Continuous atrial fibrillation monitoring using a wearable smartwatch: Using long-term Holter as reference

作者：Yannan Pan, Erdong Chen, Shihui Jie, Dongbo Huo, Zhongru Ding, Jing Zhou, Jie Jiang, Jianping Li, Yong Huo · 发表于：Digital Health · 年份：2025 · DOI：10.1177/20552076251314105 · 被引用次数：6 · 研究领域：Atrial Fibrillation Management and Outcomes、ECG Monitoring and Analysis、Cardiac pacing and defibrillation studies

Background Wearables satisfactorily detect atrial fibrillation (AF) longer than 1 hour. Our study aims to evaluate smartwatch performances for long-term AF monitoring, including AF with short durations. Methods This prospective study enrolled AF patients from 2020 to 2023. Diagnostic efficacy of the Amazfit smartwatch, with AF-identifying algorithms from photoplethysmography (PPG) and single-lead electrocardiogram (ECG), was compared with a 7-day Holter. Primary analysis included smartwatch diagnostics to identify AF longer than 5 minutes. Secondary analyses evaluated smartwatch performances under different settings and compared AF burdens between the smartwatch and Holter. Results The study analyzed 72 patients (48 males, mean age 65.4 ± 8.5) with 914 AF episodes lasting 834.7 hours, including 142 longer-than-5-minute AF episodes. Smartwatch recording time was 8927.6 hours. By individual, sensitivities and specificities of AF longer than 5 minutes were 100.0% and 83.7% for PPG and 89.7% and 67.4% for the ECG algorithm. Positive and negative predictive values were 94.9% and 99.9% for PPG and 77.6% and 99.8% for ECG. Optimal AF durations to be identified by PPG and ECG algorithms were 1.358 and 16.708 minutes. Smartwatch performances varied across AF durations and between day-time and night-time. Strong correlations (PPG: ρ = 0.877; ECG: ρ = 0.769) and excellent agreements (PPG: ICC = 0.976; ECG: ICC = 0.927) were found between AF burdens calculated from smartwatch and Holter....