P845Assessment of pulse wave pressure changes for detection of arrhythmia and comorbidities using a wrist-worn wearable device

Abstract

Introduction: Detection of clinically silent arrhythmias is paramount in long-term management of patients with atrial fibrillation (AF) to limit adverse events. Development of motion and light sensor integrated next generation wearable devices promise a noninvasive monitoring alternative to identify recurrent atrial fibrillation (AF) episodes and screen for comorbidities through pulse pressure wave analysis. This study aims to evaluate the utility of a wrist-worn device for detection of AF episodes as well as to study pulse wave changes and patient activity. Methods: Twenty six patients diagnosed with AF have been asked to wear the Wavelet wristband capable of measuring photoplethysmography (PPG) parameters for 60 days. Event correlations were performed against heart monitors and blood pressure measurements during clinic visits. Daily activity levels and overall user compliance was evaluated. Results: Patients with recurrent AF episodes (n = 4) identified during clinical visits were correctly detected by the wrist-worn sensor algorithm (Figure 1-a). A heart rate data analysis suggested silent episodes for 4 additional patients. PPG-derived pulse volume levels correlated strongly with systolic pressure measurements (R2 = 0.58) based on Student's t-test (p < 0.05) (Figure 1-b). Wristbands recorded daily average of 1.0±0.8 hours of activity, and 5697±3586 steps per day. Overall device use was 47±14 days/nights (79±24%). Weekly surveillance and follow up phone calls (n=10 patients) improved the compliance to 56±4 days/nights (94±7%). Conclusion: Successful detection of clinically confirmed AF episodes and high compliance rate confirms the use of PPG-based wearables technology for tracking AF patients, and warrants further investigations in larger populations. (Figure presented).