Abstract
Introduction: Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia, and ECG remains the gold standard for diagnosis. Wrist-worn technologies are appealing for their ability to passively process near-continuous pulse signals. Hypothesis: Our systematic review and meta-analysis qualitatively and quantitatively analyzes available literature on wrist-worn wearable devices (Apple Watch, Samsung, and KardiaBand) and their sensitivity and specificity in detecting AF compared to conventional methods. Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed, yielding 9 studies (N=1,581). Observational studies assessing the sensitivity and specificity of wrist-worn wearables in detecting AF in patients with and without a history of AF were analyzed using a fixed effect model with an inverse-variance method. Results: In patients with a history of AF, the overall sensitivity between device groups did not significantly differ (sensitivity: 96.83%; p=0.207). The overall specificity between device groups was statistically significant (specificity: 99.02%; p<0.001). The effect size for this analysis was highest in the Samsung device group. Conclusions: Wrist-worn wearable devices demonstrate promising results in detecting AF in patients with paroxysmal AF. However, more rigorous prospective data is needed to understand the limitations of these devices in regard to varying specificities, which may lead to unintended downstream medical testing and costs.
Published Version
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