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Abdelrazik A, Eldesouky M, Antoun I, Lau EYM, Koya A, Vali Z, Suleman SA, Donaldson J, Ng GA. Wearable Devices for Arrhythmia Detection: Advancements and Clinical Implications. SENSORS (BASEL, SWITZERLAND) 2025; 25:2848. [PMID: 40363284 PMCID: PMC12074175 DOI: 10.3390/s25092848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2025] [Revised: 04/25/2025] [Accepted: 04/28/2025] [Indexed: 05/15/2025]
Abstract
Cardiac arrhythmias are a growing global health concern, and the need for accessible, continuous monitoring has driven rapid advancements in wearable technologies. This review explores the evolution, capabilities, and clinical impact of modern wearables for arrhythmia detection, including smartwatches, smart rings, ECG patches, and smart textiles. In light of the recent surge in commercially available wearables across all categories, this review offers a detailed comparative analysis of leading devices, evaluating cost, regulatory approval, model specifications, and system compatibility. Smartwatches and patches, in particular, show a strong performance in atrial fibrillation detection, with patches outperforming Holter monitors in long-term monitoring and diagnostic yield. This review highlights a paradigm shift toward patient-initiated diagnostics but also discusses challenges such as false positives, regulatory gaps, and healthcare integration. Overall, wearable devices hold significant promise for reshaping arrhythmia management through early detection and remote monitoring.
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Affiliation(s)
- Ahmed Abdelrazik
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
- NIHR Leicester Cardiovascular Biomedical Research Centre, Leicester LE3 9QP, UK
| | - Mahmoud Eldesouky
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
| | - Ibrahim Antoun
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
| | - Edward Y. M. Lau
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
| | - Abdulmalik Koya
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
| | - Zakariyya Vali
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
| | - Safiyyah A. Suleman
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
| | - James Donaldson
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
| | - G. André Ng
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK; (A.A.); (M.E.); (I.A.); (E.Y.M.L.); (A.K.); (Z.V.); (S.A.S.); (J.D.)
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
- NIHR Leicester Cardiovascular Biomedical Research Centre, Leicester LE3 9QP, UK
- Leicester British Heart Foundation Centre of Research Excellence, Leicester LE3 9QP, UK
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Lee J, Brower AJ, Roukoz H, Tolkacheva EG. Complexity AF score as a novel marker of atrial fibrillation instability. Sci Rep 2024; 14:27833. [PMID: 39537673 PMCID: PMC11561269 DOI: 10.1038/s41598-024-76611-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 10/14/2024] [Indexed: 11/16/2024] Open
Abstract
Atrial fibrillation (AF) is a heart disease affecting millions of Americans. Clinicians evaluate AF-related risk by assessing the temporal pattern, variation, and severity of AF episodes through AF burden (AFB). However, existing prognostic tools based on these metrics are suboptimal, as they do not account for electrical complexity of AF signals. This study introduced Electrical Burden (EB) as a new marker to assess electrical instability and complexity of AF. We also developed a Complexity AF score that incorporates AFB, EB, and Poincaré analysis to assess the severity of AF. Electrocardiogram (ECG) from 50 AF patients in the Long-term AF database were analyzed. EB was calculated using four metrics and combined with AFB and Poincaré metrics to derive the Complexity AF score for each patient. Our results show that AFB, EB, and Poincaré metrics are independent markers, each describing different aspects of AF complexity. The Complexity AF score effectively distinguished between terminated (2.82 ± 1.29, 17 patients) and non-terminated AF groups (4 ± 1.46, 33 patients) (p-value < 0.05). This study emphasizes the importance of EB and Poincaré analysis as an indicator of electrical complexity of AF and highlights the utility of the Complexity AF score in accurately characterizing and stratifying AF to guide management.
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Affiliation(s)
- Jieun Lee
- Department of Electrical Engineering, University of Minnesota, Minneapolis, 55455, USA
| | - Autumn J Brower
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, 55455, USA
| | - Henri Roukoz
- Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, 55455, USA
| | - Elena G Tolkacheva
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, 55455, USA.
