Ding Eric Y, Tran Khanh-Van, Lessard Darleen, Wang Ziyue, Han Dong, Mohagheghian Fahimeh, Mensah Otabil Edith, Noorishirazi Kamran, Mehawej Jordy, Filippaios Andreas, Naeem Syed, Gottbrecht Matthew F, Fitzgibbons Timothy P, Saczynski Jane S, Barton Bruce, Chon Ki, McManus David D
Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States.
Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States.
JMIR Cardio. 2023 Nov 28;7:e45137. doi: 10.2196/45137.
Atrial fibrillation (AF) is a common cause of stroke, and timely diagnosis is critical for secondary prevention. Little is known about smartwatches for AF detection among stroke survivors. We aimed to examine accuracy, usability, and adherence to a smartwatch-based AF monitoring system designed by older stroke survivors and their caregivers.
This study aims to examine the feasibility of smartwatches for AF detection in older stroke survivors.
Pulsewatch is a randomized controlled trial (RCT) in which stroke survivors received either a smartwatch-smartphone dyad for AF detection (Pulsewatch system) plus an electrocardiogram patch or the patch alone for 14 days to assess the accuracy and usability of the system (phase 1). Participants were subsequently rerandomized to potentially 30 additional days of system use to examine adherence to watch wear (phase 2). Participants were aged 50 years or older, had survived an ischemic stroke, and had no major contraindications to oral anticoagulants. The accuracy for AF detection was determined by comparing it to cardiologist-overread electrocardiogram patch, and the usability was assessed with the System Usability Scale (SUS). Adherence was operationalized as daily watch wear time over the 30-day monitoring period.
A total of 120 participants were enrolled (mean age 65 years; 50/120, 41% female; 106/120, 88% White). The Pulsewatch system demonstrated 92.9% (95% CI 85.3%-97.4%) accuracy for AF detection. Mean usability score was 65 out of 100, and on average, participants wore the watch for 21.2 (SD 8.3) of the 30 days.
Our findings demonstrate that a smartwatch system designed by and for stroke survivors is a viable option for long-term arrhythmia detection among older adults at risk for AF, though it may benefit from strategies to enhance adherence to watch wear.
ClinicalTrials.gov NCT03761394; https://clinicaltrials.gov/study/NCT03761394.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1016/j.cvdhj.2021.07.002.
心房颤动（AF）是中风的常见病因，及时诊断对于二级预防至关重要。关于智能手表在中风幸存者中检测房颤的情况，人们了解甚少。我们旨在研究一款由老年中风幸存者及其护理人员设计的基于智能手表的房颤监测系统的准确性、可用性和佩戴依从性。
本研究旨在探讨智能手表在老年中风幸存者中检测房颤的可行性。
Pulsewatch是一项随机对照试验（RCT），中风幸存者被随机分配，一组接受用于房颤检测的智能手表-智能手机组合（Pulsewatch系统）加心电图贴片，另一组仅接受贴片，为期14天，以评估该系统的准确性和可用性（第一阶段）。随后，参与者被再次随机分组，可能再使用该系统30天，以研究佩戴手表的依从性（第二阶段）。参与者年龄在50岁及以上，曾经历过缺血性中风，且无口服抗凝剂的重大禁忌证。通过与心脏病专家解读的心电图贴片进行比较来确定房颤检测的准确性，并用系统可用性量表（SUS）评估可用性。依从性定义为30天监测期内每天佩戴手表的时间。
共招募了120名参与者（平均年龄65岁；50/120，41%为女性；106/120，88%为白人）。Pulsewatch系统检测房颤的准确率为92.9%（95%CI 85.3%-97.4%）。可用性平均得分为65分（满分100分），在30天里，参与者平均佩戴手表21.2天（标准差8.3天）。
我们的研究结果表明，一款由中风幸存者设计并为其使用的智能手表系统，对于有房颤风险的老年人进行长期心律失常检测是一个可行的选择，不过可能需要采取策略来提高佩戴手表的依从性。
ClinicalTrials.gov NCT03761394；https://clinicaltrials.gov/study/NCT03761394。
国际注册报告识别码（IRRID）：RR2-10.1016/j.cvdhj.2021.07.002。
