Wren Georgina H, O'Callaghan Peter, Zaidi Abbas, Thompson Andrew R, Humby Trevor, Davies William
School of Psychology, Cardiff University, Cardiff, UK.
University Hospital of Wales, Cardiff, UK.
Arch Dermatol Res. 2025 Feb 6;317(1):351. doi: 10.1007/s00403-025-03884-x.
The rare dermatological condition X-linked ichthyosis (XLI) is associated with a substantially-increased risk of cardiac arrhythmias. Arrhythmias predispose to multiple serious health conditions, and there is a need to identify them at an early stage, ideally using non-invasive, convenient, cost-effective, and reliable wearable technology methods. We tested the feasibility of monitoring heart rhythms using an Apple Watch in five adult males from the United Kingdom diagnosed with XLI. Participants returned routine electrocardiogram (ECG) traces from the watch three times per week for eight weeks (plus any traces associated with 'watch alerts' indicating arrhythmic episodes) for cardiologist review. Participant feedback was also obtained on the perceived usability/wearability of the watch/app, and on the study requirements. Participants were generally happy with the study conduct, found the watch/app straightforward to use, and there was a > 95% data return rate. Minor protocol improvements were suggested. There were few issues reported with wearability of the watch. Three participants exhibited no ECG abnormalities, but two presented with ventricular ectopic beats (VEs). Only one watch 'alert' ECG was returned, and this was considered normal sinus rhythm, suggesting the possibility of 'false positive' calls. Based on our small sample, smartwatch-based screening for cardiac rhythm abnormalities in the high-risk male XLI population appears useful, feasible, and acceptable to patients and a larger-scale clinical trial is warranted. Potentially, such devices may be more suited to detecting persistent abnormalities rather than unpredictable, acute, arrhythmic episodes. The high VE burden in some participants with XLI is consistent with septal defects underlying arrhythmia risk.
罕见的皮肤病——X连锁鱼鳞病（XLI）与心律失常风险大幅增加有关。心律失常易引发多种严重健康问题，因此有必要在早期识别它们，理想情况下使用非侵入性、便捷、经济高效且可靠的可穿戴技术方法。我们对五名来自英国的成年男性XLI患者使用苹果手表监测心律的可行性进行了测试。参与者每周三次从手表返回常规心电图（ECG）记录，持续八周（加上与指示心律失常发作的“手表警报”相关的任何记录），以供心脏病专家审查。还收集了参与者对手表/应用程序的感知可用性/可穿戴性以及研究要求的反馈。参与者总体上对研究实施感到满意，认为手表/应用程序易于使用，数据返回率超过95%。有人提出了对方案的一些小改进。关于手表的可穿戴性报告的问题很少。三名参与者未表现出心电图异常，但两名出现室性早搏（VEs）。仅返回了一份手表“警报”心电图，且被认为是正常窦性心律，这表明可能存在“假阳性”情况。基于我们的小样本，对于高危男性XLI人群，基于智能手表的心律异常筛查似乎有用、可行且为患者所接受，有必要进行更大规模的临床试验。潜在地，此类设备可能更适合检测持续性异常，而非不可预测的急性心律失常发作。一些XLI参与者中较高的室性早搏负担与心律失常风险背后的间隔缺损一致。
