scholarly journals Use of a Smart Watch for Early Detection of Paroxysmal Atrial Fibrillation: Validation Study (Preprint)

2019 ◽  
Author(s):  
Tomohiko Inui ◽  
Hiroki Kohno ◽  
Yohei Kawasaki ◽  
Kaoru Matsuura ◽  
Hideki Ueda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Pulse Rate ◽  
Validation Study ◽  
Paroxysmal Atrial Fibrillation ◽  
Wearable Devices ◽  
Coefficient Of Determination ◽  
Rate Data ◽  
Heart Rates ◽  
The Mean

BACKGROUND Wearable devices with photoplethysmography (PPG) technology can be useful for detecting paroxysmal atrial fibrillation (AF), which often goes uncaptured despite being a leading cause of stroke. OBJECTIVE This study is the first part of a 2-phase study that aimed at developing a method for immediate detection of paroxysmal AF using PPG-integrated wearable devices. In this study, the diagnostic performance of 2 major smart watches, Apple Watch Series 3 and Fitbit (FBT) Charge HR Wireless Activity Wristband, each equipped with a PPG sensor, was compared, and the pulse rate data outputted from those devices were analyzed for precision and accuracy in reference to the heart rate data from electrocardiography (ECG) during AF. METHODS A total of 40 subjects from patients who underwent cardiac surgery at a single center between September 2017 and March 2018 were monitored for postoperative AF using telemetric ECG and PPG devices. AF was diagnosed using a 12-lead ECG by qualified physicians. Each subject was given a pair of smart watches, Apple Watch and FBT, for simultaneous pulse rate monitoring. The heart rate of all subjects was also recorded on the telemetry system. Time series pulse rate trends and heart rate trends were created and analyzed for trend pattern similarities. Those trend data were then used to determine the accuracy of PPG-based pulse rate measurements in reference to ECG-based heart rate measurements during AF. RESULTS Of the 20 AF events in group FBT, 6 (30%) showed a moderate or higher correlation (cross-correlation function&gt;0.40) between pulse rate trend patterns and heart rate trend patterns. Of the 16 AF events in group Apple Watch (workout [W] mode), 12 (75%) showed a moderate or higher correlation between the 2 trend patterns. Linear regression analyses also showed a significant correlation between the pulse rates and the heart rates during AF in the subjects with Apple Watch. This correlation was not observed with FBT. The regression formula for Apple Watch W mode and FBT was X=14.203 + 0.841Y and X=58.225 + 0.228Y, respectively (where X denotes the mean of all average pulse rates during AF and Y denotes the mean of all corresponding average heart rates during AF), and the coefficient of determination (<i>R</i><sup>2</sup>) was 0.685 and 0.057, respectively (<i>P</i>&lt;.001 and .29, respectively). CONCLUSIONS In this validation study, the detection precision of AF and measurement accuracy during AF were both better with Apple Watch W mode than with FBT.

scholarly journals Use of a Smart Watch for Early Detection of Paroxysmal Atrial Fibrillation: Validation Study

JMIR Cardio ◽  
10.2196/14857 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e14857 ◽  
Author(s):  
Tomohiko Inui ◽  
Hiroki Kohno ◽  
Yohei Kawasaki ◽  
Kaoru Matsuura ◽  
Hideki Ueda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Pulse Rate ◽  
Validation Study ◽  
Paroxysmal Atrial Fibrillation ◽  
Wearable Devices ◽  
Coefficient Of Determination ◽  
Rate Data ◽  
Heart Rates ◽  
The Mean

