Distinguishing atrial fibrillation from sinus rhythm using commercial pulse detection systems: The non-interventional BAYathlon study. (May 2021)

• Record Type: Journal Article
• Authors: Müller, Christian; Hengstmann, Ulf; Fuchs, Michael; Kirchner, Martin; Kleinjung, Frank; Mathis, Harald; Martin, Stephan; Bläse, Ingo; Perings, Stefan
• Is Part Of: Digital health. Volume 7(2021)
• Publication Date: 2021-05
• Subjects: Atrial fibrillation -- electrocardiography -- algorithms -- sensitivity -- observational study -- sinus rhythm; Medical care -- Data processing -- Periodicals; Medical informatics -- Periodicals; 362.10285
• DOI: 10.1177/20552076211019620
• Languages: English
• ISSNs: 2055-2076

Abstract

Objective: Early diagnosis of atrial fibrillation (AFib) is a priority for stroke prevention. We sought to test four commercial pulse detection systems (CPDSs) for ability to distinguish AFib from normal sinus rhythm using a published algorithm (Zhou et al., PLoS One 2015;10:e0136544), compared with visual diagnosis by electrocardiogram inspection. Methods: BAYathlon was a prospective, non-interventional, single-centre study. Adult cardiology patients with documented AFib or sinus rhythm who were due to have a routine 5-min electrocardiogram were randomized to undergo a parallel 5-min pulse assessment with a Polar V800, eMotion Faros 360, TomTom heart rate monitor, or Adidas miCoach Smart Run. Results: 144 patients (73 with AFib, 71 with sinus rhythm (based on electrocardiograms); median age: 73 years; 53.5% male) were analysed. Algorithm sensitivities (primary endpoint) and specificities for AFib when applied to CPDS recordings were 93.3% and 94.1% with the Polar V800, 90.0% and 84.2% with the eMotion Faros 360, and 0% and 100% with the other CPDSs (analysis period: 127 heart rate signals + 2 min). When applied to routine electrocardiograms, the algorithm correctly detected AFib in 71/73 patients. Different analysis periods (127 heart rate signals +1 or 3 min) only slightly changed the sensitivities with the Polar V800 and eMotion Faros 360 and had no effect on the sensitivities with the other CPDSs. Conclusion: AFib screening using the applied algorithm is feasible with the Polar V800 and eMotion Faros 360 (which provide RR interval data) but not with the other CPDSs (which provide pre-processed heart rate time series). ClinicalTrials.gov identifier: NCT02875106