Abstract 11586: Pulse-based Arrhythmia Discrimination Using a Novel Smartphone Application
Introduction: Screening for atrial fibrillation (AF) normally involves the use of expensive and cumbersome outpatient monitoring equipment. Currently, smartphone based detection allows for assessment of heart rate alone or requires additional hardware which has limited its widespread use in screening for AF. We describe the use of the first smartphone based monitor that has the ability to discriminate AF from ectopy (including PACs and PVCs) without the need of additional hardware.
Methods: We analyzed 219 2-minute pulse recordings from 121 study participants with AF (n=98), PACs (n=15), or PVCs (n=15) using an iPhone 4S. We obtained pulsatile time series recordings in 91 participants after successful cardioversion to sinus rhythm from pre-existing AF. The PULSESMART app conducted pulse analysis using 3 methods [Root Mean Square of Successive RR Differences; Shannon Entropy; Poincare plot]. We examined the sensitivity, specificity, and predictive accuracy of the app for AF, PAC, and PVC discrimination from sinus rhythm using the 12-lead EKG or 3-lead telemetry as the gold standard. We also administered a brief usability questionnaire to a subgroup (n=41) of app users.
Results: The smartphone-based app demonstrated excellent sensitivity (0.970), specificity (0.935), and accuracy (0.951) for real-time identification of an irregular pulse during AF. The app also showed good accuracy for PAC (0.955) and PVC discrimination (0.960). The vast majority of surveyed app users (83%) reported that it was “useful” and “not complex” to use.
Conclusion: A smartphone app can accurately discriminate pulse recordings during AF from sinus rhythm, PACs, and PVCs without the need of additional hardware.
Author Disclosures: C.A. Napolitano: None. J. Chong: None. J.S. Saczynski: Research Grant; Significant; National Institute on Aging (K01AG33643), National Heart Lung and Blood Institute (U01HL105268). N. Esa: None. C.E. Darling: None. E. Boyer: Research Grant; Modest; 1K24DA037109, R01DA031081, R01DA03376, R56DA38366. R.K. Rosen: None. K.C. Floyd: None. K.H. Chon: Research Grant; Significant; NIH grant 1R15HL121761, Naval Research work unit N00014-12-1-0171. Ownership Interest; Significant; Patent for arrhythmia algorithm. D.D. McManus: Research Grant; Significant; NIH grant KL2RR031981, National Heart Lung and Blood Institute (U01HL105268).
- © 2015 by American Heart Association, Inc.