BACKGROUND AND PURPOSE:

• Wearable devices and smartwatches (wearables), such as the Apple Watch and AliveCor Kardia Band (both cleared by the FDA), allow individuals with atrial fibrillation (AF) to monitor their heart rate and detect arrhythmias using single lead ECG technology       
• Wang et al. (JAMA Network Open, 2021) characterized patients with AF who use wearables to determine health care use

METHODS:

• Retrospective, cohort study
• Participants
  • ≥1 AF-specific ICD-10 code from 2017 through 2019
• Exposure
  • Use of commercially available wearables with pulse rate or rhythm evaluation capabilities
• Study design
  • Electronic medical records were used to identify individuals who used wearables and had adequate pulse-rate follow-up
  • These individuals were propensity-matched (4 to 1) to individuals who did not use wearables
• Primary outcome
  • Mean pulse rates
  • Composite health care use score: Evaluation and management | Ablation | Cardioversion | Telephone encounters | Number of rate or rhythm control medication orders

RESULTS:

• 348 wearables users | 15,972 non-users
  • Apple most common, followed by Fitbit and Kardia
• Wearables users were younger (P<0.001)
  • Mean (SD) age users: 64.0 (13.0) years vs non-users 70.0 (13.8) years
• Users were also healthier (P<0.001)
  • Mean (SD) CHA2DS2-VASc score: 3.6 (2.0) vs 4.4 (2.0)
• There was no gender bias (P=0.91)
  • 42.5% women vs 42.1% women
• After matching, mean pulse rate was similar between 125 patients using wearables vs 500 patients not using wearables (P=0.04)
  • Users: 75.01 (95% CI, 72.74 to 77.27) bpm
  • Non-users: 75.79 (95% CI, 74.68 to 76.90) bpm
• There was a significant difference in use of ablation, occurring in more individuals who used wearables (P=0.001)
  • Users: 17.6%
  • Non-Users: 7.4%
• Mean composite use score was 0.28 points (95% CI, 0.01 to 0.56) higher among individuals using wearables
• Mean pulse was similar between the groups
  • Difference −0.79 bpm (95% CI, −3.28 to 1.71)

CONCLUSION:

• Individuals with AF who use wearable devices or smartwatches had more follow-up health care use than non-users with similar pulse rates
• The authors state

This study’s finding suggests that wearable use among patients with AF is associated with increased health care use and support the need for randomized clinical trials to measure the impact of wearables on health outcomes and use among patients with AF

Learn More – Primary Sources:

Association of Wearable Device Use With Pulse Rate and Health Care Use in Adults With Atrial Fibrillation

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