Diagnostic Accuracy of Apple Watch Electrocardiogram for Atrial Fibrillation: A Systematic Review and Meta-Analysis.

BACKGROUND

Electrocardiography (ECG) is the gold standard for the diagnosis of atrial fibrillation (AF). Recently, smartwatches like the Apple Watch have emerged as a promising, user-friendly device for rapid detection and diagnosis of AF, but the reliability and diagnostic accuracy still remain controversial.

OBJECTIVES

The purpose of this study was to perform a systematic review and diagnostic test accuracy meta-analysis evaluating the diagnostic performance of the Apple Watch ECG in detecting AF.

METHODS

The literature search was conducted on PubMed, Embase, and Cochrane Library through April 2024 for studies comparing the diagnostic accuracy of Apple Watch to standard 12-lead ECG. Statistical analysis was performed using R Software version 4.4.0 and OpenMeta[Analyst]. Pooled analyses of sensitivity, specificity, and area under the receiver operating characteristic curve were determined along with their 95% CIs. The quality of studies was analyzed using the QUADAS-2 tool.

RESULTS

The meta-analysis included 11 studies comprising 4,241 participants. Their mean age was 62.56 ± 3.92 years, and 28% of the patients were females. The pooled sensitivity and specificity of the Apple Watch for detecting AF were 94.8% (95% CI: 91.7% to 96.8%; I = 67%) and 95% (95% CI: 88.6% to 97.8%; I = 88%), respectively. The area under the receiver operating characteristic curve was 0.96 (95% CI: 0.92-0.97).

CONCLUSIONS

The Apple Watch ECG carries high accuracy in detecting atrial fibrillation, providing a convenient diagnostic option for patients.