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Mobile Photoplethysmographic Technology to Detect Atrial Fibrillation
Open accessAbstract
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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“Another study also found a high PPV for possible AF episodes identified from 45- to 60-s PPG recordings”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [30]
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Metadata
- 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)
- 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
- bronze
- doi.org
- 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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