Role of wearable rhythm recordings in clinical decision making—The wEHRAbles project
Open accessAbstract
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.
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It is most likely that, when used in clinical practice, PPG-based devices could prompt ECG-based assessment when possible AF is detected, rather than being used for decision making on their own.
“It is most likely that, when used in clinical practice, PPG-based devices could prompt ECG-based assessment when possible AF is detected, rather than being used for decision making on their own”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [202]
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How to use digital devices to detect and manage arrhythmias: an EHRA practical guide
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Self-citationWearable Photoplethysmography for Cardiovascular Monitoring
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Self-citationJensen, M. T., Treskes, R. W., Caiani, E. G., Casado-Arroyo, R., Cowie, M. R., Dilaveris, P., Duncker, D., Di Rienzo, M., Frederix, I., De Groot, N., et al. (2021) · European Heart Journal - Digital Health · doi:10.1093/ehjdh/ztab011 · Cited by 93 · see citing works
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- Authors
- Manninger, M., Kosiuk, J., Zweiker, D., Njeim, M., Antolic, B., Kircanski, B., Larsen, J. M., Svennberg, E., Vanduynhoven, P., & Duncker, D.
- Affiliations
- Medical University of Graz (AT)
- Helios Clinic Koethen Germany
- Saint Joseph University (LB)
- University Medical Centre Ljubljana Department of Cardiology Ljubljana Slovenia
- Clinical Centre of Serbia Pacemaker Centre Belgrade Serbia
- Aalborg University Hospital (DK)
- Karolinska University Hospital (SE)
- Onze Lieve Vrouwziekenhuis Hospital (BE)
- Medizinische Hochschule Hannover (DE)
- Corresponding author
- Duncker, David
- ORCID
- Venue
- Clinical Cardiology
- Publisher
- Wiley
- Published
- 2020-07-22
- Volume
- 43
- Issue
- 9
- Pages
- 1032-1039
- ISSN
- 0160-9289 (ISSN-L)
- 1932-8737
- PMC
- PMC7462183
- OpenAlex
- W3044085570
- Cited by
- 50
- References
- 16
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 15 · 2020: 3
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Cardiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion, cc-by)
- Funders
- Deutsche Forschungsgemeinschaft (Open Access Publication Fund)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- wearable devices, photoplethysmography, clinical decision-making, supraventricular arrhythmias, atrial fibrillation, arrhythmia screening, anticoagulation, invasive electrophysiology, physician perceptions, data overload
- MeSH terms
- Clinical Decision-Making, Wearable Electronic Devices, Action Potentials, Adult, Atrial Fibrillation, Electrocardiography, Heart Conduction System, Heart Rate, Humans, Predictive Value of Tests, Prognosis, Tachycardia, Supraventricular, Reproducibility of Results, Photoplethysmography, Health Care Surveys
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