Diagnostic accuracy of an algorithm for detecting atrial fibrillation in a wrist‐type pulse wave monitor

Kabutoya, Tomoyuki; Takahashi, Shinichi; Watanabe, Tomonori; Imai, Yasushi; Uemoto, Kazuhiro; Yasui, Nobuhiko; Kario, Kazuomi

doi:10.1111/jch.13648

Cited by 16 publications

(14 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 93 These devices could also provide data on environmental conditions, and may also be useful for detecting arrhythmias, such as atrial fibrillation. 94 Further research and developments in this area could improve the accessibility and acceptability of HBPM.…”

Section: Digital Management Of Hypertension and New Developmentsmentioning

confidence: 99%

Home Blood Pressure Monitoring: Current Status and New Developments

Kario

2021

American Journal of Hypertension

Self Cite

View full text Add to dashboard Cite

Home blood pressure monitoring (HBPM) is a reliable, convenient and less costly alternative to ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of hypertension. Recognition and use of HBPM has dramatically increased over the last 20 years and current guidelines make strong recommendations for the use of both HBPM and ABPM in patients with hypertension. The accuracy and reliability of home BP measurements requires use of a validated device and standardized procedures, and good patient information and training. Key HBPM parameters include morning BP, evening BP and the morning-evening difference. In addition, newer semi-automatic HBPM devices can also measure nighttime BP at fixed intervals during sleep. Advances in technology mean that HBPM devices could provide additional relevant data (e.g. environmental conditions) or determine BP in response to a specific trigger (e.g. hypoxia, increased heart rate). The value of HBPM is highlighted by a growing body of evidence showing that home BP is an important predictor of target organ damage, and cardiovascular disease- and stroke-related morbidity and mortality, and provides better prognostic information than office BP. In addition, use of HBPM to monitor antihypertensive therapy can help to optimize reductions in BP, improve BP control, and reduce target organ damage and cardiovascular risk. Overall, HBPM should play a central role in the management of patients with hypertension, with the goal of identifying increased risk and predicting the onset of cardiovascular disease events, allowing proactive interventions to reduce risk and eliminate adverse outcomes.

show abstract

Section: Digital Management Of Hypertension and New Developmentsmentioning

confidence: 99%

Home Blood Pressure Monitoring: Current Status and New Developments

Kario

2021

American Journal of Hypertension

Self Cite

View full text Add to dashboard Cite

show abstract

“… 61 , 62 Initial data suggest that wearable technology could also be useful for detecting arrhythmias, such as atrial fibrillation. 114 …”

Section: Potential For Digital Platforms and Artificial Intelligencementioning

confidence: 99%

Management of Hypertension in the Digital Era

Kario

2020

Hypertension

Self Cite

141

View full text Add to dashboard Cite

Out-of-office blood pressure measurement is an essential part of diagnosing and managing hypertension. In the era of advanced digital health information technology, the approach to achieving this is shifting from traditional methods (ambulatory and home blood pressure monitoring) to wearable devices and technology. Wearable blood pressure monitors allow frequent blood pressure measurements (ideally continuous beat-by-beat monitoring of blood pressure) with minimal stress on the patient. It is expected that wearable devices will dramatically change the quality of detection and management of hypertension by increasing the number of measurements in different situations, allowing accurate detection of phenotypes that have a negative impact on cardiovascular prognosis, such as masked hypertension and abnormal blood pressure variability. Frequent blood pressure measurements and the addition of new features such as monitoring of environmental conditions allows interpretation of blood pressure data in the context of daily stressors and different situations. This new digital approach to hypertension contributes to anticipation medicine, which refers to strategies designed to identify increasing risk and predict the onset of cardiovascular events based on a series of data collected over time, allowing proactive interventions to reduce risk. To achieve this, further research and validation is required to develop wearable blood pressure monitoring devices that provide the same accuracy as current approaches and can effectively contribute to personalized medicine.

show abstract

“…The radial artery pulse wave is an important signal in health monitoring and disease diagnosis, which contains abundant physiological information. Different from the ECG signal which is often used to detect all kinds of arrhythmias [1], the radial artery pulse wave not only contains the information of heart rate and its variability which is widely used in smart watches and other wearable devices [2][3][4] but also can assist conventional methods to diagnose and monitor the occurrence and development of multiple common dis-eases such as hypertension, diabetes, and coronary heart disease [5][6][7][8][9][10]. In addition, the acquisition of radial artery pulse wave is much more convenient than ECG.…”

Section: Introductionmentioning

confidence: 99%

A New Measure of Pulse Rate Variability and Detection of Atrial Fibrillation Based on Improved Time Synchronous Averaging

Ding

Wang

Hao

et al. 2021

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Background. Pulse rate variability monitoring and atrial fibrillation detection algorithms have been widely used in wearable devices, but the accuracies of these algorithms are restricted by the signal quality of pulse wave. Time synchronous averaging is a powerful noise reduction method for periodic and approximately periodic signals. It is usually used to extract single-period pulse waveforms, but has nothing to do with pulse rate variability monitoring and atrial fibrillation detection traditionally. If this method is improved properly, it may provide a new way to measure pulse rate variability and to detect atrial fibrillation, which may have some potential advantages under the condition of poor signal quality. Objective. The objective of this paper was to develop a new measure of pulse rate variability by improving existing time synchronous averaging and to detect atrial fibrillation by the new measure of pulse rate variability. Methods. During time synchronous averaging, two adjacent periods were regarded as the basic unit to calculate the average signal, and the difference between waveforms of the two adjacent periods was the new measure of pulse rate variability. 3 types of distance measures (Euclidean distance, Manhattan distance, and cosine distance) were tested to measure this difference on a simulated training set with a capacity of 1000. The distance measure, which can accurately distinguish regular pulse rate and irregular pulse rate, was used to detect atrial fibrillation on the testing set with a capacity of 62 (11 with atrial fibrillation, 8 with premature contraction, and 43 with sinus rhythm). The receiver operating characteristic curve was used to evaluate the performance of the indexes. Results. The Euclidean distance between waveforms of the two adjacent periods performs best on the training set. On the testing set, the Euclidean distance in atrial fibrillation group is significantly higher than that of the other two groups. The area under receiver operating characteristic curve to identify atrial fibrillation was 0.998. With the threshold of 2.1, the accuracy, sensitivity, and specificity were 98.39%, 100%, and 98.04%, respectively. This new index can detect atrial fibrillation from pulse wave signal. Conclusion. This algorithm not only provides a new perspective to detect AF but also accomplishes the monitoring of PRV and the extraction of single-period pulse wave through the same technical route, which may promote the popularization and application of pulse wave.

show abstract

Diagnostic accuracy of an algorithm for detecting atrial fibrillation in a wrist‐type pulse wave monitor

Cited by 16 publications

References 30 publications

Home Blood Pressure Monitoring: Current Status and New Developments

Home Blood Pressure Monitoring: Current Status and New Developments

Management of Hypertension in the Digital Era

A New Measure of Pulse Rate Variability and Detection of Atrial Fibrillation Based on Improved Time Synchronous Averaging

Contact Info

Product

Resources

About