Background Wearable devices with photoplethysmography (PPG) technology can be useful for detecting paroxysmal atrial fibrillation (AF), which often goes uncaptured despite being a leading cause of stroke. Objective This study is the first part of a 2-phase study that aimed at developing a method for immediate detection of paroxysmal AF using PPG-integrated wearable devices. In this study, the diagnostic performance of 2 major smart watches, Apple Watch Series 3 and Fitbit (FBT) Charge HR Wireless Activity Wristband, each equipped with a PPG sensor, was compared, and the pulse rate data outputted from those devices were analyzed for precision and accuracy in reference to the heart rate data from electrocardiography (ECG) during AF. Methods A total of 40 subjects from patients who underwent cardiac surgery at a single center between September 2017 and March 2018 were monitored for postoperative AF using telemetric ECG and PPG devices. AF was diagnosed using a 12-lead ECG by qualified physicians. Each subject was given a pair of smart watches, Apple Watch and FBT, for simultaneous pulse rate monitoring. The heart rate of all subjects was also recorded on the telemetry system. Time series pulse rate trends and heart rate trends were created and analyzed for trend pattern similarities. Those trend data were then used to determine the accuracy of PPG-based pulse rate measurements in reference to ECG-based heart rate measurements during AF. Results Of the 20 AF events in group FBT, 6 (30%) showed a moderate or higher correlation (cross-correlation function>0.40) between pulse rate trend patterns and heart rate trend patterns. Of the 16 AF events in group Apple Watch (workout [W] mode), 12 (75%) showed a moderate or higher correlation between the 2 trend patterns. Linear regression analyses also showed a significant correlation between the pulse rates and the heart rates during AF in the subjects with Apple Watch. This correlation was not observed with FBT. The regression formula for Apple Watch W mode and FBT was X=14.203 + 0.841Y and X=58.225 + 0.228Y, respectively (where X denotes the mean of all average pulse rates during AF and Y denotes the mean of all corresponding average heart rates during AF), and the coefficient of determination (R2) was 0.685 and 0.057, respectively (P<.001 and .29, respectively). Conclusions In this validation study, the detection precision of AF and measurement accuracy during AF were both better with Apple Watch W mode than with FBT.

scholarly journals QTc interval prolongation and life-threatening arrhythmias during hospitalization in patients with COVID-19. Results from a multi-center prospective registry

2020 ◽  
Author(s):  
Francesco Santoro ◽  
Francesco Monitillo ◽  
Pasquale Raimondo ◽  
Agostino Lopizzo ◽  
Gaetano Brindicci ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Antiviral Therapy ◽  
Paroxysmal Atrial Fibrillation ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Heart Rates ◽  
Basal Heart Rate ◽  
Qtc Interval Prolongation ◽  
Life Threatening

Abstract Background Prolonged QTc interval and life-threatening arrhythmias (LTA) are potential drug induced complications previously reported with antimalarial, antivirals and antibiotics. Objectives To evaluate prevalence and predictors of QTc interval prolongation and incidence of LTA during hospitalization for COVID-19 among patients with normal admission QTc. Methods 110 consecutive patients were enrolled in a multicenter international registry. 12-lead ECG was performed at admission, after 7 and 14 days; QTc values were analyzed. Results Fifteen (14%) patients developed a prolonged-QTc (pQT) after 7 days (mean QTc increase 66±20msec, +16%, p&lt;0.001); these patients were older, had higher basal heart rates, higher rates of paroxysmal atrial fibrillation, lower platelet count. QTc increase was inversely proportional to baseline QTc levels and leukocyte count and directly to basal heart rates(p&lt;0.01).At multivariate stepwise analysis including age, male gender, paroxysmal atrial fibrillation, basal QTc values, basal heart rate and dual antiviral therapy, age(OR 1.06, 95% C.I. 1.00-1.13, p&lt;0.05), basal heart rate(OR 1.07, 95% C.I. 1.02-1.13, p&lt;0.01) and dual antiviral therapy(OR 12.46, 95% C.I. 2.09-74.20, p&lt;0.1) were independent predictors of QT-prolongation.Incidence of LTA during hospitalization was 3.6%. One patient experienced cardiac arrest and three non-sustained ventricular tachycardia. LTAs were recorded after a median of 9 days from hospitalization and were associated with 50% of mortality rate. Conclusions After 7 days of hospitalization, 14% of patients with Covid-19 developed pQTc; age, basal heart rate and dual antiviral therapy were found as independent predictor of pQTc. Life threatening arrhythmias have an incidence of 3.6% and were associated with poor outcome.

