Recent research has shown the efficacy of wearable devices in improving the screening and detection of atrial fibrillation (AFib). Mobile health technologies such as fitness trackers, smartwatches, and phones have the potential to enhance both AFib detection and management using photoplethysmography (PPG) technology. This study was published in the Journal of the American College of Cardiology and was presented at the European Society of Cardiology (ESC).
AFib is characterized by an irregular heart rhythm, caused by the atria, or upper chambers of the heart, contracting randomly. At times, this causes the atria to contract so rapidly that the muscle cannot relax, resulting in reduced cardiac efficiency and higher blood clot risks. This condition is the most common arrhythmia seen and affects roughly one million citizens in the UK. AFib puts patients at an increased risk for stroke, death, heart failure, and dementia. This arrhythmia is currently difficult to detect due to a lack of noticeable symptoms.
A Mobile Health Solution
PPG is an inexpensive optical technique that can be used to detect changes in blood volume at the microvascular tissue bed. This noninvasive technique can be used to measure heart rate and cardiac cycle through the surface of the skin.
Led by Associate Professor Yutao Guo of the Chinese PLA General Hospital in Beijing and Professor Gregory Lip, lead for the Liverpool Centre for Cardiovascular Science/Price-Evans Chair of Cardiovascular Medicine at the University of Liverpool, a research team aimed to determine how well PPG devices can screen for AFib. To do so, the team used a wearable Huawei device combined with clinical care techniques to manage AFib.
Wearable Device Proves to be Effective
In their work, Guo and colleagues recruited 187,912 participants who used smart devices to measure their pulse rhythms from October 2018 to May 2019. In this timeframe, 424 (0.23%) of the participants were suspected to have AFib by the wearable device. 227 of these participants (87%) were then confirmed to have AFib by physician examination. After confirming the presence of their arrhythmia, these patients were properly treated.
“Based on our present study, continuous home-monitoring with smart device based PPG technology could be a feasible, cost-effective approach for AF screening,” said Guo. “There were 95% patients following entry into a program of integrated AF care, and approximately 80% of high risk patients were successfully anticoagulated. This would help efforts at screening and detection of AF, as well as early interventions to reduce stroke and other AF-related complications.”
“Improved AF care requires early detection and the opportunity for streamlined management decision-making,” added Lip. “Better detection can be followed by implementing the priorities of AF management, which is as ‘easy as ABC’: Avoid stroke; Better symptom optimization; Cardiovascular and risk factor management.”
This project was funded by the National Natural Science Foundation of China and the Health and Family Planning Commission of Heilongjiang Province, China. Additional funding came from the NIHR Global Health Research Group on Atrial Fibrillation management as well.
— American College of Cardiology (@ACCinTouch) September 5, 2019