Wearable Devices in Cardiovascular Medicine

Abstract

Wearable devices, such as smartwatches and activity trackers, are commonly used by patients in their everyday lives to manage their health and well-being. These devices collect and analyze long-term continuous data on measures of behavioral or physiologic function, which may provide clinicians with a more comprehensive view of a patients’ health compared with the traditional sporadic measures captured by office visits and hospitalizations. Wearable devices have a wide range of potential clinical applications ranging from arrhythmia screening of high-risk individuals to remote management of chronic conditions such as heart failure or peripheral artery disease. As the use of wearable devices continues to grow, we must adopt a multifaceted approach with collaboration among all key stakeholders to effectively and safely integrate these technologies into routine clinical practice. In this Review, we summarize the features of wearable devices and associated machine learning techniques. We describe key research studies that illustrate the role of wearable devices in the screening and management of cardiovascular conditions and identify directions for future research. Last, we highlight the challenges that are currently hindering the widespread use of wearable devices in cardiovascular medicine and provide short- and long-term solutions to promote increased use of wearable devices in clinical care.

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“…This subset of participants was then monitored by doctors, and 34% were found to have atrial fibrillation-a leading cause of stroke (Perez et al 2019). A recent review of wearable devices shows evidence that their use reduces rehospitalization after home rehabilitation, improves glycemic control, and reduces readmission for heart failure management (Hughes et al 2023).…”

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“…141 Given the importance of quantifying PH patients' functional limitations, accelerometry may yield complementary or surrogate information for 6MWD. 35,141 A recent decision by the FDA to accept accelerometry as a primary endpoint for a phase 3 clinical trial shows that accelerometry has the potential to become a common endpoint for PH clinical trials. 142,143 Similarly, implantable devices may provide valuable RWD to advance the understanding and care of patients with PH.…”

“…A recent review describes (1) wearable devices and associated machine learning (ML) techniques, (2) research studies that have investigated the role of wearable devices in the early detection and treatment of cardiovascular conditions (e.g., atrial fibrillation or heart failure), and (3) some of the challenges and opportunities related to the use of PGHD from wearable devices. 35 Although noninvasive biometrics generate a wealth of data, the use of these data remains limited by several concerns. For example, the tendency of individuals to modify their behavior when they are being observed (the Hawthorne effect) may limit the value of biometric data collected from wearables and other readily visible sources.…”

“…These personal wearables capture important biometric data, including heart rate, ECG, oxygen saturation, sleep quality, and step count/activity, which may provide a more comprehensive picture of patients than episodic measurements made in clinics and hospitals. A recent review describes (1) wearable devices and associated machine learning (ML) techniques, (2) research studies that have investigated the role of wearable devices in the early detection and treatment of cardiovascular conditions (e.g., atrial fibrillation or heart failure), and (3) some of the challenges and opportunities related to the use of PGHD from wearable devices 35 …”

“…In a recent study of pediatric patients with PAH, Zijlstra et al found that physical activity, as assessed by accelerometers, correlated with indices of disease severity (including 6MWD) and predicted clinical deterioration 141 . Given the importance of quantifying PH patients' functional limitations, accelerometry may yield complementary or surrogate information for 6MWD 35,141 . A recent decision by the FDA to accept accelerometry as a primary endpoint for a phase 3 clinical trial shows that accelerometry has the potential to become a common endpoint for PH clinical trials 142,143 …”