Abstract
The possibilities and implementation of wearable cardiac monitoring beyond atrial fibrillation are increasing continuously. This review focuses on the real-world use and evolution of these devices for other arrhythmias, cardiovascular diseases and some of their risk factors beyond atrial fibrillation. The management of nonatrial fibrillation arrhythmias represents a broad field of wearable technologies in cardiology using Holter, event recorder, electrocardiogram (ECG) patches, wristbands and textiles. Implementation in other patient cohorts, such as ST-elevation myocardial infarction (STEMI), heart failure or sleep apnea, is feasible and expanding. In addition to appropriate accuracy, clinical studies must address the validation of clinical pathways including the appropriate device and clinical decisions resulting from the surrogate assessed.
Highlights
Advances in wearable technologies have provided new opportunities for the diagnosis and management of cardiovascular diseases and their risk factors
When a wearable medical device was advocated by a healthcare provider and prescribed, their use was supported by evidence of effectiveness, reliability and safety
In a small study with 10 patients admitted for newly diagnosed heart failure, activity measured via daily step count correlated with left ventricular ejection fraction (LVEF), six-minute walk test (6MWT) and peak VO2 after hospital discharge (r = 0.44, r = 0.67 and r = 0.57, respectively) [73]
Summary
Advances in wearable technologies have provided new opportunities for the diagnosis and management of cardiovascular diseases and their risk factors. The wearable industry will expand further with the rapid use and assimilation of digital health As these devices are increasingly being offered and utilized, it has been difficult for healthcare providers to manage the data and recommend which, if any, tools should be used for the diagnosis and management of cardiovascular diseases and its risk factors. Current direct-to-consumer cardiac monitors are not continuous and are for the surveillance or “spot checking” of arrhythmias and, at this time, do not replace the continuous monitors that are prescribed by a healthcare provider Those devices that require patient activation will remain limited due to their under-detection of subclinical or minimally symptomatic arrhythmias. This review will focus on the real-world use and evolution of these devices for other arrhythmias, other cardiovascular diseases and some of their risk factors beyond AF
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