scholarly journals Autonomic Alterations After Pulmonary Vein Isolation in the CIRCA‐DOSE (Cryoballoon vs Irrigated Radiofrequency Catheter Ablation) Study

2021 ◽  
Author(s):  
Lisa Y. W. Tang ◽  
Nathaniel M. Hawkins ◽  
Kendall Ho ◽  
Roger Tam ◽  
Marc W. Deyell ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
Mean Difference ◽  
Heart Rates ◽  
Cardiac Monitor ◽  
Implantable Cardiac Monitor

Background The natural history of autonomic alterations following catheter ablation of drug‐refractory paroxysmal atrial fibrillation is poorly defined, largely because of the historical reliance on non‐invasive intermittent rhythm monitoring for outcome ascertainment. Methods and Results The study included 346 patients with drug‐refractory paroxysmal atrial fibrillation undergoing pulmonary vein isolation using contemporary advanced‐generation ablation technologies. All patients underwent insertion of a Reveal LINQ (Medtronic) implantable cardiac monitor before ablation. The implantable cardiac monitor continuously recorded physical activity, heart rate variability (measured as the SD of the average normal‐to‐normal), daytime heart rate, and nighttime heart rate. Longitudinal autonomic data in the 2‐month period leading up to the date of ablation were compared with the period from 91 to 365 days following ablation. Following ablation there was a significant decrease in SD of the average normal‐to‐normal (mean difference versus baseline of 19.3 ms; range, 12.9–25.7; P <0.0001), and significant increases in daytime and nighttime heart rates (mean difference versus baseline of 9.6 bpm; range, 7.4–11.8; P <0.0001, and 7.4 bpm; range, 5.4–9.3; P <0.0001, respectively). Patients free of arrhythmia recurrence had significantly faster daytime (11±11 versus 8±12 bpm, P =0.001) and nighttime heart rates (8±9 versus 6±8 bpm, P =0.049), but no difference in SD of the average normal‐to‐normal ( P =0.09) compared with those with atrial fibrillation recurrence. Ablation technology and cryoablation duration did not influence these autonomic nervous system effects. Conclusions Pulmonary vein isolation results in significant sustained changes in the heart rate parameters related to autonomic function. These changes are correlated with procedural outcome and are independent of the ablation technology used. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01913522.

scholarly journals P095 Heart Rate Variability during Sleep in Paroxysmal Atrial Fibrillation patients with and without Obstructive Sleep Apnoea

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A52
Author(s):  
A Mohammadieh ◽  
H Dissanayake ◽  
K Sutherland ◽  
S Ucak ◽  
P de Chazal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Paroxysmal Atrial Fibrillation ◽  
Sleep Apnoea ◽  
Relative Reduction ◽  
Obstructive Sleep ◽  
Sympathetic Modulation ◽  
Ectopic Beats

Abstract Introduction Physiological studies have demonstrated the importance of the autonomic nervous system in mediating acute apnoea-induced atrial fibrillation (AF). We aimed to compare Heart Rate Variability (HRV) markers of autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). A secondary aim was the analysis of ectopic beats in these groups. Methods Nocturnal ECG traces from 89 PAF patients who underwent in-laboratory polysomnography were included. After identifying ectopic beats in the ECGs, periods of arrhythmia as well as sleep apnoea events were excluded. HRV time and frequency domains were reported by sleep stage (REM vs Non-REM) for patients with and without OSA. Results Frequency domain analysis of HRV during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.13 ± 15.74 vs 47.98 ± 14.60, p = 0.008*) and reduced cardiac sympathetic modulation (LF/HF ratio: 2.05 ± 2.02 vs 1.17 ± 0.98, p = 0.007*). Results remained significant after adjusting for age, sex and BMI (adjusted p values 0.024 and 0.018 respectively). PAF patients with severe OSA (AHI ≥ 30/hr) had more AF beats and Ventricular Ectopic Beats than those without severe OSA (22.7 ± 42.8% vs 3.7 ± 17.9%, p = 0.006*, 1.7 ± 3.8 vs 0.3 ± 0.9%, p = 0.004* respectively). Conclusions This is the first study of HRV in AF patients with and without OSA. It suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA.

