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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
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Feb-2020 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
PubMed URL: 31787389
Type: Journal Article
Subjects: Accuracy
Atrial fibrillation
Heart rate
Smart watch
Appears in Collections:Journal articles

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