Detection of supraventricular arrhythmias with apple watch

Abstract

Abstract Introduction With the recent developments in wearable technology, detecting arrhythmias has become much easier. Although smartwatches are commonly used to detect patients with atrial fibrillation, there is no consensus on their efficiency in detecting supraventricular tachycardias (SVT). Methods & Results Electrophysiological procedures were performed on 47 patients that have been previously documented to have SVT by a 12-lead ECG. All patients had sinus rhythm before the procedure. A narrow complex SVT which patients had at least once was induced by electrophysiological methods. Induced SVTs were recorded with a 6th-generation Apple Watch as one rhythm strip. Among the induced tachycardias, 27 typical AVNRT, 11 AVRT and 9 AT/AFLwere diagnosed. These records obtained from the smartwatch were evaluated by 3 cardiology residents and 3 attending cardiologists. Evaluated records were predicted among attending physicians with a minimum sensitivity of 66.0% and maximum sensitivity of 76.6%. Among residents, minimum and maximum sensitivity rates were 68.1% and 74.5%, respectively. The reliability between residents and attendings was assessed separately using Fleiss’s kappa method. The interrater reliability was found to be Kappa=0.465 (p<0.001), 95% CI (0.30-0.63) within the group of residents and Kappa=0.519, (p<0.001), 95% CI (0.35-0.68) within the group of attendings. Overall Kappa value was 0.417 (p<0.001), 95% CI (0.34-0.49), indicating a significantly important moderate level of agreement (p<0.001). Conclusion To the best of our knowledge, this is the first study showing how accurately clinicians can interpret the recording of SVTs with wearable devices such as smart watches, whose definitive diagnosis was made invasively by electrophysiological study. As presented in our study, induced, and subsequently recorded SVTs were predicted with high sensitivity and a moderate reliability rate. Adoption of smartwatches could significantly limit the delays in diagnosis and treatment of patients admitted to the hospitals with complaints of palpitations that cannot be documented.Statistics