Objective To evaluate the accuracy of continuous photoplethysmography algorithms for atrial fibrillation diagnosis and atrial fibrillation burden evaluation via wearable devices.Methods This study was a self-controlled prospective cohort study.A total of 254 consecutive inpatients were recruited from the Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University from September 2022 to November 2022.All participants were required to wear two devices at the same time:(1)an electrocardiogram(ECG)watch for acquisition of photoplethysmography(watch-recorded-photoplethysmography,W-PPG)and electrocardiogram(watch-recorded-electrocardiogram,W-ECG);(2)an ECG patch for acquisition of electrocardiogram(patch-recorded-electrocardiogram,P-ECG).The results were measured in 30 s data segments and individual participants,separately,which were calculated for sensitivity and specificity by comparing them with the results of expert-read ECG according to the receiver operating characteristic curve.Four groups were separated according to the proportion of the atrial fibrillation burden,and the difference of atrial fibrillation burden from algorithm and expert-read ECG was calculated.Results All 254 subjects completed the study.The mean age of participants was(63.04± 11.04)years old,99(38.98％)of them were female,and 97(38.19％)patients had persistent atrial fibrillation.Expert-read ECG results were taken as standard criteria in all calculations.The P-ECG algorithm had a sensitivity of 94.86％(95％CI:94.81％-94.91％)and a specificity of 99.30％(95％CI:99.28％-99.31％)when measured in data segments.The W-PPG algorithm had a sensitivity of 96.07％(95％CI:95.97％-96.18％)and a specificity of 98.62％(95％CI:98.59％-98.65％).When measured in terms of individual participants,the P-ECG algorithm had a sensitivity of 92.55％(95％CI:87.57％-95.71％)and a specificity of 96.39％(95％CI:93.45％-98.09％),while the W-PPG algorithm had a sensitivity of 93.71％(95％CI:88.75％-96.67％)and a specificity of 89.62％(95％CI:85.61％-92.65％).When measured in terms of a single acquisition of W-ECG records,the W-ECG algorithm had a sensitivity of 92.04％(95％CI:88.14％-94.78％)and a specificity of 96.19％(95％CI:94.35％-97.47％).For atrial fibrillation burden assessment,the difference between the W-PPG analysis results and the expert-read ECG results was less than 2％in all burden distribution intervals.Conclusions Continuous photoplethysmography algorithm applied to wearable devices to detect atrial fibrillation is a feasible strategy.Taking expert-read ECG results as standard,continuous monitoring of PPG by a smartwatch is highly accurate for atrial fibrillation diagnosis and can also be used to effectively complete atrial fibrillation burden assessment.
NETL
NSTL
万方数据
