2021 ISHNE/HRS/EHRA/APHRS Expert Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society

Varma, Niraj; Cygankiewicz, Iwona; Turakhia, Mintu P.; Heidbüchel, Hein; Hu, Yu Feng; Chen, Lin Y.; Couderc, Jean Philippe; Cronin, Edmond M.; Estep, Jerry D.; Grieten, Lars; Lane, Deirdre A.; Mehra, Reena; Page, Alex; Passman, Rod; Piccini, Jonathan P.; Piotrowicz, Ewa; Piotrowicz, Ryszard; Platonov, Pyotr G.; Ribeiro, Antônio Luiz Pinho; Rich, Robert E.; Russo, Andrea M.; Slotwiner, David J.; Steinberg, Jonathan S.; Svennberg, Emma

doi:10.1161/circep.120.009204

Cited by 63 publications

(43 citation statements)

References 407 publications

(157 reference statements)

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“…The increased use of telehealth and telemonitoring during the COVID-19 pandemic has increased the salience of personal digital device data in clinical decision-making, highlighting how these devices could inform postprocedural follow-up in the absence of in-person clinical encounters. 26 , 27 , 28 For example, patients who are detected to be in sinus rhythm by a mobile ECG device, whose activity levels remain stable based on step count recorded by a personal digital device, and who report a lack of symptoms on PROMs may be able to avoid in-person follow-up after AF ablation. Similarly, the increasing emphasis on same-day discharge for procedures for which patients were generally hospitalized in the past could lead to the need for greater home monitoring through personal digital devices and PROMs.…”

Section: Discussionmentioning

confidence: 99%

Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices

Bartlett

Ross

Shah

et al. 2021

Cardiovascular Digital Health Journal

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices

Bartlett

Ross

Shah

et al. 2021

Cardiovascular Digital Health Journal

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“…Accelerated by the Covid-19 pandemic ( 4 ) new wearable technologies have the potential to expand the availability of medical care ( 5 , 6 ), reduce health inequities in remote areas ( 7 ) and integrate into the workflow of dedicated AF teams ( 8 ). However, clinicians need to assess the cost-effectiveness, regulatory approval, specific clinical applications, patient expectations, data logistics and other issues of each mobile health (mHealth) tool ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

High Specificity Wearable Device With Photoplethysmography and Six-Lead Electrocardiography for Atrial Fibrillation Detection Challenged by Frequent Premature Contractions: DoubleCheck-AF

Bacevicius

Abramikas

Dvinelis

et al. 2022

Front. Cardiovasc. Med.

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BackgroundConsumer smartwatches have gained attention as mobile health (mHealth) tools able to detect atrial fibrillation (AF) using photoplethysmography (PPG) or a short strip of electrocardiogram (ECG). PPG has limited accuracy due to the movement artifacts, whereas ECG cannot be used continuously, is usually displayed as a single-lead signal and is limited in asymptomatic cases.ObjectiveDoubleCheck-AF is a validation study of a wrist-worn device dedicated to providing both continuous PPG-based rhythm monitoring and instant 6-lead ECG with no wires. We evaluated its ability to differentiate between AF and sinus rhythm (SR) with particular emphasis on the challenge of frequent premature beats.Methods and ResultsWe performed a prospective, non-randomized study of 344 participants including 121 patients in AF. To challenge the specificity of the device two control groups were selected: 95 patients in stable SR and 128 patients in SR with frequent premature ventricular or atrial contractions (PVCs/PACs). All ECG tracings were labeled by two independent diagnosis-blinded cardiologists as “AF,” “SR” or “Cannot be concluded.” In case of disagreement, a third cardiologist was consulted. A simultaneously recorded ECG of Holter monitor served as a reference. It revealed a high burden of ectopy in the corresponding control group: 6.2 PVCs/PACs per minute, bigeminy/trigeminy episodes in 24.2% (31/128) and runs of ≥3 beats in 9.4% (12/128) of patients. AF detection with PPG-based algorithm, ECG of the wearable and combination of both yielded sensitivity and specificity of 94.2 and 96.9%; 99.2 and 99.1%; 94.2 and 99.6%, respectively. All seven false-positive PPG-based cases were from the frequent PVCs/PACs group compared to none from the stable SR group (P < 0.001). In the majority of these cases (6/7) cardiologists were able to correct the diagnosis to SR with the help of the ECG of the device (P = 0.012).ConclusionsThis is the first wearable combining PPG-based AF detection algorithm for screening of AF together with an instant 6-lead ECG with no wires for manual rhythm confirmation. The system maintained high specificity despite a remarkable amount of frequent single or multiple premature contractions.

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“…Currently, there is a growing demand on the part of patients and healthcare workers for remote monitoring systems that use digital technologies to collect medical data from individuals, thus eliminating the need to visit a medical facility in person. 1 , 2 …”

mentioning

confidence: 99%

Practical Utility of the Postal Service in Delivering a Self-Fitted, Wearable, Long-Term Electrocardiogram Monitoring Device for Outpatient Care

et al. 2021

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Background: Demand is growing for remote electrocardiogram (ECG) monitoring systems in the COVID-19 era in Japan. This study describes initial experiences with a small wireless ECG monitoring device and the utility of delivery via the postal service for outpatient care in Japan. Methods and Results:Long-term ECG monitoring following postal delivery of the small ECG device was evaluated in 25 patients. The patients had no difficulties with either the postal delivery or self-fitting and wearing the devices. A median of 57 h monitoring per patient was performed. Arrhythmic events were detected in 8 patients. Most patients were satisfied with both the ECG devices and postal delivery. Conclusions:Postal delivery of ECG devices could be used in clinical practice to achieve less or no in-person contact during the COVID-19 era.

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Cited by 63 publications

References 407 publications

Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices

Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices

High Specificity Wearable Device With Photoplethysmography and Six-Lead Electrocardiography for Atrial Fibrillation Detection Challenged by Frequent Premature Contractions: DoubleCheck-AF

Practical Utility of the Postal Service in Delivering a Self-Fitted, Wearable, Long-Term Electrocardiogram Monitoring Device for Outpatient Care

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