Arrhythmias & electrophysiology
Wearable Irregular Heart Rhythm Detection Recurrences and Electrocardiographic Atrial Fibrillation Confirmation: The Fitbit Heart Study
Authors' conclusion
Irregular heart rhythms are common after initial detection using a wrist-worn wearable device. Longer electrocardiographic monitoring periods increase the likelihood of confirming AF.
Study context
- Population
- Wrist-worn photoplethysmography device users without diagnosed atrial fibrillation (AF) who wore and returned a 1-week ECG patch monitor after receiving an irregular heart rhythm detection (IHRD)analyzed, of 455,699 participants enrolled
- Participants
- 1,057 users
- Outcome
- Age and sex of participants
Main finding
As reported in the abstract
Aged 40 to 64 years
570
53.9%
Aged ≥65 years
422
39.9%
Women
510
48.2%
Further findings
Follow-up after ECG patch initiation
- Median follow-up
- 80 days (interquartile range, 45-122 days)
Frequency of another IHRD · 3 months
- Frequency of another IHRD
- 57.2% (95% CI, 53.1%-60.9%)
Estimated diagnostic yield for AF after an initial IHRD, by ECG monitoring strategy
- 10-second ECG
- 7.6% (95% CI, 6.2%-9.0%)
- Twice-daily 30-second ECGs over 1 week
- 19.0% (95% CI, 16.7%-21.2%)
- 24-hour monitor
- 17.4% (95% CI, 15.5%-19.3%)
- 1-week monitor
- 32.2% (95% CI, 29.4%-35.0%)
- 2-week monitor
- 46.8% (95% CI, 42.7%-50.8%)
- 4-week monitor
- 60.8% (95% CI, 56.5%-65.1%)
Predictors of recurrent IHRD
- Older age
- P < 0.001
- Male sex
- P = 0.001
- Vascular disease
- P = 0.03
- Longer initial runs of consecutive IHRDs at detection
- P = 0.02
- Less nightly sleep
- P = 0.03
- Risk of a recurrent IHRD was greater with each factor
Original publication
Wearable Irregular Heart Rhythm Detection Recurrences and Electrocardiographic Atrial Fibrillation Confirmation: The Fitbit Heart Study. Circ Arrhythm Electrophysiol. Published 25 June 2025. doi:10.
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