Arrhythmias & electrophysiology
“But for the blind spot”: Accuracy and diagnostic performance of smart watch cardiac features in pediatric patients
Authors' conclusion
We found high levels of agreement for AW-HR values with gold standard modalities during sinus rhythm and poor agreement during tachyarrhythmias, likely due to hemodynamic effects of tachyarrhythmias on PPG-based measurements. AW-ECGs had good sensitivity and moderate specificity in identification of non-sinus rhythm in children.
Study context
- Population
- Children ≤18 years during telemetry admission, electrophysiological study or exercise stress test1,090 HR measurements
- Participants
- 80 children
- Comparison
- Apple Watch HR and single-lead electrocardiographic (ECG) vs gold standard modalities
- Outcome
- Accuracy of AW-HR vs gold standard in sinus rhythm and arrhythmias; identification of non-sinus rhythm by AW-ECG
Methodological detailsblinded ECG review by 3 pediatric electrophysiologists, Settings: telemetry 41% [n = 33]; Electrophysiological study (EPS) 34% [n = 27]; Exercise stress test (EST) 25% [n = 20]
- Blinded ECG review by 3 pediatric electrophysiologists
- Settings: telemetry 41% [n = 33]; EPS 34% [n = 27]; EST 25% [n = 20]
Performance
As reported in the abstract
| Test or model | Intraclass correlation coefficient (ICC), AW-HR in sinus rhythm | ICC, AW-HR in tachyarrhythmias | Sensitivity, non-sinus rhythm by AW-ECG | Specificity, non-sinus rhythm by AW-ECG |
|---|---|---|---|---|
| Apple Watch (AW) | 0.99 (0.98-0.99) | 0.24-0.27 | 89%-96% | 78%-87% |
Apple Watch (AW)
Intraclass correlation coefficient (ICC), AW-HR in sinus rhythm0.99 (0.98-0.99)
ICC, AW-HR in tachyarrhythmias0.24-0.27
Sensitivity, non-sinus rhythm by AW-ECG89%-96%
Specificity, non-sinus rhythm by AW-ECG78%-87%
Original publication
“But for the blind spot”: Accuracy and diagnostic performance of smart watch cardiac features in pediatric patients. Heart Rhythm. Published 20 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it