Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting
<b>Background/Objectives</b>: Atrial fibrillation (AF) remains a major risk factor for stroke. It is often asymptomatic and paroxysmal, making it difficult to detect with conventional electrocardiography (ECG). While photoplethysmography (PPG)-based devices like smartwatches have demonst...
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MDPI AG
2025-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/10/1233 |
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| author | Khaled Abdelhamid Pamela Reissenberger Diana Piper Nicole Koenig Bianca Hoelz Julia Schlaepfer Simone Gysler Helena McCullough Sebastian Ramin-Wright Anna-Lena Gabathuler Jahnvi Khandpur Milene Meier Jens Eckstein |
| author_facet | Khaled Abdelhamid Pamela Reissenberger Diana Piper Nicole Koenig Bianca Hoelz Julia Schlaepfer Simone Gysler Helena McCullough Sebastian Ramin-Wright Anna-Lena Gabathuler Jahnvi Khandpur Milene Meier Jens Eckstein |
| author_sort | Khaled Abdelhamid |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Atrial fibrillation (AF) remains a major risk factor for stroke. It is often asymptomatic and paroxysmal, making it difficult to detect with conventional electrocardiography (ECG). While photoplethysmography (PPG)-based devices like smartwatches have demonstrated efficacy in detecting AF, they are rarely integrated into hospital infrastructure. The study aimed to establish a seamless system for real-time AF screening in hospitalized high-risk patients using a wrist-worn PPG device integrated into a hospital’s data infrastructure. <b>Methods</b>: In this investigator-initiated prospective clinical trial conducted at the University Hospital Basel, patients with a CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥ 2 and no history of AF received a wristband equipped with a PPG sensor for continuous monitoring during their hospital stay. The PPG data were automatically transmitted, analyzed, stored, and visualized. Upon detection of an absolute arrhythmia (AA) in the PPG signal, a Holter ECG was administered. <b>Results</b>: The analysis encompassed 346 patients (mean age 72 ± 10 years, 175 females (50.6%), mean CHA<sub>2</sub>DS<sub>2</sub>-VASc score 3.5 ± 1.3)). The mean monitoring duration was 4.3 ± 4.4 days. AA in the PPG signal was detected in twelve patients (3.5%, CI: 1.5–5.4%), with most cases identified within 24 h (<i>p</i> = 0.004). There was a 1.3 times higher AA burden during the nighttime compared to daytime (<i>p</i> = 0.03). Compliance was high (304/346, 87.9%). No instances of AF were confirmed in the nine patients undergoing Holter ECG. <b>Conclusions</b>: This study successfully pioneered an automated infrastructure for AF screening in hospitalized patients through the use of wrist-worn PPG devices. This implementation allowed for real-time data visualization and intervention in the form of a Holter ECG. The high compliance and early AA detection achieved in this study underscore the potential and relevance of this novel infrastructure in clinical practice. |
| format | Article |
| id | doaj-art-e520fa7400754033b88adfe42adca0de |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-e520fa7400754033b88adfe42adca0de2025-08-20T01:56:16ZengMDPI AGDiagnostics2075-44182025-05-011510123310.3390/diagnostics15101233Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital SettingKhaled Abdelhamid0Pamela Reissenberger1Diana Piper2Nicole Koenig3Bianca Hoelz4Julia Schlaepfer5Simone Gysler6Helena McCullough7Sebastian Ramin-Wright8Anna-Lena Gabathuler9Jahnvi Khandpur10Milene Meier11Jens Eckstein12Department of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandPreventicus GmbH, 07743 Jena, GermanyPreventicus GmbH, 07743 Jena, GermanyInnovation Management, Department of D&ICT, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland<b>Background/Objectives</b>: Atrial fibrillation (AF) remains a major risk factor for stroke. It is often asymptomatic and paroxysmal, making it difficult to detect with conventional electrocardiography (ECG). While photoplethysmography (PPG)-based devices like smartwatches have demonstrated efficacy in detecting AF, they are rarely integrated into hospital infrastructure. The study aimed to establish a seamless system for real-time AF screening in hospitalized high-risk patients using a wrist-worn PPG device integrated into a hospital’s data infrastructure. <b>Methods</b>: In this investigator-initiated prospective clinical trial conducted at the University Hospital Basel, patients with a CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥ 2 and no history of AF received a wristband equipped with a PPG sensor for continuous monitoring during their hospital stay. The PPG data were automatically transmitted, analyzed, stored, and visualized. Upon detection of an absolute arrhythmia (AA) in the PPG signal, a Holter ECG was administered. <b>Results</b>: The analysis encompassed 346 patients (mean age 72 ± 10 years, 175 females (50.6%), mean CHA<sub>2</sub>DS<sub>2</sub>-VASc score 3.5 ± 1.3)). The mean monitoring duration was 4.3 ± 4.4 days. AA in the PPG signal was detected in twelve patients (3.5%, CI: 1.5–5.4%), with most cases identified within 24 h (<i>p</i> = 0.004). There was a 1.3 times higher AA burden during the nighttime compared to daytime (<i>p</i> = 0.03). Compliance was high (304/346, 87.9%). No instances of AF were confirmed in the nine patients undergoing Holter ECG. <b>Conclusions</b>: This study successfully pioneered an automated infrastructure for AF screening in hospitalized patients through the use of wrist-worn PPG devices. This implementation allowed for real-time data visualization and intervention in the form of a Holter ECG. The high compliance and early AA detection achieved in this study underscore the potential and relevance of this novel infrastructure in clinical practice.https://www.mdpi.com/2075-4418/15/10/1233wearableatrial fibrillationphotoplethysmographyscreening |
| spellingShingle | Khaled Abdelhamid Pamela Reissenberger Diana Piper Nicole Koenig Bianca Hoelz Julia Schlaepfer Simone Gysler Helena McCullough Sebastian Ramin-Wright Anna-Lena Gabathuler Jahnvi Khandpur Milene Meier Jens Eckstein Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting Diagnostics wearable atrial fibrillation photoplethysmography screening |
| title | Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting |
| title_full | Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting |
| title_fullStr | Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting |
| title_full_unstemmed | Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting |
| title_short | Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting |
| title_sort | fully automated photoplethysmography based wearable atrial fibrillation screening in a hospital setting |
| topic | wearable atrial fibrillation photoplethysmography screening |
| url | https://www.mdpi.com/2075-4418/15/10/1233 |
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