Arrhythmias & electrophysiology
Consumer wearable devices for evaluation of heart rate control using digoxin versus beta-blockers: the RATE-AF randomized trial
Authors' conclusion
The results of this study indicate that digoxin and beta-blockers have equivalent effects on heart rate in atrial fibrillation at rest and on exertion, and suggest that dynamic monitoring of individuals with arrhythmia using wearable technology could be an alternative to in-person assessment.
Study context
- Population
- Older, multimorbid patients with permanent AF and HF; wrist-worn wearable linked to smartphone for 20 weeksmean age 75.6 y, 40% women
- Participants
- 53 participants
- Comparison
- Digoxin vs beta-blockers
- Primary endpoint
- Heart rate (wearable-measured)
- Follow-up
- 20 weeks
Methodological detailswearables substudy, Heart rate (n = 143,379,796) and physical activity (n = 23,704,307) intervals obtained
- Wearables substudy
- Heart rate (n = 143,379,796) and physical activity (n = 23,704,307) intervals obtained
Primary result
As reported in the abstract
Heart rate
Regression coefficient
1.22
95% CI −2.82 to 5.27P = 0.55
unadjusted
Regression coefficient
0.66
95% CI −3.45 to 4.77P = 0.75
adjusted
Further findings
| Outcome | Wearable data (convolutional neural network) | ECG heart rate and 6-minute walk test | P value |
|---|---|---|---|
| Prediction of NYHA class 5 months after baseline (F1 score) | F1 score 0.56 (95% CI 0.41–0.70) | F1 score 0.55 (95% CI 0.41–0.68) | P = 0.88 |
Heart rate accounting for physical activity
- No difference in heart rate between groups
- P = 0.74
Heart rate in patients with high activity (≥30,000 steps per week)
- No difference in heart rate between groups
- P = 0.97
Original publication
Consumer wearable devices for evaluation of heart rate control using digoxin versus beta-blockers: the RATE-AF randomized trial. Nat Med. Published 15 July 2024. doi:10.
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