scholarly journals 778 Heart rate variability after circumferential pulmonary veins catheter ablation in patients with paroxysmal atrial fibrillation: long-term follow-up results

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 177-177
Author(s):  
K. Szydlo ◽  
A. Wnuk-Wojnar ◽  
M. Trusz-Gluza ◽  
C. Czerwinski ◽  
I. Wozniak-Skowerska ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Long Term Follow Up

Diagnosis of Atrial Fibrillation Using Machine Learning with Wearable Devices after Cardiac Surgery (Preprint)

2021 ◽  
Author(s):  
Daisuke Hiraoka ◽  
Tomohiko Inui ◽  
Eiryo Kawakami ◽  
Megumi Oya ◽  
Ayumu Tsuji ◽  
...  
Keyword(s):  
Machine Learning ◽  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Early Detection ◽  
Pulse Rate ◽  
Paroxysmal Atrial Fibrillation ◽  
Wearable Device ◽  
Strongly Correlated ◽  
Cross Correlation Analysis ◽  
Data Output

BACKGROUND Some attempts have been made to detect atrial fibrillation with a wearable device equipped with photoelectric volumetric pulse wave technology, and it is expected to be applied under real clinical conditions. OBJECTIVE This study is the second part of a two-phase study aimed at developing a method for immediate detection of paroxysmal atrial fibrillation (AF) using a wearable device with built-in PPG. The objective of this study is to develop an algorithm to immediately diagnose atrial fibrillation by wearing an Apple Watch equipped with a photoplethysmography (PPG) sensor on patients undergoing cardiac surgery and using machine learning of the pulse data output from the device. METHODS A total of 80 subjects who underwent cardiac surgery at a single institution between June 2020 and March 2021 were monitored for postoperative atrial fibrillation using telemetry monitored ECG and Apple Watch. Atrial fibrillation was diagnosed by qualified physicians from telemetry-monitored ECGs and 12-lead ECGs; a diagnostic algorithm was developed using machine learning on pulse rate data output from the Apple Watch. RESULTS One of the 80 patients was excluded from the analysis due to redness of the Apple Watch wearer. 27 (34.2%) of the 79 patients developed AF, and 199 events of AF, including brief AF, were observed. 18 events of AF lasting longer than 1 hour were observed, and Cross-correlation analysis (CCF) showed that pulse rate measured by Apple Watch was strongly correlated (CCF 0.6-0.8) with 8 events and very strongly correlated (CCF >0.8) with 3 events. The diagnostic accuracy by machine learning was 0.7952 (sensitivity 0.6312, specificity 0.8605 at the point closest to the top-left) for the AUC of the ROC curve. CONCLUSIONS We were able to safely monitor pulse rate in patients after cardiac surgery by wearing an Apple Watch. Although the pulse rate from the PPG sensor does not follow the heart rate of the telemetry monitoring ECG in some parts, which may reduce the accuracy of the diagnosis of atrial fibrillation by machine learning, we have shown the possibility of clinical application of early detection of atrial fibrillation using only the pulse rate collected by the PPG sensor. CLINICALTRIAL The use of wristband type continuous pulse measurement device with artificial intelligence for early detection of paroxysmal atrial fibrillation Clinical Research Protocol No. jRCTs032200032 https://jrct.niph.go.jp/latest-detail/jRCTs032200032

P373Arterial stiffness changes in patients with obesity and atrial fibrillation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Tarzimanova ◽  
V I Podzolkov ◽  
A E Bragina ◽  
M V Pisarev ◽  
R G Gataulin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Arterial Stiffness ◽  
Sinus Rhythm ◽  
Body Mass ◽  
Paroxysmal Atrial Fibrillation ◽  
Obese Patients ◽  
Waist To Hip Ratio ◽  
Group I ◽  
The Mean

