Digital Devices for Arrhythmia Detection: What Is Still Missing?

IF 2.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Naoya Kataoka, Teruhiko Imamura
{"title":"Digital Devices for Arrhythmia Detection: What Is Still Missing?","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1002/clc.70074","DOIUrl":null,"url":null,"abstract":"<p>Various digital devices have been developed to detect atrial fibrillation (AF). Manninger and colleagues demonstrated that intermittent electrocardiogram (ECG)-based digital devices are increasingly being integrated into clinical practice, whereas photoplethysmography (PPG)-based devices are less commonly utilized for the diagnosis and screening of AF [<span>1</span>].</p><p>In the three proposed clinical scenarios—(1) symptomatic low-risk patients, (2) asymptomatic high-risk patients, and (3) symptomatic high-risk patients—many clinicians demonstrated a preference for diagnostic tools other than PPG-based devices [<span>1</span>]. The authors highlighted this trend and emphasized the need for enhanced education regarding novel PPG-based digital technologies. However, ECG-based tools, which provide greater diagnostic accuracy than PPG-based devices, may be more suitable in scenarios (1) and (3), where patients already exhibit clear symptoms of AF.</p><p>The debate over the type of device (PPG-based vs. ECG-based) may not be the most critical issue at present. While PPG-based devices demonstrate high accuracy in AF screening [<span>2</span>], the duration of arrhythmia monitoring is arguably more significant. Devices that impose minimal burden on patients are likely to be preferred for prolonged monitoring.</p><p>The clinical implications of aggressive intervention for AF detected by wearable devices remain uncertain. The prevalence of AF in the general population is quite low (approximately 1%) [<span>2</span>], and among those diagnosed, only 30% experience adverse outcomes such as thromboembolism or heart failure. Consequently, the number needed to treat to achieve a meaningful clinical benefit from wearable devices is exceptionally high [<span>3</span>]. Therefore, optimizing patient selection for the implementation of PPG-based devices warrants greater consideration.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664457/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Cardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/clc.70074","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Various digital devices have been developed to detect atrial fibrillation (AF). Manninger and colleagues demonstrated that intermittent electrocardiogram (ECG)-based digital devices are increasingly being integrated into clinical practice, whereas photoplethysmography (PPG)-based devices are less commonly utilized for the diagnosis and screening of AF [1].

In the three proposed clinical scenarios—(1) symptomatic low-risk patients, (2) asymptomatic high-risk patients, and (3) symptomatic high-risk patients—many clinicians demonstrated a preference for diagnostic tools other than PPG-based devices [1]. The authors highlighted this trend and emphasized the need for enhanced education regarding novel PPG-based digital technologies. However, ECG-based tools, which provide greater diagnostic accuracy than PPG-based devices, may be more suitable in scenarios (1) and (3), where patients already exhibit clear symptoms of AF.

The debate over the type of device (PPG-based vs. ECG-based) may not be the most critical issue at present. While PPG-based devices demonstrate high accuracy in AF screening [2], the duration of arrhythmia monitoring is arguably more significant. Devices that impose minimal burden on patients are likely to be preferred for prolonged monitoring.

The clinical implications of aggressive intervention for AF detected by wearable devices remain uncertain. The prevalence of AF in the general population is quite low (approximately 1%) [2], and among those diagnosed, only 30% experience adverse outcomes such as thromboembolism or heart failure. Consequently, the number needed to treat to achieve a meaningful clinical benefit from wearable devices is exceptionally high [3]. Therefore, optimizing patient selection for the implementation of PPG-based devices warrants greater consideration.

The authors have nothing to report.

The authors declare no conflicts of interest.

心律失常检测的数字设备:还缺少什么?
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信