Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke
IntroductionUndiagnosed atrial fibrillation (AF) is a potential underlying cause of cryptogenic stroke. Prolonged screening for AF using a photoplethysmography (PPG) smartwatch might offer a solution for detecting AF in patients with cryptogenic stroke. In this study, we aim to investigate this stra...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Stroke |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fstro.2024.1496003/full |
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| author | Marthe J. Huntelaar Jasper L. Selder Luuk H. G. A. Hopman Marieke C. Visser Cornelis P. Allaart |
| author_facet | Marthe J. Huntelaar Jasper L. Selder Luuk H. G. A. Hopman Marieke C. Visser Cornelis P. Allaart |
| author_sort | Marthe J. Huntelaar |
| collection | DOAJ |
| description | IntroductionUndiagnosed atrial fibrillation (AF) is a potential underlying cause of cryptogenic stroke. Prolonged screening for AF using a photoplethysmography (PPG) smartwatch might offer a solution for detecting AF in patients with cryptogenic stroke. In this study, we aim to investigate this strategy by comparing AF detection rates using a PPG-smartwatch and 48 h Holter monitor.MethodsFrom December 2019, patients with cryptogenic stroke were included to undergo 28 days of semi-continuous AF monitoring using a Fitbit smartwatch with a PPG-based FibriCheck algorithm, with simultaneous Holter monitoring during the first 48 h. From April 2021, a detailed screening log was installed to characterize potential study participants.ResultsAfter logged screening of 1,312 patients, enrollment was prematurely halted due to slower-than-expected inclusion rates. 40.8% of the screened patients had cryptogenic stroke, of which 92.5% were non-eligible for inclusion due to logistical, technological, and study-related challenges. Of the 43 patients enrolled, 37 completed PPG monitoring using a smartwatch. 43% of patients had PPG-detected AF in the 28 days after cryptogenic stroke. During the first 48 h, PPG-based screening detected AF in 2 patients, whereas no AF was detected using concurrent Holter monitoring.ConclusionThe PPG-smartwatch detected AF in 43% of the participants after cryptogenic stroke. However, discrepancies with concurrent Holter monitoring raise major concerns about the accuracy of the detected PPG-based AF. Moreover, the feasibility of a PPG-based screening strategy is limited due to logistical and technological challenges, partly inherent to cryptogenic stroke patients. |
| format | Article |
| id | doaj-art-4ae9ab064b9443228ffb38d97e8c5e6b |
| institution | Kabale University |
| issn | 2813-3056 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Stroke |
| spelling | doaj-art-4ae9ab064b9443228ffb38d97e8c5e6b2024-12-05T04:25:16ZengFrontiers Media S.A.Frontiers in Stroke2813-30562024-12-01310.3389/fstro.2024.14960031496003Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic strokeMarthe J. Huntelaar0Jasper L. Selder1Luuk H. G. A. Hopman2Marieke C. Visser3Cornelis P. Allaart4Department of Cardiology, Amsterdam UMC, location VUmc, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, location VUmc, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, location VUmc, Amsterdam, NetherlandsDepartment of Neurology, Amsterdam UMC, location VUmc, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, location VUmc, Amsterdam, NetherlandsIntroductionUndiagnosed atrial fibrillation (AF) is a potential underlying cause of cryptogenic stroke. Prolonged screening for AF using a photoplethysmography (PPG) smartwatch might offer a solution for detecting AF in patients with cryptogenic stroke. In this study, we aim to investigate this strategy by comparing AF detection rates using a PPG-smartwatch and 48 h Holter monitor.MethodsFrom December 2019, patients with cryptogenic stroke were included to undergo 28 days of semi-continuous AF monitoring using a Fitbit smartwatch with a PPG-based FibriCheck algorithm, with simultaneous Holter monitoring during the first 48 h. From April 2021, a detailed screening log was installed to characterize potential study participants.ResultsAfter logged screening of 1,312 patients, enrollment was prematurely halted due to slower-than-expected inclusion rates. 40.8% of the screened patients had cryptogenic stroke, of which 92.5% were non-eligible for inclusion due to logistical, technological, and study-related challenges. Of the 43 patients enrolled, 37 completed PPG monitoring using a smartwatch. 43% of patients had PPG-detected AF in the 28 days after cryptogenic stroke. During the first 48 h, PPG-based screening detected AF in 2 patients, whereas no AF was detected using concurrent Holter monitoring.ConclusionThe PPG-smartwatch detected AF in 43% of the participants after cryptogenic stroke. However, discrepancies with concurrent Holter monitoring raise major concerns about the accuracy of the detected PPG-based AF. Moreover, the feasibility of a PPG-based screening strategy is limited due to logistical and technological challenges, partly inherent to cryptogenic stroke patients.https://www.frontiersin.org/articles/10.3389/fstro.2024.1496003/fullcryptogenic strokeatrial fibrillationphotoplethysmography (PPG)Holter monitoringscreening for AF |
| spellingShingle | Marthe J. Huntelaar Jasper L. Selder Luuk H. G. A. Hopman Marieke C. Visser Cornelis P. Allaart Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke Frontiers in Stroke cryptogenic stroke atrial fibrillation photoplethysmography (PPG) Holter monitoring screening for AF |
| title | Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke |
| title_full | Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke |
| title_fullStr | Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke |
| title_full_unstemmed | Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke |
| title_short | Photoplethysmography-based atrial fibrillation detection in patients after crytpogenic stroke |
| title_sort | photoplethysmography based atrial fibrillation detection in patients after crytpogenic stroke |
| topic | cryptogenic stroke atrial fibrillation photoplethysmography (PPG) Holter monitoring screening for AF |
| url | https://www.frontiersin.org/articles/10.3389/fstro.2024.1496003/full |
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