Abstract Objective To study the changes in arterial stiffness in patients with obesity and paroxysmal atrial fibrillation (AF). Materials and methods The study included 82 obese patients. Forty-two of them (group I) had paroxysmal AF, their mean age was 60.9 ± 6.2 years. The control group (group II) included 40 obese patients in sinus rhythm with the mean age of 57.2 ± 6.5 years.  We studied arterial stiffness using cardio-ankle vascular index (CAVI) measured by the VaSera device (VS-1000) in all the patients. Patients from group I were evaluated after 3 days of sinus rhythm restoration and maintenance. We also measured the anthropometric indicators which included body mass index, waist circumference, abdominal sagittal diameter, waist-to-hip and waist-to-height ratios. Results There were no significant differences in body mass index between 2 groups. The waist-to-hip ratio was significantly higher in patients with obesity and paroxysmal atrial fibrillation than in obese patients in sinus rhythm and was 1.37 ± 0.09 and 0.84 ± 0.06, respectively (p = 0.002). The mean value of CAVI was 9.61 ± 1.51 and 6.42 ± 0.18 in group I and group II respectively; this difference was significant (p = 0.001). There was a strong positive correlation between CAVI and waist-to-hip ratio in the group I patients (p = 0.02). The results show that vascular stiffness is significantly higher in obesity patients with paroxysmal form AF. Conclusion Positive correlations between increased arterial stiffness and anthropometric indicators confirm the role of visceral obesity in the development of AF.

scholarly journals MediYoga as a part of a self-management programme among patients with paroxysmal atrial fibrillation – a randomised study

2019 ◽  
Vol 19 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Maria Wahlström ◽  
Mårten Rosenqvist ◽  
Jörgen Medin ◽  
Ulla Walfridsson ◽  
Monica Rydell-Karlsson
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Heart Rate ◽  
Paroxysmal Atrial Fibrillation ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Background: Paroxysmal atrial fibrillation is associated with impaired health-related quality of life. Yoga has been suggested to improve health-related quality of life among patients with heart failure and hypertension. Aim: The aim of the study was to evaluate the effects of MediYoga, in respect of health-related quality of life, blood pressure, heart rate, as well as N-terminal pro b-type natriuretic peptide, among patients with symptomatic paroxysmal atrial fibrillation, compared with standard therapy or relaxation. Methods: Patients with symptomatic paroxysmal atrial fibrillation, n=132, were stratified for gender and randomised to MediYoga, a relaxation group or a control group, 44 patients per group with a 12-week follow-up. Health-related quality of life, blood pressure, heart rate and N-terminal pro b-type natriuretic peptide were assessed. Results: After 12 weeks, there were no differences in health-related quality of life between the groups. There were improvements in Short-Form Health Survey bodily pain, general health, social function, mental health and mental component summary scores within the MediYoga group ( p=0.014, p=0.037, p=0.029, p=0.030, p=0.019, respectively). No change was seen in the relaxation and control groups. Systolic blood pressure decreased in the MediYoga group (134±18 to 127±13) compared with the control group (126±17 to 127±15, p=0.041); no difference compared with the relaxation group (131±17 to 125±12). Diastolic blood pressure decreased in the MediYoga group (79±9 to 74 ±9) compared with the control group (76±9 to 79±8, p=0.005); no difference compared with the relaxation group (76±9 to 77±8). There were no differences in heart rate and N-terminal pro b-type natriuretic peptide between the groups after 12 weeks. Conclusions: MediYoga improves health-related quality of life and decreases blood pressure in patients with paroxysmal atrial fibrillation. MediYoga may be used as a part of a self-management programme among patients with paroxysmal atrial fibrillation.

scholarly journals Differences in Heart Rate Dynamics Before the Spontaneous Onset of Long and Short Episodes of Paroxysmal Atrial Fibrillation

2001 ◽  
Vol 6 (2) ◽  
pp. 134-142 ◽  
Author(s):  
Saila Vikman ◽  
Sinikka Yli-Mäyry ◽  
Timo H. Mäkikallio ◽  
K.E. Juhani Airaksinen ◽  
Heikki V. Huikuri
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Paroxysmal Atrial Fibrillation ◽  
Heart Rate Dynamics ◽  
Spontaneous Onset
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