Abstract
Background: Atrial fibrillation affects nearly 60 million adults worldwide. Atrial fibrillation is associated with a high risk of cardiovascular morbidity, therefore early detection of atrial fibrillation is important for improving patient outcomes. Apple Watch has an ECG which can detect atrial fibrillation but users do not always contact a doctor. We report in-depth interviews with users who detected atrial fibrillation with Apple Watch. Methods: In this research, participants wearing an Apple Watch received real-time electrocardiograms via their smartphone, and received telemedicine guidance from our smartphone application. This research was a single arm study with 489 participants conducted with the goal of evaluating the effectiveness of telemedicine by using Apple Watch. In a three-month experiment, 412 participants measured more than once and 89 participants measured once a day on average. 20 participants experienced atrial fibrillation which was detected by their Apple Watch. Finally, five participants connected to a Telehealth doctor, who based on the data from the Apple Watch and the patient's symptoms was able to give appropriate medical guidance. Results: We carried out in-depth interviews with four participants who detected atrial fibrillation. Two participants did not understand the detection. Afterwards they received an explanation of atrial fibrillation from the person in charge of the experiment via email, after which the participants applied for telemedicine. The other two participants were familiar with atrial fibrillation and did not apply because they had existing medical history and subjective symptoms. In addition, we conducted a questionnaire survey about telemedicine from the 20 participants who detected their atrial fibrillation. 95% of questionnaire respondents were aware of telemedicine, which was free in this experiment. However, 53% of questionnaire respondents did not understand the risks and basic information about atrial fibrillation. Moreover, 47% of questionnaire respondents selected that they were not going to contact a doctor if they do not have subjective symptoms. Conclusions: Early detection of atrial fibrillation is important for patients, but people do not always get in connect with an online doctor. We confirmed that one of the reasons is lack of knowledge about atrial fibrillation and another is lack of subjective symptoms.
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