Open AccessRole of wearable rhythm recordings in clinical decision making—The wEHRAbles project
Author(s) -
Manninger Martin,
Kosiuk Jedrzej,
Zweiker David,
Njeim Mario,
Antolic Bor,
Kircanski Bratislav,
Larsen Jacob M.,
Svennberg Emma,
Vanduynhoven Philippe,
Duncker David
Publication year - 2020
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23404
Subject(s) - medicine , asymptomatic , atrial fibrillation , photoplethysmogram , wearable technology , wearable computer , rhythm , supraventricular tachycardia , physical medicine and rehabilitation , physical therapy , cardiology , tachycardia , filter (signal processing) , computer science , computer vision , embedded system
Background Multiple wearable devices for rhythm analysis have been developed using either photoplethysmography (PPG) or handheld ECG. Hypothesis The aim of this survey was to assess impact of these technologies on physicians' clinical decision‐making regarding initiation of diagnostic steps, drug therapy, and invasive strategies. Methods The online survey included 10 questions on types of devices, advantages, and disadvantages of wearable devices as well as case scenarios for patients with supraventricular arrhythmias and atrial fibrillation (AF). Results A total of 417 physicians (median age 37 [IQR 32‐43] years) from 42 countries world‐wide completed the survey. When presented a tracing of a regular tachycardia by a symptomatic patient, most participants would trigger further diagnostic steps (90% for single‐lead ECG vs 83% for PPG, P < .001), while a single‐lead ECG would be sufficient to perform an invasive EP study in approximately half of participants (51% vs 22% for PPG, P < .001). When presented with a single‐lead ECG tracing suggesting AF, most participants (90%) would trigger further diagnostic steps. A symptomatic AF patient would trigger anticoagulation treatment to a higher extent as an asymptomatic patient (59% vs 21%, P < .001). PPG tracings would only rarely lead to therapeutic steps regardless of symptoms. Most participants would like scientific society recommendations on the use of wearable devices (62%). Conclusions Tracings from wearable rhythm devices suggestive of arrhythmias are most likely to trigger further diagnostic steps, and in the case of PPG recordings rarely therapeutic interventions. A majority of participants expect these devices to facilitate diagnostics and arrhythmia screening but fear data overload and expect scientific society recommendations on the use of wearables.