False atrial fibrillation alerts from smartwatches are associated with decreased perceived physical well-being and confidence in chronic symptoms management (3 April 2023)

Summary

Wrist-based wearables in the US have been FDA approved for atrial fibrillation (AF) detection. However, the health behaviour impact of false AF alerts from wearables on older patients at high risk for AF are not known.

Content

In this work, the authors analysed data from the Pulsewatch (NCT03761394) study, which randomised patients with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days.

At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. The authors used linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management.

The authors developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.