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Cited by 495Non-Invasive Vital Sign MonitoringAtrial Fibrillation Management and OutcomesMobile Health and mHealth Applications

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

Mobile Photoplethysmographic Technology to Detect Atrial Fibrillation

Open access
Guo, Yutao, Wang, Hao, Zhang, Hui, Liu, Tong, Liang, Zhaoguang, Xia, Yunlong, Yan, Li, Xing, Yunli, Shi, Haili, Li, Shuyan, Liu, Yanxia, Liu, Fan, Feng, Mei, Chen, Yundai, Lip, Gregory Y.H., Guo, Yutao, Lip, Gregory Y.H., Lane, Deirdre A., Chen, Yundai, Wang, Liming, Eckstein, Jens, Thomas, G Neil, Tong, Liu, Mei, Feng, Xuejun, Liu, Xiaoming, Li, Zhaoliang, Shan, Xiangming, Shi, Wei, Zhang, Yunli, Xing, Jing, Wen, Fan, Wu, Sitong, Yang, Xiaoqing, Jin, Bo, Yang, Xiaojuan, Bai, Yuting, Jiang, Yangxia, Liu, Yingying, Song, Zhongju, Tan, Li, Yang, Tianzhu, Luan, Chunfeng, Niu, Lili, Zhang, Shuyan, Li, Zulu, Wang, Bing, Xv, Liming, Liu, Yuanzhe, Jin, Yunlong, Xia, Xiaohong, Chen, Fang, Wu, Lina, Zhong, yihong, Sun, shujie, Jia, Jing, Li, Nan, Li, shijun, Li, huixia, Liu, Rong, Li, Fan, Liu, qingfeng, Ge, tianyun, Guan, Yuan, Wen, Xin, Li, Yan, Ren, xiaoping, Chen, ronghua, Chen, Yun, Shi, yulan, Zhao, haili, Shi, yujie, Zhao, quanchun, Wang, weidong, Sun, Lin, Wei, Chan, Esther, Guangliang, Shan, Chen, Yao, Wei, Zong, Dandi, Chen, Xiang, Han, Anding, Xu, Xiaohan, Fan, Ziqiang, Yu, Xiang, Gu, Fulin, Ge·2019·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2019.08.019
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Abstract

Background Low detection and nonadherence are major problems in current management approaches for patients with suspected atrial fibrillation (AF). Mobile health devices may enable earlier AF detection and improved AF management.Objectives This study sought to investigate the effectiveness of AF screening in a large population-based cohort using smart device-based photoplethysmography (PPG) technology, combined with a clinical care AF management pathway using a mobile health approach.Methods AF screening was performed with smart devices using PPG technology, which were made available for the population ≥18 years of age across China. Monitoring for at least 14 days with a wristband (Honor Band 4) or wristwatch (Huawei Watch GT, Honor Watch, Huawei Technologies Co., Ltd., Shenzhen, China) was allowed. The patients with "possible AF" episodes using the PPG algorithm were further confirmed by health providers among the MAFA (mobile AF app) Telecare center and network hospitals, with clinical evaluation, electrocardiogram, or 24-h Holter monitoring.Results There were 246,541 individuals who downloaded the PPG screening app, and 187,912 individuals used smart devices to monitor their pulse rhythm between October 26, 2018, and May 20, 2019. Among those with PPG monitoring (mean age 35 years, 86.7% male), 424 (of 187,912, 0.23%) (mean age 54 years, 87.0% male) received a "suspected AF" notification. Of those effectively followed up, 227 individuals (of 262, 87.0%) were confirmed as having AF, with the positive predictive value of PPG signals being 91.6% (95% confidential interval [CI]: 91.5% to 91.8%). Both suspected AF and identified AF markedly increased with age (p for trend <0.001), and individuals in Northeast China had the highest proportion of detected AF of 0.28% (95% CI: 0.20% to 0.39%). Of the individuals with identified AF, 216 (of 227, 95.1%) subsequently entered a program of integrated AF management using a mobile AF application; approximately 80% of high-risk patients were successfully anticoagulated.Conclusions Based on the present study, continuous home monitoring with smart device-based PPG technology could be a feasible approach for AF screening. This would help efforts at screening and detection of AF, as well as early interventions to reduce stroke and other AF-related complications. (Mobile Health [mHealth] Technology for Improved Screening, Patient Involvement and Optimizing Integrated Care in Atrial Fibrillation [MAFA II]; ChiCTR-OOC-17014138).

