Author + information
- Received February 14, 2018
- Revision received March 1, 2018
- Accepted March 2, 2018
- Published online March 10, 2018.
- Joseph M. Bumgarner, MDa,
- Cameron T. Lambert, MDa,
- Ayman A. Hussein, MDa,
- Daniel J. Cantillon, MDa,
- Bryan Baranowski, MDa,
- Kathy Wolski, MPHb,
- Bruce D. Lindsay, MDa,
- Oussama M. Wazni, MD MBAa and
- Khaldoun G. Tarakji, MD MPHa,∗ (, )@khaldountarakji
- aDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- bCleveland Clinic Coordinating Center for Clinical Research (C5Research), Cleveland Clinic, Cleveland, Ohio
- ↵∗Corresponding Author: Khaldoun G. Tarakji, MD MPH Section of Cardiac Pacing and Electrophysiology Heart and Vascular Institute Cleveland Clinic 9500 Euclid Avenue, J2-2 Cleveland, Ohio 44195 Telephone: (216) 445-9225 Fax: (216) 445-6149.
Background The Kardia Band (KB) is a novel technology that enables patients to record a rhythm strip using an Apple smartwatch. The band is paired with an app providing automated detection of atrial fibrillation (AF).
Objectives To examine whether the KB could accurately differentiate sinus rhythm (SR) from AF compared to physician-interpreted 12-lead ECGs and KB recordings.
Methods Consecutive patients with AF presenting for cardioversion (CV) were enrolled. Patients underwent pre-CV ECG along with a KB recording. If CV performed, a post-CV ECG was obtained along with a KB recording. The KB interpretations were compared to physician-reviewed ECGs. The KB recordings were reviewed by blinded electrophysiologists and compared to ECG interpretations. Sensitivity, specificity and K coefficient were measured.
Results One hundred patients were enrolled (Age 68 ± 11 years). Eight patients did not undergo CV. There were 169 simultaneous ECG and KB recordings. Fifty-seven were non-interpretable by the KB. Compared to ECG, the KB interpreted AF with 93% sensitivity, 84% specificity and K coefficient 0.77. Physician-interpretation of KB recordings demonstrated 99% sensitivity, 83% specificity and K coefficient 0.83. Of 57 non-interpretable KB recordings, interpreting electrophysiologists diagnosed AF with 100% sensitivity, 80% specificity and K coefficient 0.74. Among 113 cases where KB and physician readings of the same recording were interpretable, agreement was excellent (K coefficient 0.88).
Conclusions The KB algorithm for AF detection, supported by physician review can accurately differentiate AF from SR. This technology can help screen patients prior to elective CV and avoid unnecessary procedures.
Funding: AliveCor (AliveCor, Mountain View, CA) provided the Kardia Band monitors which were connected to an Apple Watch and paired via Bluetooth to a smartphone device for utilization in the study. AliveCor was not involved in the design, implementation, data analysis, or manuscript preparation of the study.
AAH: Consulting Abbott, Biosense Webster
DJC: Consulting Abbott, Boston Scientific, Stryker Sustainability, LifeWatch
OMW: Speaker honorarium, Spectranetics
KGT: Medical advisory board for Medtronic, AliveCor
- Received February 14, 2018.
- Revision received March 1, 2018.
- Accepted March 2, 2018.