智能手表在心房心律失常中心率评估中的应用。

Smart watches for heart rate assessment in atrial arrhythmias.

机构信息

Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Victoria, Australia.

Monash Cardiovascular Research Centre, Department of Medicine, Monash University and Monash Heart, Monash Health, Clayton, Victoria, Australia.

出版信息

Int J Cardiol. 2018 Sep 1;266:124-127. doi: 10.1016/j.ijcard.2018.02.073.

DOI:10.1016/j.ijcard.2018.02.073

PMID:29887428

Abstract

BACKGROUND

Despite studies demonstrating the accuracy of smart watches (SW) and wearable heart rate (HR) monitors in sinus rhythm, no data exists regarding their utility in arrhythmias.

METHODS

102 hospitalized patients were evaluated at rest using continuous electrocardiogram (ECG) monitoring with concomitant SW-HR (FitBit, FB, Apple Watch, AW) for 30 min.

RESULTS

Across all devices, 38,616 HR values were recorded. Sinus rhythm cohort demonstrated strong agreement for both devices with a low bias (FB & AW Bias = 1 beat). In atrial arrhythmias, AW demonstrated a stronger correlation than FB (AW r = 0.83, FB r = 0.56, both p < 0.01) with a lower bias (Bias AW = -5 beats, FB = -18 beats). Atrial flutter demonstrated strongest agreement in both devices with a mean bias <1 beat. However, in AF, there was significant HR underestimation (Bias FB = -28 beats, AW-8 beats) with wide limits of agreement. Despite HR underestimation in AF, when SW recorded HR ≥ 100 in arrhythmias, 98% of values were within ±10-beats of ECG-HR.

CONCLUSIONS

SW demonstrate strong agreement for HR estimation in sinus rhythm and atrial flutter but underestimates HR in AF. Tachycardic episodes recorded at rest on a SW may be suggestive of an underlying atrial tachyarrhythmia and warrant further clinical evaluation.

CLINICAL TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) ACTRN: 12616001374459.

摘要

背景

尽管有研究表明智能手表（SW）和可穿戴心率（HR）监测器在窦性心律中的准确性，但在心律失常方面尚无相关数据。

方法

102 名住院患者在静息状态下使用连续心电图（ECG）监测，并同时使用 SW-HR（FitBit，FB，Apple Watch，AW）监测 30 分钟。

结果

在所有设备上，共记录了 38616 个 HR 值。窦性心律组两种设备均具有较强的一致性，且偏差较小（FB 和 AW 偏差=1 次心跳）。在房性心律失常中，AW 的相关性强于 FB（AW r=0.83，FB r=0.56，均 p<0.01），且偏差较小（AW 偏差=-5 次心跳，FB 偏差=-18 次心跳）。在房扑中，两种设备的一致性最强，平均偏差小于 1 次心跳。然而，在房颤中，存在明显的 HR 低估（FB 偏差=-28 次心跳，AW 偏差=-8 次心跳），且一致性范围较宽。尽管房颤中存在 HR 低估，但当 SW 记录的 HR≥100 次/分时，98%的数值与 ECG-HR 的差值在±10 次心跳以内。