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      Rationale and design of a large-scale, app-based study to identify cardiac arrhythmias using a smartwatch: The Apple Heart Study.

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          Abstract

          Smartwatch and fitness band wearable consumer electronics can passively measure pulse rate from the wrist using photoplethysmography (PPG). Identification of pulse irregularity or variability from these data has the potential to identify atrial fibrillation or atrial flutter (AF, collectively). The rapidly expanding consumer base of these devices allows for detection of undiagnosed AF at scale.

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          Heart Disease and Stroke Statistics—2018 Update: A Report From the American Heart Association

          Emelia Benjamin, Salim S. Virani, Clifton Callaway … (2018)
          Article 0 comments Cited 1434 times – based on 0 reviews     Review now
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            Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation.

            Robert G. Hart, Lesly A. Pearce, Maria I. Aguilar (2007)
            Atrial fibrillation is a strong independent risk factor for stroke. To characterize the efficacy and safety of antithrombotic agents for stroke prevention in patients who have atrial fibrillation, adding 13 recent randomized trials to a previous meta-analysis. Randomized trials identified by using the Cochrane Stroke Group search strategy, 1966 to March 2007, unrestricted by language. All published randomized trials with a mean follow-up of 3 months or longer that tested antithrombotic agents in patients who have nonvalvular atrial fibrillation. Two coauthors independently extracted information regarding interventions; participants; and occurrences of ischemic and hemorrhagic stroke, major extracranial bleeding, and death. Twenty-nine trials included 28,044 participants (mean age, 71 years; mean follow-up, 1.5 years). Compared with the control, adjusted-dose warfarin (6 trials, 2900 participants) and antiplatelet agents (8 trials, 4876 participants) reduced stroke by 64% (95% CI, 49% to 74%) and 22% (CI, 6% to 35%), respectively. Adjusted-dose warfarin was substantially more efficacious than antiplatelet therapy (relative risk reduction, 39% [CI, 22% to 52%]) (12 trials, 12 963 participants). Other randomized comparisons were inconclusive. Absolute increases in major extracranial hemorrhage were small (< or =0.3% per year) on the basis of meta-analysis. Methodological features and quality varied substantially and often were incompletely reported. Adjusted-dose warfarin and antiplatelet agents reduce stroke by approximately 60% and by approximately 20%, respectively, in patients who have atrial fibrillation. Warfarin is substantially more efficacious (by approximately 40%) than antiplatelet therapy. Absolute increases in major extracranial hemorrhage associated with antithrombotic therapy in participants from the trials included in this meta-analysis were less than the absolute reductions in stroke. Judicious use of antithrombotic therapy importantly reduces stroke for most patients who have atrial fibrillation.
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              2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.

              Craig T. January, L Wann, Joseph Alpert … (2014)
              Article 0 comments Cited 486 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Am Heart J
                Title: American heart journal
                Publisher: Elsevier BV
                ISSN (Electronic): 1097-6744
                ISSN (Print): 0002-8703
                Publication date (Electronic): January 2019
                Volume: 207
                Affiliations
                [1 ] Center for Digital Health, Stanford University Stanford, CA; VA Palo Alto Health Care System, Palo Alto, CA. Electronic address: mintu@stanford.edu.
                [2 ] Quantitative Sciences Unit, Stanford University, Stanford, CA.
                [3 ] Stanford Center for Clinical Research, Stanford University, Stanford, CA.
                [4 ] Information Resources and Technology, Stanford University, Stanford, CA.
                [5 ] Apple Inc. Cupertino, CA.
                [6 ] Lankenau Heart Institute and Jefferson Medical College, Philadelphia, PA.
                [7 ] University of Colorado School of Medicine, Denver, CO.
                [8 ] Division of Cardiovascular Disease, Cooper Medical School of Rowan University, Camden, NJ.
                [9 ] StopAfib.org, American Foundation for Women's Health, Decatur, TX.
                [10 ] Duke Clinical Research Institute, Duke University, Durham, NC.
                [11 ] Division of Cardiovascular Medicine, Stanford University, Stanford, CA. Electronic address: mvperez@stanford.edu.
                Article
                Publisher Item ID: S0002-8703(18)30271-0 Mid ID: NIHMS1680152
                DOI: 10.1016/j.ahj.2018.09.002
                PMC ID: 8099048
                PubMed ID: 30392584
                SO-VID: 5eecc172-73ac-4ff9-a4a8-933b0221f94b
                Copyright © Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
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