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Title: Accuracy of wrist-worn heart rate monitors for rate control assessment in atrial fibrillation.
Austin Authors: Al-Kaisey, Ahmed M;Koshy, Anoop N ;Ha, Francis J;Spencer, Ryan;Toner, Liam ;Sajeev, Jithin K;Teh, Andrew W ;Farouque, Omar ;Lim, Han S 
Affiliation: Department of Cardiology, Eastern Health, Boxhill, Victoria, Australia
University of Melbourne, Melbourne, Australia
Eastern Health Clinical School, Monash University, Victoria, Australia
Issue Date: Feb-2020
Date: 2019-11-18
Publication information: International Journal of Cardiology 2020; 300: 161-164
Abstract: Wrist-worn heart rate (HR) monitors are increasingly popular. A paucity of data exists on their accuracy in atrial fibrillation (AF) in ambulatory patients. We sought to assess the HR accuracy of two commercially available smart watches [SW] (Fitbit Charge HR [FB] and Apple Watch Series 3 [AW]) compared with Holter monitoring in an ambulant patient cohort. Thirty-two participants ≥18 years referred for 24-hour Holter monitoring were prospectively recruited. Each participant was randomly allocated to wear either a FB or AW along with their Holter monitor. Across all devices, 53,288 heart rate values were analysed from 32 participants. Twenty wore the AW (17 had persistent AF and 3 had sinus rhythm [SR]) while 12 participants wore the FB (9 in persistent AF and 3 in SR). Participants in SR demonstrated strong agreement compared to Holter monitoring (bias <1 beat, limits of agreement [LoA] -11 to 11 beats). In AF, both devices underestimated HR measurements (bias -9 beats, LoA -41 to 23). The degree of underestimation was more pronounced when HR > 100 bpm (bias of -28 beats for HR range 100-120 bpm, -48 for 120-140 bpm, and -69 for >140 bpm) compared to a slower HR (bias of -6 for HR range 80-100 bpm, <1 for 60-80 bpm, and -1 for <60 bpm). In ambulatory patients, smartwatches underestimated HR in AF particularly at HR ranges >100 bpm. Further improvements in device technology are needed before integrating them into the clinical management of rate control in AF.
DOI: 10.1016/j.ijcard.2019.11.120
ORCID: 0000-0002-8741-8631
Journal: International Journal of Cardiology
PubMed URL: 31787389
Type: Journal Article
Subjects: Accuracy
Atrial fibrillation
Heart rate
Smart watch
Appears in Collections:Journal articles

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