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Accepted for/Published in: JMIR Cardio

Date Submitted: Jan 30, 2020
Date Accepted: Dec 15, 2020

The final, peer-reviewed published version of this preprint can be found here:

Heart Rate Measurements in Patients with Obstructive Sleep Apnea and Atrial Fibrillation: Prospective Pilot Study Assessing Apple Watch’s Agreement With Telemetry Data

Huynh P, Shan R, Osuji N, Ding J, Isakadze N, Marvel FA, Sharma G, Martin SS

Heart Rate Measurements in Patients with Obstructive Sleep Apnea and Atrial Fibrillation: Prospective Pilot Study Assessing Apple Watch’s Agreement With Telemetry Data

JMIR Cardio 2021;5(1):e18050

DOI: 10.2196/18050

PMID: 33555260

PMCID: 8411424

Accuracy of Apple Watch Heart Rate Measurements in Patients with Obstructive Sleep Apnea and Atrial Fibrillation

  • Pauline Huynh; 
  • Rongzi Shan; 
  • Ngozi Osuji; 
  • Jie Ding; 
  • Nino Isakadze; 
  • Francoise A. Marvel; 
  • Garima Sharma; 
  • Seth S. Martin

ABSTRACT

Background:

Patients with obstructive sleep apnea (OSA) are at higher risk for atrial fibrillation (AF). Consumer wearable heart rate (HR) sensors may be a means for passive HR monitoring in patients with AF.

Objective:

To assess the Apple Watch’s agreement with telemetry in measuring HR in patients with OSA in AF.

Methods:

Patients with OSA in AF were prospectively recruited prior to cardioversion/ablation procedures. HR was sampled every 10 seconds for 60 seconds using telemetry and an Apple Watch concomitantly. Agreement between devices was assessed using modified Bland-Altman analysis accounting for repeated measures per patient, mixed-effects regression modeling with the patient as a random effect while controlling for rapid ventricular response, and Lin's concordance correlation coefficient.

Results:

20 patients (mean 66 +/- 6.5 years, 85% male, 3 (15%) with RVR) participated in this study, yielding 134 HR observations per device. The Apple Watch had 95% of differences fall within 18.5 beats per minute (bpm) above and 18.3 bpm below telemetry measurements, with a mean bias of 0.26 bpm. After controlling for RVR, 95% of differences fell between -14.3 and 14.5 bpm with a mean bias of 0.23 bpm. Lin’s concordance correlation coefficient was 0.88 (95% CI 0.85-0.91), suggesting acceptable agreement between the Apple Watch and telemetry.

Conclusions:

In OSA patients in AF, the Apple Watch provided acceptable agreement with HR measurements by telemetry. Further studies with larger sample populations and wider range of HR are needed to confirm these findings.


 Citation

Please cite as:

Huynh P, Shan R, Osuji N, Ding J, Isakadze N, Marvel FA, Sharma G, Martin SS

Heart Rate Measurements in Patients with Obstructive Sleep Apnea and Atrial Fibrillation: Prospective Pilot Study Assessing Apple Watch’s Agreement With Telemetry Data

JMIR Cardio 2021;5(1):e18050

DOI: 10.2196/18050

PMID: 33555260

PMCID: 8411424

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