Detection of Tachyarrhythmias in a Large Cohort of Infants Using Direct-to-Consumer Heart Rate Monitoring

Abstract

Current estimates of the incidence of tachyarrhythmias in infants rely on clinical documentation and may not reflect the true rate in the general population. Our aim was to describe the epidemiology of tachyarrhythmia detected in a large cohort of infants using direct-to-consumer heart rate (HR) monitoring. Data were collected from Owlet Smart Sock devices used in infants in the US with birthdates betweenFebruary 2017 and February 2019. We queried the HR data for episodes of tachyarrhythmia (HR of ≥240 bpm for >60seconds). The study included 100 949 infants (50.8% male) monitored for more than 200 million total hours. We identified 5070 episodes of tachyarrhythmia in 2508 infants. The cumulative incidence of tachyarrhythmia in our cohort was 2.5% over the first year of life. The median age at the time of the first episode of tachyarrhythmia was 36days (range, 1-358days). Tachyarrhythmia was more common in infants with congenital heart disease (4.0% vs 2.4%; P=.015) and in females (2.7% vs 2.0%; P<.001). The median length of an episode was 7.3minutes(range, 60seconds to 5.4hours) and the probability of an episode lasting longer than 45minutes was 16.8% (95% CI, 15.4%-18.3%). We found the cumulative incidence of tachyarrhythmia among infants using direct-to-consumer HR monitors to be higher than previously reported in studies relying on clinical diagnosis. This finding may represent previously undetected subclinical disease in young infants, the significance of which remains uncertain. Clinicians should be prepared to discuss these events with parents.