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Clinical Summary

The first Apple Watch Afib detection results are in

Takeaway

  • The Apple Heart Study results are in.
  • They show a low rate of irregular pulse identification at only 0.52% of the 419,297 enrolled participants.
  • About a third of notified users had Afib on ECG patch.
  • 84% of notifications were consonant with Afib.

Why this matters

  • These authors say that the reported estimates can guide clinicians in discussions with patients who come in with a notification.
  • Accompanying editorial says that the study reveals “both the power and the limitations of digital innovation in medicine.”

Key results

  • 2161 of 419,297 participants received an irregular pulse notification, and 76% of them contacted a clinician.
  • They were more likely to be older, white, male, and have CHA2DS2-VASc ≥2.
  • 450 (20.8% of those notified) returned ECG patches, and 34% (97.5% CI, 29%-39%) of this group had Afib.
  • Afib rates among those who returned patches ranged from 18% in patients under age 40 years to 35% for those age 65+ years.
  • 20 participants were “urgently contacted,” including 1 who had a ventricular tachycardia.
  • Among participants who completed an end-of-study survey:
    • 404/929 (44%) of notified participants had a new Afib diagnosis.
    • 3070 of 293,015 (1.0%) of those not notified had a new Afib diagnosis.
  • Of 16 app-related adverse events, 15 were anxiety-related.

Study design

  • Participants used an app for the Apple smartphone that allowed smartwatch-based pulse monitoring.
  • Funding: Apple.

Limitations

  • Low numbers of notified participants returning ECG patch.
  • Absence or presence of aberrant pulse notification does not exclude or confirm Afib diagnosis.

References


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