Wearable Devices in Cardiovascular Medicine

Abstract

Wearable devices, such as smartwatches and activity trackers, are commonly used by patients in their everyday lives to manage their health and well-being. These devices collect and analyze long-term continuous data on measures of behavioral or physiologic function, which may provide clinicians with a more comprehensive view of a patients' health compared with the traditional sporadic measures captured by office visits and hospitalizations. Wearable devices have a wide range of potential clinical applications ranging from arrhythmia screening of high-risk individuals to remote management of chronic conditions such as heart failure or peripheral artery disease. As the use of wearable devices continues to grow, we must adopt a multifaceted approach with collaboration among all key stakeholders to effectively and safely integrate these technologies into routine clinical practice. In this Review, we summarize the features of wearable devices and associated machine learning techniques. We describe key research studies that illustrate the role of wearable devices in the screening and management of cardiovascular conditions and identify directions for future research. Last, we highlight the challenges that are currently hindering the widespread use of wearable devices in cardiovascular medicine and provide short- and long-term solutions to promote increased use of wearable devices in clinical care.

Keywords: cardiac rehabilitation; cardiology; digital technology; healthy lifestyle; wearable electronic devices.

Figure 1:. Overview of Wearable Devices.

A) Common sensor modalities utilized by wearable devices to generate physiologic measurements. B) Key physiologic measures, sensors, and potential clinical applications in cardiovascular medicine. Abbreviations: ballistocardiogram (BCG), cardiovascular disease (CVD), electrocardiogram (ECG), Global Positioning System (GPS), heart failure (HF), myocardial infarction (MI), peripheral artery disease (PAD), photoplethysmography (PPG), seismocardiogram (SCG). * Continuous glucose monitoring (CGM) devices use biochemical sensors to measure glucose levels and have important clinical applications for type 1 and type 2 diabetes. However, they are difficult to integrate into consumer-grade wearables and are usually a stand-alone device.

Figure 2:. Short and Long-Term Roadmap to Increase the Use of Wearable Devices in Clinical Care.

Abbreviations: acute coronary syndrome (ACS), artificial intelligence (AI), cardiovascular (CV), coronary artery disease (CAD), electronic health record (EHR), Health Insurance Portability and Accountability Act (HIPAA), Institute of Electrical and Electronics Engineers (IEEE), machine learning (ML), randomized controlled trial (RCT)