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

Abstract

Importance: Increasingly, individuals with atrial fibrillation (AF) use wearable devices (hereafter wearables) that measure pulse rate and detect arrhythmia. The associations of wearables with health outcomes and health care use are unknown. Objective: To characterize patients with AF who use wearables and compare pulse rate and health care use between individuals who use wearables and those who do not. Design, Setting, and Participants: This retrospective, propensity-matched cohort study included 90 days of follow-up of patients in a tertiary care, academic health system. Included patients were adults with at least 1 AF-specific International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code from 2017 through 2019. Electronic medical records were reviewed to identify 125 individuals who used wearables and had adequate pulse-rate follow-up who were then matched using propensity scores 4 to 1 with 500 individuals who did not use wearables. Data were analyzed from June 2020 through February 2021. Exposure: Using commercially available wearables with pulse rate or rhythm evaluation capabilities. Main Outcomes and Measures: Mean pulse rates from measures taken in the clinic or hospital and a composite health care use score were recorded. The composite outcome included evaluation and management, ablation, cardioversion, telephone encounters, and number of rate or rhythm control medication orders. Results: Among 16320 patients with AF included in the analysis, 348 patients used wearables and 15972 individuals did not use wearables. Prior to matching, patients using wearables were younger (mean [SD] age, 64.0 [13.0] years vs 70.0 [13.8] years; P