Smart af

Up to 20% of patients with ischemic stroke or transient ischemic attack have a prior history of known atrial fibrillation (AF). Additionally, unknown AF can be detected by different monitoring strategies in up to 23% of patients with cryptogenic or non-cardioembolic stroke. However, most studies had substantial gaps in monitoring time, especially early after the index event. Following this, AF rates would be higher if patients underwent continuous monitoring early after stroke, avoiding any gaps in monitoring...

OBJECTIVE: Rotors, regions of spiral wave reentry in cardiac tissues, are considered as the drivers of atrial fibrillation (AF), the most common arrhythmia. Whereas physics-based approaches have been widely deployed to detect the rotors, in-depth knowledge in cardiac physiology and electrogram interpretation skills are typically needed. The recent leap forward in smart sensing, data acquisition, and Artificial Intelligence (AI) has offered an unprecedented opportunity to transform diagnosis and treatment in cardiac ailment, including AF...

Atrial high-rate episodes (AHRE) are atrial tachyarrhythmias detected by continuous rhythm monitoring by pacemakers, defibrillators, or implantable cardiac monitors. AHRE occur in 10-30 % of elderly patients without atrial fibrillation. However, it remains unclear whether the presence of these arrhythmias has therapeutic consequences. The presence of AHRE increases the risk of stroke compared with patients without AHRE. Oral anticoagulation would have the potential to reduce the risk of stroke in patients with AHRE but is also associated with a rate of major bleeding of approximately 2 %/year...

For the diagnosis of atrial fibrillation, it is mandatory to make an ECG during the arrhythmia. In patients with paroxysmal atrial fibrillation this can be challenging. Consumer wearables such as smart watches with automated AF detection can be helpful for diagnosing even asymptomatic AF, as long as they offer the possibility to record a one lead ECG rhythm strip. Once AF is diagnosed, therapeutic decisions, such as rate-control versus rhythm-control and start of oral anticoagulation therapy need to be made on an individual basis in each patient...

BACKGROUND: Commercially available health devices are gaining momentum and represent a great opportunity for monitoring patients for prolonged periods. This study aimed at testing the feasibility of a smart device-based secondary prevention program in a cohort of patients with cryptogenic stroke. METHODS: In this proof-of-principle study, patients with non-disabling ischemic stroke and transient ischemic attacks (TIA) in the subacute phase were provided with a smartwatch and smart devices to monitor several parameters - i...

BACKGROUND: In patients with symptomatic heart failure (HF) and previous heart failure hospitalization (HFH), hemodynamic-guided HF management using a wireless pulmonary artery pressure (PAP) sensor reduces HFH, but it is unclear whether these benefits extend to patients who have not been recently hospitalized but remain at risk because of elevated natriuretic peptides (NPs). OBJECTIVES: This study assessed the efficacy and safety of hemodynamic-guided HF management in patients with elevated NPs but no recent HFH...

BACKGROUND: Several smart devices are able to detect atrial fibrillation automatically by recording a single-lead electrocardiogram, and have created a work overload at the hospital level as a result of the need for over-reads by physicians. AIM: To compare the atrial fibrillation detection performances of the manufacturers' algorithms of five smart devices and a novel deep neural network-based algorithm. METHODS: We compared the rate of inconclusive tracings and the diagnostic accuracy for the detection of atrial fibrillation between the manufacturers' algorithms and the deep neural network-based algorithm on five smart devices, using a physician-interpreted 12-lead electrocardiogram as the reference standard...

Speech processing algorithms, especially sound source localization (SSL), speech enhancement, and speaker tracking are considered to be the main fields in this application. Most speech processing algorithms require knowing the number of speakers for real implementation. In this article, a novel method for estimating the number of speakers is proposed based on the hive shaped nested microphone array (HNMA) by wavelet packet transform (WPT) and 2D sub-band adaptive steered response power (SB-2DASRP) with phase transform (PHAT) and maximum likelihood (ML) filters, and, finally, the agglomerative classification and elbow criteria for obtaining the number of speakers in near-field scenarios...

Artificial intelligence (AI) offers a wide range of applications in clinical practice, and new technologies are rapidly evolving the healthcare industry and enhancing outcomes. Smartwatches represent the most popular type of wearable AI device that can assist people in detecting cardiac arrhythmias via constant monitoring of heart activity. Numerous advantages result from integrating AI into healthcare systems, including improved patient care, lower rates of medical errors, better treatment recommendations, and more accurate diagnosis of diseases...

AIMS: The SMART Pass™ (SP) algorithm is a high-pass filter that aims to reduce inappropriate therapy (IT) in subcutaneous internal cardiac defibrillator (S-ICD), but SP can deactivate due to low amplitude sensed R waves or asystole. The association between IT and SP deactivation and management strategies were evaluated, hypothesizing SP deactivation increases the risk of IT and device re-programming, or lead/generator re-positioning could reduce this risk. METHODS AND RESULTS: Retrospective single-centre audit of Emblem™ S-ICD devices implanted 2016 to 2020 utilizing health records and remote monitoring data...

