Zhang Yi, Xiong Tian-Yuan, Yang Xue-Mei, Chen De-Fang, Li Yi-Ming, Bao Yun, Chen Mao
Department of Cardiology and Laboratory of Heart Valve Disease, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.
Department of Nursing, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.
Rev Cardiovasc Med. 2023 Jan 4;24(1):11. doi: 10.31083/j.rcm2401011. eCollection 2023 Jan.
As an emerging arrhythmia monitor, ambulatory smartwatch electrocardiogram (ECG) provides an option for home-based monitoring of delayed new-onset arrhythmic events after transcatheter aortic valve replacement (TAVR). We aimed to validate the diagnostic efficacy of a consumer smartwatch ECG in TAVR recipients, while further explore the occurrence rate of both tachy- and brady-arrhythmia for 30 days after discharge to support risk management.
Consecutive TAVR recipients from February 26th, 2021 to December 13th, 2021 were enrolled prospectively, receiving simultaneous 24-hour Holter and 12-lead ECG compared with smartwatch ECG during hospitalization and daily smartwatch ECG collection for 30 days after discharge.
Among 110 patients, the efficacy of smartwatch ECG presented sensitivity and specificity in diagnosing atrial fibrillation (AF) as 1.00 and 0.97, left bundle branch block (LBBB) as 0.61 and 0.88, and right bundle branch block (RBBB) as 0.60 and 0.97, respectively, compared with 24-hour Holter; presented sensitivity and specificity in diagnosing AF as 0.88 and 1.00, LBBB as 0.90 and 0.96, and RBBB as 0.83 and 0.94, respectively, compared with 12-lead ECG. At 30-day follow-up, new-onset arrhythmia included new-onset severe conduction disturbance (SCD) (23.6%), new-onset AF (21.8%), new-onset permanent LBBB (14.5%) and new-onset permanent RBBB (0.9%); 69.2% (36/52) of early new-onset LBBB recovered at 30-day follow-up.
The diagnostic efficacy of consumer smartwatch ECG in arrhythmic events among TAVR population was acceptable, which provided a recommendable option for home-based management.
; Identifier: ChiCTR2000041244; http://www.chictr.org.cn/showproj.aspx?proj=66324.
作为一种新兴的心律失常监测设备，动态智能手表心电图（ECG）为经导管主动脉瓣置换术（TAVR）后延迟发生的新发心律失常事件的家庭监测提供了一种选择。我们旨在验证消费级智能手表心电图在TAVR接受者中的诊断效能，同时进一步探究出院后30天内心动过速和心动过缓心律失常的发生率，以支持风险管理。
前瞻性纳入2021年2月26日至2021年12月13日连续的TAVR接受者，在住院期间同时接受24小时动态心电图监测和12导联心电图检查，并与智能手表心电图进行比较，出院后每天收集智能手表心电图，持续30天。
在110例患者中，与24小时动态心电图相比，智能手表心电图诊断心房颤动（AF）的敏感性和特异性分别为1.0和 .97，诊断左束支传导阻滞（LBBB）的敏感性和特异性分别为0.61和0.88，诊断右束支传导阻滞（RBBB）的敏感性和特异性分别为0.60和0.97；与12导联心电图相比，诊断AF的敏感性和特异性分别为0.88和1.00，诊断LBBB的敏感性和特异性分别为0.90和0.96，诊断RBBB的敏感性和特异性分别为0.83和0.94。在30天随访时，新发心律失常包括新发严重传导障碍（SCD）（23.6%）、新发AF（21.8%）、新发永久性LBBB（14.5%）和新发永久性RBBB（0.9%）；69.2%（36/52）的早期新发LBBB在30天随访时恢复。
消费级智能手表心电图在TAVR人群心律失常事件中的诊断效能是可接受的，为家庭管理提供了一个可推荐的选择。
；标识符：ChiCTR2000041244；http://www.chictr.org.cn/showproj.aspx?proj=66324 。