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Authors
Guo, Y., Wang, H., Zhang, H., Liu, T., Liang, Z., Xia, Y., Yan, L., Xing, Y., Shi, H., Li, S., Liu, Y., Liu, F., Feng, M., Chen, Y., Lip, G. Y. H., Guo, Y., Lip, G. Y. H., Lane, D. A., Chen, Y., Wang, L., Eckstein, J., Thomas, G. N., Tong, L., Mei, F., Xuejun, L., Xiaoming, L., Zhaoliang, S., Xiangming, S., Wei, Z., Yunli, X., Jing, W., Fan, W., Sitong, Y., Xiaoqing, J., Bo, Y., Xiaojuan, B., Yuting, J., Yangxia, L., Yingying, S., Zhongju, T., Li, Y., Tianzhu, L., Chunfeng, N., Lili, Z., Shuyan, L., Zulu, W., Bing, X., Liming, L., Yuanzhe, J., Yunlong, X., Xiaohong, C., Fang, W., Lina, Z., yihong, S., shujie, J., Jing, L., Nan, L., shijun, L., huixia, L., Rong, L., Fan, L., qingfeng, G., tianyun, G., Yuan, W., Xin, L., Yan, R., xiaoping, C., ronghua, C., Yun, S., yulan, Z., haili, S., yujie, Z., quanchun, W., weidong, S., Lin, W., Chan, E., Guangliang, S., Chen, Y., Wei, Z., Dandi, C., Xiang, H., Anding, X., Xiaohan, F., Ziqiang, Y., Xiang, G., & Fulin, G.
Affiliations
  • Chinese People's Liberation Army (CN)
  • First Affiliated Hospital of Dalian Medical University (CN)
  • Capital Medical University (CN)
  • Zhengzhou University (CN)
  • General Hospital of Shenyang Military Region (CN)
  • Second Hospital of Hebei Medical University (CN)
  • Shanxi Dayi Hospital (CN)
  • Chinese PLA General Hospital (CN)
  • University Hospital of Basel (CH)
  • Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
Corresponding author
Chen, Yao
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2019-11
Volume
74
Issue
19
Pages
2365-2375
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2019.08.019
OpenAlex
W2970354537
Cited by
489
References
31
Citations by year
2026: 49 · 2025: 73 · 2024: 69 · 2023: 67 · 2022: 73 · 2021: 90 · 2020: 60 · 2019: 5
FWCI
20.02
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion, cc-by-nc-nd)
Funders
  • Pfizer
  • National Institute for Health and Care Research (NF-SI-0616-10010)
  • University of Birmingham
  • National Natural Science Foundation of China (H2501)
  • Daiichi-Sankyo
  • Health and Family Planning Commission of Heilongjiang Province (2017-036)
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
atrial fibrillation, photoplethysmography, mobile health, wearable devices, atrial fibrillation screening, anticoagulation, mobile health apps, positive predictive value, telecare, population-based cohort, China, Northeast China, Holter monitoring, electrocardiogram, anticoagulation adherence
MeSH terms
Adult, Aged, Algorithms, Atrial Fibrillation, China, Female, Humans, Male, Middle Aged, Sensitivity and Specificity, Photoplethysmography, Telemedicine, Monitoring, Ambulatory, Young Adult, Mobile Applications

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