Continuous 24-h Photoplethysmogram Monitoring Enables Detection of Atrial Fibrillation

Frontiers in Physiology

Mika P. Tarvainen¹  Tiina M. Laitinen²  Tomi P. Laitinen²  Helena Jäntti³  Pekka Kuoppa⁴  Jukka A. Lipponen⁴  Tero J. Martikainen⁵  Maaret Castrén⁶  Eemu-Samuli Väliaho⁸  Onni E. Santala⁸  Jari Halonen⁹  Juha E. K. Hartikainen⁹  Tuomas T. Rissanen^1,10  Olli Rantula^1,11  Noora S. Naukkarinen^1,11 

[1] 0Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland;1Imaging Center, Kuopio University Hospital, Kuopio, Finland;Center for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland;Department of Applied Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio, Finland;Department of Emergency Care, Kuopio University Hospital, Kuopio, Finland;Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland;Department of Emergency Medicine, University of Helsinki, Helsinki, Finland;Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland;Heart Center, Kuopio University Hospital, Kuopio, Finland;Heart Center, North Karelia Central Hospital, Joensuu, Finland;School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland;

关键词: atrial fibrillation;    photoplethysmography;    photoplethysmogram;    quality;    algorithms;    monitoring;   

DOI  :  10.3389/fphys.2021.778775

来源: DOAJ

【 摘 要 】

Aim: Atrial fibrillation (AF) detection is challenging because it is often asymptomatic and paroxysmal. We evaluated continuous photoplethysmogram (PPG) for signal quality and detection of AF.Methods: PPGs were recorded using a wrist-band device in 173 patients (76 AF, 97 sinus rhythm, SR) for 24 h. Simultaneously recorded 3-lead ambulatory ECG served as control. The recordings were split into 10-, 20-, 30-, and 60-min time-frames. The sensitivity, specificity, and F1-score of AF detection were evaluated for each time-frame. AF alarms were generated to simulate continuous AF monitoring. Sensitivities, specificities, and positive predictive values (PPVs) of the alarms were evaluated. User experiences of PPG and ECG recordings were assessed. The study was registered in the Clinical Trials database (NCT03507335).Results: The quality of PPG signal was better during night-time than in daytime (67.3 ± 22.4% vs. 30.5 ± 19.4%, p < 0.001). The 30-min time-frame yielded the highest F1-score (0.9536), identifying AF correctly in 72/76 AF patients (sensitivity 94.7%), only 3/97 SR patients receiving a false AF diagnosis (specificity 96.9%). The sensitivity and PPV of the simulated AF alarms were 78.2 and 97.2% at night, and 49.3 and 97.0% during the daytime. 82% of patients were willing to use the device at home.Conclusion: PPG wrist-band provided reliable AF identification both during daytime and night-time. The PPG data’s quality was better at night. The positive user experience suggests that wearable PPG devices could be feasible for continuous rhythm monitoring.

【 授权许可】

Unknown