Abstract
BackgroundPatients with obstructive sleep apnea (OSA) are at a higher risk for atrial fibrillation (AF). Consumer wearable heart rate (HR) sensors may be a means for passive HR monitoring in patients with AF.ObjectiveThe aim of this study was to assess the Apple Watch’s agreement with telemetry in measuring HR in patients with OSA in AF.MethodsPatients with OSA in AF were prospectively recruited prior to cardioversion/ablation procedures. HR was sampled every 10 seconds for 60 seconds using telemetry and an Apple Watch concomitantly. Agreement of Apple Watch with telemetry, which is the current gold-standard device for measuring HR, was assessed using mixed effects limits agreement and Lin’s concordance correlation coefficient.ResultsA total of 20 patients (mean 66 [SD 6.5] years, 85% [n=17] male) participated in this study, yielding 134 HR observations per device. Modified Bland–Altman plot revealed that the variability of the paired difference of the Apple Watch compared with telemetry increased as the magnitude of HR measurements increased. The Apple Watch produced regression-based 95% limits of agreement of 27.8 – 0.3 × average HR – 15.0 to 27.8 – 0.3 × average HR + 15.0 beats per minute (bpm) with a mean bias of 27.8 – 0.33 × average HR bpm. Lin’s concordance correlation coefficient was 0.88 (95% CI 0.85-0.91), suggesting acceptable agreement between the Apple Watch and telemetry.ConclusionsIn patients with OSA in AF, the Apple Watch provided acceptable agreement with HR measurements by telemetry. Further studies with larger sample populations and wider range of HR are needed to confirm these findings.
Highlights
Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia, with a lifetime risk of 1 in 4 among individuals over the age of 40 and about 1 in 3 among individuals over the age of 55, thereby posing substantial public health and economic burden [1,2]
Over the course of 6 months, we screened 201 consecutive patients who were scheduled for cardioversion and atrial fibrillation (AF) ablation procedures
This study presents a pilot effort to assess the level of agreement in heart rate (HR) measurements between PPG technology using the Apple Watch (1st generation) and telemetry during episodes of AF
Summary
Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia, with a lifetime risk of 1 in 4 among individuals over the age of 40 and about 1 in 3 among individuals over the age of 55, thereby posing substantial public health and economic burden [1,2]. AF is associated with significant cardiovascular and cerebrovascular morbidity and http://cardio.jmir.org/2021/1/e18050/ XSLFO RenderX. Of high risk for developing AF are individuals with sleep breathing disorders, including obstructive sleep apnea (OSA). A strong association between OSA and AF has been consistently observed in both epidemiological and clinical cohorts, with patients with OSA being 2 to 4 times more likely to develop AF compared to those without OSA [6,7,8]. Gami et al [9] reported significantly higher prevalence (49% vs 32%) of OSA and a strong association (adjusted odds ratio of 2.19) between OSA and AF in patients undergoing electrical cardioversion as compared to patients without AF. Patients with obstructive sleep apnea (OSA) are at a higher risk for atrial fibrillation (AF). Consumer wearable heart rate (HR) sensors may be a means for passive HR monitoring in patients with AF
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