exhibit high accuracy in discriminating between sinus rhythm and AF.
• No significant performance variations were found among the evaluated ECG and PPG-based CWDs.
• These findings support the utility of CWDs for AF detection in a broad population.