This is a randomized controlled trial evaluating atrial fibrillation (AF) detection through smartwatch-based screening in high-risk patients using an Apple Watch with integrated PPG and ECG functions.
This is a multicenter randomized controlled trial evaluating whether six months of heart rate and rhythm monitoring with a smartwatch (Apple Watch Series 5 or 8) equipped with photoplethysmography (PPG) and ECG functions increases atrial fibrillation (AF) detection in high-risk cardiac patients (age ≥65, CHA₂DS₂-VASc ≥2 for men, ≥3 for women) without previously known AF. Patients are randomized to either smartwatch-based monitoring or standard care. Participants in the intervention group receive an Apple Watch paired with a smartphone app and are instructed to wear the device for at least 12 hours per day. Continuous rhythm monitoring is performed using PPG, with ECGs recorded upon symptom onset or irregular rhythm detection. ECG data are transmitted via the app to a secure platform and reviewed within 24 hours by an independent eHealth team supervised by a cardiologist. Patients and their treating physicians are notified upon new AF diagnoses. To evaluate the primary endpoint, a total of 218 patients per arm were required according to the sample size calculation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
436
Smartwatch for detecting atrial fibrillation using photoplethysmography (PPG)
Cardiology Center of the Netherlands
Amsterdam, North Holland, Netherlands
Spaarne Gasthuis
Haarlem, North Holland, Netherlands
The incidence of atrial fibrillation
Detected with an Apple watch or with any other device such as a holter or on an ECG or telemetry
Time frame: 6 months
The time until atrial fibrillation is first detected (days)
The number of days between the date of inclusion and the date AF is detected
Time frame: 6 months
The number of patients for whom medication for AF is initiated at the end of the study (anticoagulation and antiarrhythmic drugs)
Time frame: 6 months
The number of patients that undergo major cardiovascular events during the study period
Time frame: 6 months
Number of emergency department visits
Emergency department visits that take place during the study period, for any reason
Time frame: 6 months
The number of new arrhythmia diagnoses other than AF in each study arm
Detected by either the Apple watch, telemetry, holter or other devices used to detect arrhythmias
Time frame: 6 months
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