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Diagnostic accuracy of Apple Watch Series 6 recorded single-lead ECGs for identifying supraventricular tachyarrhythmias: a comparative analysis with invasive electrophysiological study

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Abstract

Background

The advancements in wearable technology have made the detection of arrhythmias more accessible. While smartwatches are commonly used to detect patients with atrial fibrillation, their effectiveness in the differential diagnosis of supraventricular tachycardias (SVT) lacks consensus.

Methods

A study was conducted on 47 patients with documented SVTs on a 12-lead ECG. All patients in the cohort underwent electrophysiology study with induction of SVT. A 6th generation Apple Watch was used to record ECG tracings during baseline sinus rhythm and during induced SVT. Cardiology residents and attending cardiologists evaluated these recordings to diagnose the differential diagnosis of SVT.

Results

The evaluation revealed 27 cases of typical atrioventricular nodal reentrant tachycardia (AVNRT), 11 cases of atrioventricular reentrant tachycardia (AVRT), and 9 cases of atrial tachycardia/atrial flutter (AT/AFL) among the induced tachycardias. Attending physicians achieved an accuracy of 66.0 to 76.6%, and residents demonstrated accuracy rates between 68.1 and 74.5%. Interrater reliability was assessed using Fleiss’s Kappa method, resulting in a moderate level of agreement between residents (Kappa = 0.465, p < 0.001, 95% CI 0.30–0.63) and attendings (Kappa = 0.519, p < 0.001, 95% CI 0.35–0.68). The overall Kappa value was 0.417 (p < 0.001, 95% CI 0.34–0.49).

Conclusions

Smartwatch recordings demonstrate moderate feasibility in diagnosing SVT when following a pre-specified algorithm. However, this diagnostic performance was lower than the accuracy obtained from 12-lead ECG tracings when blinded to procedure outcomes.

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Data availability

The data is available and permission might be sought per reasonable request.

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Acknowledgements

This work is dedicated to Mustafa Kemal Atatürk, with sincere gratitude for his pivotal role in fostering a scientific environment in our country through the 1933 University reform.

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Author notes

  1. Kivanc Yalin and Ali Ugur Soysal contributed equally to this work and both are first authors.

Authors and Affiliations

  1. Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Kivanc Yalin, Ali Ugur Soysal, Baris Ikitimur, Hasan Tokdil, Gunduz Incesu, Hakan Yalman, Murat Cimci & Hakan Karpuz

  2. Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Beyza Irem Yabaci

  3. Cardiology Clinic, Kocaeli City Hospital, Kocaeli, Turkey

    Sukriye Ebru Onder

  4. Cardiology Clinic, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey

    Adem Atici

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  1. Kivanc Yalin
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Correspondence to Kivanc Yalin.

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Ethical approval and consent to participate

The study was approved by the Institutional Ethics Committee (approval no. 106294). Informed consent was provided by all patients.

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Yalin, K., Soysal, A.U., Ikitimur, B. et al. Diagnostic accuracy of Apple Watch Series 6 recorded single-lead ECGs for identifying supraventricular tachyarrhythmias: a comparative analysis with invasive electrophysiological study. J Interv Card Electrophysiol (2023). https://doi.org/10.1007/s10840-023-01695-6

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