CONGRESS ABSTRACT

Abstract: Smartwatches are becoming pivotal in atrial fibrillation (AF) detection, transforming screening from sporadic tests to continuous monitoring. This review highlights recent data on AF detection accuracy—sensitivity up to 98%—and the potential to expand cardiac care accessibility. We address challenges like false-positive rates and EHR integration, proposing how smartwatches could revolutionize AF screening for at-risk populations. Introduction Atrial fibrillation (AF) increases stroke risk fivefold, yet many cases go undiagnosed due to asymptomatic presentation. Traditional screening methods often miss early AF. Smartwatches, with ECG and photoplethysmography (PPG) sensors, offer continuous, real-time AF monitoring, potentially closing diagnostic gaps. This review examines smartwatch efficacy in AF screening and its implications for public health. Methods We reviewed studies on AF detection with smartwatches, emphasizing those with ≥1,000 participants. Searches included “AF smartwatch detection” and “wearable ECG accuracy.” Primary outcomes were sensitivity, specificity, and patient engagement. Results AF Detection Accuracy: Studies show smartwatch sensitivity from 93% to 98% and specificity between 76% and 98%. The Apple Heart Study (n = 419,297) reported an 84% predictive value for AF in users 65+. PPG vs. ECG: PPG provides passive rhythm tracking, while ECG offers confirmatory readings, reducing false positives in motion but still requiring clinical review. Patient Engagement: High adherence (90% daily use) indicates user acceptance, though 15% of users reported anxiety, highlighting the need for balanced patient education. Discussion Public Health Potential: Smartwatches could prevent 1 in 4 AF-related strokes, especially in remote settings. Early AF detection could significantly reduce stroke rates and healthcare costs. Challenges: False positives remain high, leading to unnecessary follow-ups. Improving algorithmic specificity is essential for clinical adoption. Interoperability: Integration with EHRs is crucial. Standardized protocols would make smartwatch data actionable in patient care. Conclusion Smartwatches offer a paradigm shift in AF screening, enabling earlier diagnosis outside traditional clinical settings. While promising, advancements in data accuracy and clinical integration are needed to fully realize their potential in cardiac care.