可穿戴技术在隐源性中风或来源不明的栓塞性中风后心脏监测中的应用:系统性综述。

Singapore medical journal Pub Date : 2024-07-01 Epub Date: 2024-03-06 DOI:10.4103/singaporemedj.SMJ-2022-143
Jamie Sy Ho, Elizabeth Sy Ho, Leonard Ll Yeo, William Kf Kong, Tony Yw Li, Benjamin Yq Tan, Mark Y Chan, Vijay K Sharma, Kian-Keong Poh, Ching-Hui Sia
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引用次数: 0

摘要

导言:隐源性卒中或来源不明的栓塞性卒中(ESUS)发生后,有必要进行长时间的心脏监测,以识别需要抗凝治疗的心房颤动(AF)。与传统管理方法相比,可穿戴设备可提高房颤检测率。我们旨在回顾可穿戴设备用于隐源性卒中后和 ESUS 后监测的证据:我们于 2022 年 7 月 21 日对 PubMed、EMBASE、Scopus 和 clinicaltrials.gov 进行了系统检索,确定了所有调查可穿戴设备在隐源性卒中或 ESUS 患者中使用情况的研究。对房颤检测结果进行了分析。总结了基于心电图(ECG)(外部可穿戴、手持、贴片、移动心电遥测[MCT]、智能手表)和基于光电血压计(PPG)(智能手表、智能手机)设备的文献报告:共纳入了 27 项相关研究(2 项随机对照试验、7 项前瞻性试验、10 项队列研究、6 项病例系列和 2 项病例报告)。只有四项研究将可穿戴技术与 Holter 监测或植入式循环记录器进行了比较,这些研究在荟萃分析中未显示出显著差异(几率比 2.35,95% 置信区间 [CI]0.74-7.48,I2 = 70%)。20.7%(95% CI 14.9-27.2,I2 = 76%)的患者通过外部可穿戴设备检测到房颤,9.6%(95% CI 7.4-11.9%,I2 = 56%)的患者通过 MCT 检测到新房颤。调查的其他设备包括贴片传感器、手持式心电图记录仪和基于 PPG 的智能手机应用程序,这些设备在隐源性卒中后和 ESUS 后环境中均显示出可行性:结论:基于心电图或 PPG 的可穿戴设备可有效检测隐源性卒中和 ESUS 后的阵发性房颤,但还需进一步研究,以确定这些设备与 Holter 监护仪和植入式循环记录仪的可比性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of wearable technology in cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source: a systematic review.

Introduction: Prolonged cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source (ESUS) is necessary to identify atrial fibrillation (AF) that requires anticoagulation. Wearable devices may improve AF detection compared to conventional management. We aimed to review the evidence for the use of wearable devices in post-cryptogenic stroke and post-ESUS monitoring.

Methods: We performed a systematic search of PubMed, EMBASE, Scopus and clinicaltrials.gov on 21 July 2022, identifying all studies that investigated the use of wearable devices in patients with cryptogenic stroke or ESUS. The outcomes of AF detection were analysed. Literature reports on electrocardiogram (ECG)-based (external wearable, handheld, patch, mobile cardiac telemetry [MCT], smartwatch) and photoplethysmography (PPG)-based (smartwatch, smartphone) devices were summarised.

Results: A total of 27 relevant studies were included (two randomised controlled trials, seven prospective trials, 10 cohort studies, six case series and two case reports). Only four studies compared wearable technology to Holter monitoring or implantable loop recorder, and these studies showed no significant differences on meta-analysis (odds ratio 2.35, 95% confidence interval [CI] 0.74-7.48, I 2 = 70%). External wearable devices detected AF in 20.7% (95% CI 14.9-27.2, I 2 = 76%) of patients and MCT detected new AF in 9.6% (95% CI 7.4%-11.9%, I 2 = 56%) of patients. Other devices investigated included patch sensors, handheld ECG recorders and PPG-based smartphone apps, which demonstrated feasibility in the post-cryptogenic stroke and post-ESUS setting.

Conclusion: Wearable devices that are ECG or PPG based are effective for paroxysmal AF detection after cryptogenic stroke and ESUS, but further studies are needed to establish how they compare with Holter monitors and implantable loop recorder.

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