Since the beginning of the COVID-19 pandemic, the use of face masks has become not only mandatory in several countries but also an acceptable approach for combating the pandemic. In the quest for designing an effective and useful face mask, triboelectric nanogenerators (TENGs) have been recently proposed. Novel functionalities are provided with the use of TENGs in face masks due to the induced triboelectrification generated by the exhaled and inhaled breath, allowing their use as an energy sensor. Nonetheless, within the face mask, the presence of nontextile plastics or other common triboelectric (TE) materials can be undesired...

AIMS: Atrial fibrillation (AF) is the most common arrhythmia worldwide. The AF is associated with severe mortality, morbidity, and healthcare costs, and guidelines recommend screening people at risk. However, screening methods and organization still need to be clarified. The current study aimed to assess the feasibility of a fully digital self-screening procedure and to assess the prevalence of undetected AF using a continuous patch electrocardiogram (ECG) monitoring system. METHODS AND RESULTS: Individuals ≥65 years old with at least one additional risk factor for stroke from the general population of Norway were invited to a fully digital continuous self-screening for AF using a patch ECG device (ECG247 Smart Heart Sensor)...

AIMS: Insertable cardiac monitors (ICMs) are indicated for long-term monitoring of unexplained syncope or palpitations, and for detection of bradycardia, ventricular tachycardia, and/or atrial fibrillation (AF). The aim of our study was to evaluate the safety and clinical value associated with a new generation ICM (Confirm Rx™, Abbott, Illinois, USA), featuring a new remote monitoring system based on smartphone patient applications. METHODS AND RESULTS: The SMART Registry is an international prospective observational study...

Few studies have examined the link between short-term exposure to air pollutants and atrial fibrillation (AF) episodes. This study aims to examine the association of hourly criteria air pollutants with AF episodes. We employ a smart device-based photoplethysmography technology to screen AF from 2018 to 2021. Hourly concentrations of six criteria air pollutants are matched to the onset hour of AF for each participant. We adopt a time-stratified case-crossover design to capture the acute effects of air pollutants on AF episodes, using conditional logistic regression models...

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BACKGROUND: Multiple smart devices capable to detect atrial fibrillation (AF) are presently available. Sensitivity and specificity for the detection of AF may differ between available smart devices, and this has not yet been adequately investigated. OBJECTIVES: The aim was to assess the accuracy of 5 smart devices in identifying AF compared with a physician-interpreted 12-lead electrocardiogram as the reference standard in a real-world cohort of patients. METHODS: We consecutively enrolled patients presenting to a cardiology service at a tertiary referral center in a prospective, diagnostic study...

BACKGROUND: Over the past few years, smartwatches have become increasingly popular in the monitoring of arrhythmias. Although the detection of atrial fibrillation with smartwatches has been the subject of various articles, there is no comprehensive research on the detection of arrhythmias other than atrial fibrillation. In this study, we included individual cases from the literature to identify the characteristics of patients with smartwatch-detected arrhythmias other than atrial fibrillation...

Clinical applications of passive long-term heart rate (HR) monitoring in patients with cardiac arrhythmias include adequate drug titration of atrioventricular (AV) nodal drugs and assessment of medical compliance with treatment. A majority of patients treated with beta-blockers, especially patients with atrial fibrillation (AF), require some degree of drug titration during the first 6 months of treatment to ensure that adequate HR control and medicine compliance has been achieved. Failing to achieve adequate rate control in patients with AF can lead to worsening symptoms, heart failure exacerbations, and potentially tachycardia-induced cardiomyopathy...

AIMS: Simplified detection of atrial arrhythmias via consumer-electronics would enable earlier therapy in at-risk populations. Whether this is feasible and effective in older populations is not known. METHODS AND RESULTS: The fully remote, investigator-initiated Smart phone and wearable detected atrial arrhythmia in O lder A dults C ase finding study (Smart in OAC-AFNET 9) digitally enrolled participants ≥65 years without known atrial fibrillation, not receiving oral anticoagulation in Germany, Poland, and Spain for 8 weeks...

BACKGROUND: Several wearable, medical-grade consumer ECG devices are now available and integrated into consumer electronics like multi sensor fitness watches and scales. Specific consumer ECGs can also come in the form of patches or thin sensor plates in credit card or other shapes. Watches with ECG capabilities are often multi vital sign sensor devices. The majority of these devices are usually connected to a mobile smartphone. However, there are pros and cons to their use. METHODS: We review here an exemplary selection of modern consumer ECG devices based on device type, recording method and the number of standard ECG channels derived...