Sylvain Ploux1, Marc Strik2, Théo Caillol1, F Daniel Ramirez1, Saer Abu-Alrub1, Hugo Marchand1, Samuel Buliard1, Michel Haïssaguerre1, Pierre Bordachar1. 1. Cardiothoracic unit, Bordeaux university hospital, CHU, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux université, 33600 Pessac, France. 2. Cardiothoracic unit, Bordeaux university hospital, CHU, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux université, 33600 Pessac, France. Electronic address: marcstrik@gmail.com.
Abstract
BACKGROUND: When worn on the wrist, smartwatch electrocardiograms may provide important but incomplete information. AIMS: We sought to evaluate the added benefit of placing the smartwatch on the ankle and on the chest to diagnose various electrocardiographic abnormalities compared with 12-lead electrocardiograms. METHODS: Two hundred and sixty patients with (n=189) or without (n=71) known cardiac disorders underwent 12-lead electrocardiogram and smartwatch electrocardiogram recordings of lead I (AW-I) and of leads I and II and pseudo chest leads V1 and V6 (AW-4). AW-I and AW-4 diagnoses (three-cardiologist consensus) were compared with 12-lead electrocardiogram diagnoses (three-cardiologist consensus) to calculate sensitivity and specificity. RESULTS: AW-I showed high accuracy for the diagnoses of atrial fibrillation (96% sensitivity, 91% specificity) and complete bundle branch block (85% sensitivity, 98% specificity). Compared with AW-I, AW-4 improved detection of an abnormal 12-lead electrocardiogram (91% vs. 80% sensitivity; P<0.01), atrial flutter/tachycardia (69% vs. 25% sensitivity; P=0.04), T-wave abnormalities (77% vs. 34% sensitivity; P<0.01), pathological Q-waves (41% vs. 7% sensitivity; P<0.01) and left anterior hemiblock (70% vs. 0% sensitivity; P=0.02). AW-4 also enabled better differentiation between atrioventricular block and sinus bradycardia (from 81% to 95% correct; P=0.03) and between atrial fibrillation and atrial flutter/tachycardia (from 71% to 89% correct; P=0.02), but not between bundle branch blocks (from 82% to 87% correct; P=0.57). CONCLUSIONS: A smartwatch electrocardiogram on the wrist accurately diagnoses atrial fibrillation and bundle branch block. Recording additional leads significantly improves the accuracy of detecting an abnormal electrocardiogram and repolarization changes, and also allows for better differentiation of brady- and tachyarrhythmias.
BACKGROUND: When worn on the wrist, smartwatch electrocardiograms may provide important but incomplete information. AIMS: We sought to evaluate the added benefit of placing the smartwatch on the ankle and on the chest to diagnose various electrocardiographic abnormalities compared with 12-lead electrocardiograms. METHODS: Two hundred and sixty patients with (n=189) or without (n=71) known cardiac disorders underwent 12-lead electrocardiogram and smartwatch electrocardiogram recordings of lead I (AW-I) and of leads I and II and pseudo chest leads V1 and V6 (AW-4). AW-I and AW-4 diagnoses (three-cardiologist consensus) were compared with 12-lead electrocardiogram diagnoses (three-cardiologist consensus) to calculate sensitivity and specificity. RESULTS: AW-I showed high accuracy for the diagnoses of atrial fibrillation (96% sensitivity, 91% specificity) and complete bundle branch block (85% sensitivity, 98% specificity). Compared with AW-I, AW-4 improved detection of an abnormal 12-lead electrocardiogram (91% vs. 80% sensitivity; P<0.01), atrial flutter/tachycardia (69% vs. 25% sensitivity; P=0.04), T-wave abnormalities (77% vs. 34% sensitivity; P<0.01), pathological Q-waves (41% vs. 7% sensitivity; P<0.01) and left anterior hemiblock (70% vs. 0% sensitivity; P=0.02). AW-4 also enabled better differentiation between atrioventricular block and sinus bradycardia (from 81% to 95% correct; P=0.03) and between atrial fibrillation and atrial flutter/tachycardia (from 71% to 89% correct; P=0.02), but not between bundle branch blocks (from 82% to 87% correct; P=0.57). CONCLUSIONS: A smartwatch electrocardiogram on the wrist accurately diagnoses atrial fibrillation and bundle branch block. Recording additional leads significantly improves the accuracy of detecting an abnormal electrocardiogram and repolarization changes, and also allows for better differentiation of brady- and tachyarrhythmias.
Authors: Saer Abu-Alrub; Marc Strik; F Daniel Ramirez; Nadir Moussaoui; Hugo Pierre Racine; Hugo Marchand; Samuel Buliard; Michel Haïssaguerre; Sylvain Ploux; Pierre Bordachar Journal: Front Cardiovasc Med Date: 2022-02-04