- Institute for Engineering in Medicine, University of Minnesota, Minneapolis, 55455, USA.
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Gomez SE, Larson J, Hlatky MA, Rodriguez F, Wheeler M, Greenland P, LaMonte M, Froelicher V, Stefanick ML, Wallace R, Kooperberg C, Tinker LF, Schoenberg J, Soliman EZ, Vitolins MZ, Saquib N, Nuño T, Haring B, Perez MV. Prevalence of frequent premature ventricular contractions and nonsustained ventricular tachycardia in older women screened for atrial fibrillation in the Women's Health Initiative. Heart Rhythm 2024; 21:1280-1288. [PMID: 38403238 PMCID: PMC11338634 DOI: 10.1016/j.hrthm.2024.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Frequent premature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) have been associated with cardiovascular disease and mortality. Their prevalence, especially in ambulatory populations, is understudied and limited by few female participants and the use of short-duration (24- to 48-hour) monitoring. OBJECTIVE The objective of this study was to report the prevalence of frequent PVCs and NSVT in a community-based population of women likely to undergo electrocardiogram (ECG) screening by sequential patch monitoring. METHODS Participants from the Women's Health Initiative Strong and Healthy (WHISH) trial with no history of atrial fibrillation (AF) but 5-year predicted risk of incident AF ≥5% by CHARGE-AF score were randomly selected to undergo screening with 7-day ECG patch monitors at baseline, 6 months, and 12 months. Recordings were reviewed for PVCs and NSVT (>5 beats); data were analyzed with multivariate regression models. RESULTS There were 1067 participants who underwent ECG screening at baseline, 866 at 6 months, and 777 at 12 months. Frequent PVCs were found on at least 1 patch from 4.3% of participants, and 1 or more episodes of NSVT were found in 12 (1.1%) women. PVC frequency directly correlated with CHARGE-AF score and NSVT on any patch. Detection of frequent PVCs increased with sequential monitoring. CONCLUSION In postmenopausal women at high risk for AF, frequent PVCs were relatively common (4.3%) and correlated with higher CHARGE-AF score. As strategies for AF screening continue to evolve, particularly in those individuals at high risk of AF, the prevalence of incidental ventricular arrhythmias is an important benchmark to guide clinical decision-making.
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Affiliation(s)
- Sofia E Gomez
- Department of Medicine, Stanford University School of Medicine, Stanford, California.
| | | | - Mark A Hlatky
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Fatima Rodriguez
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Matthew Wheeler
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Michael LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - Victor Froelicher
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Marcia L Stefanick
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Robert Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | | | | | | | - Elsayed Z Soliman
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Nazmus Saquib
- Department of Epidemiology, Sulaiman Alrajhi University, Al Bukayriyah, Saudi Arabia
| | - Tomas Nuño
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Bernhard Haring
- Department of Internal Medicine, University of Würzburg, Würzburg, Germany
| | - Marco V Perez
- Department of Medicine, Stanford University School of Medicine, Stanford, California
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Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, Deswal A, Eckhardt LL, Goldberger ZD, Gopinathannair R, Gorenek B, Hess PL, Hlatky M, Hogan G, Ibeh C, Indik JH, Kido K, Kusumoto F, Link MS, Linta KT, Marcus GM, McCarthy PM, Patel N, Patton KK, Perez MV, Piccini JP, Russo AM, Sanders P, Streur MM, Thomas KL, Times S, Tisdale JE, Valente AM, Van Wagoner DR. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2024; 149:e1-e156. [PMID: 38033089 PMCID: PMC11095842 DOI: 10.1161/cir.0000000000001193] [Citation(s) in RCA: 837] [Impact Index Per Article: 837.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
AIM The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.
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Affiliation(s)
| | | | | | | | | | | | - Anita Deswal
- ACC/AHA Joint Committee on Clinical Practice Guidelines liaison
| | | | | | | | | | - Paul L Hess
- ACC/AHA Joint Committee on Performance Measures liaison
| | | | | | | | | | - Kazuhiko Kido
- American College of Clinical Pharmacy representative
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