Abstract

Introduction: occurrence of ventricular arrhythmias (VAs) has a dramatic impact on prognosis of patients with heart failure (HF). Hypothesis: wearable devices, including smartwatch (SW), might provide real-time informations in patients at risk of VAs. Aims: we therefore evaluated if SW detection of QRS interval width and voltage could reproducibly detect VAs and/or premature ventricular contractions (PVCs) in HF patients. Methods: HF patients (N=100) underwent continuous electrocardiographic (ECG) recordings through telemetry and SW during hospital admission. Left ventricular ejection fraction (EF) and laboratory pro-BNP levels assessments were obtained as well. Correlation of the ECG results was addressed using Pearson’s analysis for normally distributed data and Spearman’s analysis for non-parametric data. Bland-Altman was used for reliability between telemetry and SW ECG measurements. Results: mean EF was 45.92±12.12%; mean pro-BNP was 2826±5823 pg/mL. Using the SW and the ECG data, QRS width and voltage correlation coefficients were 0.990 (p<0.001) and 0.974 (p<0.001), respectively. Concordance was found between the two assessments for QRS width (bias, 0.20; SD 3.0; lower limit, –5.68; upper limit, 6.08), and voltage (bias, -0.029; SD, 0.611; lower limit, –1.227; upper limit, 1.169). Moreover, we found correlation coefficients of 0.964 (p<0.001) and 0.970 (p<0.001), respectively, for PVCs width and PVCs voltage using SW and telemetry or other ECG report. Similarly, both techniques showed positive concordance for PVCs width (bias, 0.368; SD, 2.65; lower limit, -4.83; upper limit, 5.56) and PVCs voltage (bias, 0.54; SD, 1.25; lower limit, -1.91; and upper limit, 2.996). Remarkably, VAs identification by the SW was reproducible and standardized. Conclusions: continuous monitoring through SW might be considered in HF patients upon discharge.

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