False Atrial Fibrillation Alerts from Smartwatches are Associated with Decreased Perceived Physical Well-being and Confidence in Chronic Symptoms Management.

Wrist-based wearables have been FDA approved for AF detection. However, the health behavior impact of false AF alerts from wearables on older patients at high risk for AF are not known. In this work, we analyzed data from the Pulsewatch (NCT03761394) study, which randomized patients (≥50 years) with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days. At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. We employed linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management. We developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.

Déclaration de conflit d'intérêts

Competing Interests Dr. McManus reports receiving honorary fees, speaking/consulting fees, or research grants from FLEXcon, Heart Rhythm Society, Rose Consulting, Bristol-Myers Squibb, Pfizer, Boston Biomedical Associates, Avania, VentureWell, Samsung, Phillips, CareEvolution, Boehringer-Ingelheim, Biotronik, Otsuka Pharmaceuticals, and Sanofi; he also declares financial support for serving on the Steering Committee for the GUARD-AF study (ClinicalTrials.gov identifier NCT04126486) and Advisory Committee for the Fitbit Heart Study (ClinicalTrials.gov identifier NCT04176926). He reports non-financial research support from Apple Computer and Fitbit. The other authors have no competing interests.