Beyond the wrist: Using a smartwatch electrocardiogram to detect electrocardiographic abnormalities.
Apple watch
Digital health
Electrocardiogram
Montre connectée
Santé numérique Télémedecine
Smartwatch
Telemedicine
Électrocardiogramme
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
16
03
2021
revised:
08
11
2021
accepted:
09
11
2021
pubmed:
27
12
2021
medline:
18
1
2022
entrez:
26
12
2021
Statut:
ppublish
Résumé
When worn on the wrist, smartwatch electrocardiograms may provide important but incomplete information. We sought to evaluate the added benefit of placing the smartwatch on the ankle and on the chest to diagnose various electrocardiographic abnormalities compared with 12-lead electrocardiograms. Two hundred and sixty patients with (n=189) or without (n=71) known cardiac disorders underwent 12-lead electrocardiogram and smartwatch electrocardiogram recordings of lead I (AW-I) and of leads I and II and pseudo chest leads V1 and V6 (AW-4). AW-I and AW-4 diagnoses (three-cardiologist consensus) were compared with 12-lead electrocardiogram diagnoses (three-cardiologist consensus) to calculate sensitivity and specificity. AW-I showed high accuracy for the diagnoses of atrial fibrillation (96% sensitivity, 91% specificity) and complete bundle branch block (85% sensitivity, 98% specificity). Compared with AW-I, AW-4 improved detection of an abnormal 12-lead electrocardiogram (91% vs. 80% sensitivity; P<0.01), atrial flutter/tachycardia (69% vs. 25% sensitivity; P=0.04), T-wave abnormalities (77% vs. 34% sensitivity; P<0.01), pathological Q-waves (41% vs. 7% sensitivity; P<0.01) and left anterior hemiblock (70% vs. 0% sensitivity; P=0.02). AW-4 also enabled better differentiation between atrioventricular block and sinus bradycardia (from 81% to 95% correct; P=0.03) and between atrial fibrillation and atrial flutter/tachycardia (from 71% to 89% correct; P=0.02), but not between bundle branch blocks (from 82% to 87% correct; P=0.57). A smartwatch electrocardiogram on the wrist accurately diagnoses atrial fibrillation and bundle branch block. Recording additional leads significantly improves the accuracy of detecting an abnormal electrocardiogram and repolarization changes, and also allows for better differentiation of brady- and tachyarrhythmias.
Sections du résumé
BACKGROUND
BACKGROUND
When worn on the wrist, smartwatch electrocardiograms may provide important but incomplete information.
AIMS
OBJECTIVE
We sought to evaluate the added benefit of placing the smartwatch on the ankle and on the chest to diagnose various electrocardiographic abnormalities compared with 12-lead electrocardiograms.
METHODS
METHODS
Two hundred and sixty patients with (n=189) or without (n=71) known cardiac disorders underwent 12-lead electrocardiogram and smartwatch electrocardiogram recordings of lead I (AW-I) and of leads I and II and pseudo chest leads V1 and V6 (AW-4). AW-I and AW-4 diagnoses (three-cardiologist consensus) were compared with 12-lead electrocardiogram diagnoses (three-cardiologist consensus) to calculate sensitivity and specificity.
RESULTS
RESULTS
AW-I showed high accuracy for the diagnoses of atrial fibrillation (96% sensitivity, 91% specificity) and complete bundle branch block (85% sensitivity, 98% specificity). Compared with AW-I, AW-4 improved detection of an abnormal 12-lead electrocardiogram (91% vs. 80% sensitivity; P<0.01), atrial flutter/tachycardia (69% vs. 25% sensitivity; P=0.04), T-wave abnormalities (77% vs. 34% sensitivity; P<0.01), pathological Q-waves (41% vs. 7% sensitivity; P<0.01) and left anterior hemiblock (70% vs. 0% sensitivity; P=0.02). AW-4 also enabled better differentiation between atrioventricular block and sinus bradycardia (from 81% to 95% correct; P=0.03) and between atrial fibrillation and atrial flutter/tachycardia (from 71% to 89% correct; P=0.02), but not between bundle branch blocks (from 82% to 87% correct; P=0.57).
CONCLUSIONS
CONCLUSIONS
A smartwatch electrocardiogram on the wrist accurately diagnoses atrial fibrillation and bundle branch block. Recording additional leads significantly improves the accuracy of detecting an abnormal electrocardiogram and repolarization changes, and also allows for better differentiation of brady- and tachyarrhythmias.
Identifiants
pubmed: 34953753
pii: S1875-2136(21)00221-7
doi: 10.1016/j.acvd.2021.11.003
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
29-36Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.