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. 2023 May 4;4(4):118-125.
doi: 10.1016/j.cvdhj.2023.04.002. eCollection 2023 Aug.

Anxiety, patient activation, and quality of life among stroke survivors prescribed smartwatches for atrial fibrillation monitoring

Tenes J Paul  1 , Khanh-Van Tran  1 , Jordy Mehawej  1 , Darleen Lessard  2 , Eric Ding  2 , Andreas Filippaios  1 , Sakeina Howard-Wilson  1 , Edith Mensah Otabil  1 , Kamran Noorishirazi  1 , Syed Naeem  1 , Alex Hamel  1 , Dong Han  3 , Ki H Chon  3 , Bruce Barton  2 , Jane Saczynski  4 , David McManus  1
Affiliations

Anxiety, patient activation, and quality of life among stroke survivors prescribed smartwatches for atrial fibrillation monitoring

Tenes J Paul et al. Cardiovasc Digit Health J. .

Abstract

Background: The detection of atrial fibrillation (AF) in stroke survivors is critical to decreasing the risk of recurrent stroke. Smartwatches have emerged as a convenient and accurate means of AF diagnosis; however, the impact on critical patient-reported outcomes, including anxiety, engagement, and quality of life, remains ill defined.

Objectives: To examine the association between smartwatch prescription for AF detection and the patient-reported outcomes of anxiety, patient activation, and self-reported health.

Methods: We used data from the Pulsewatch trial, a 2-phase randomized controlled trial that included participants aged 50 years or older with a history of ischemic stroke. Participants were randomized to use either a proprietary smartphone-smartwatch app for 30 days of AF monitoring or no cardiac rhythm monitoring. Validated surveys were deployed before and after the 30-day study period to assess anxiety, patient activation, and self-rated physical and mental health. Logistic regression and generalized estimation equations were used to examine the association between smartwatch prescription for AF monitoring and changes in the patient-reported outcomes.

Results: A total of 110 participants (mean age 64 years, 41% female, 91% non-Hispanic White) were studied. Seventy percent of intervention participants were novice smartwatch users, as opposed to 84% of controls, and there was no significant difference in baseline rates of anxiety, activation, or self-rated health between the 2 groups. The incidence of new AF among smartwatch users was 6%. Participants who were prescribed smartwatches did not have a statistically significant change in anxiety, activation, or self-reported health as compared to those who were not prescribed smartwatches. The results held even after removing participants who received an AF alert on the watch.

Conclusion: The prescription of smartwatches to stroke survivors for AF monitoring does not adversely affect key patient-reported outcomes. Further research is needed to better inform the successful deployment of smartwatches in clinical practice.

Keywords: Atrial fibrillation; Elderly; Smartwatches; Stroke; Wearables.

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Figures

Figure 1
Figure 1
Process of participant randomization for phases 1 and 2, as well as the devices given to participants in each phase. The current study analyzes data from phase 2.
Figure 2
Figure 2
Key screenshots of the Pulsewatch smartphone-smartwatch system given to intervention participants.
See this image and copyright information in PMC

References

    1. Tsao C.W., Aday A.W., Almarzooq Z.I., et al. Heart disease and stroke statistics-2022 update: a report from the American Heart Association. Circulation. 2022;145:e153–e639. - PubMed
    1. Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–867. - PubMed
    1. January C.T., Wann L.S., Calkins H., et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society in collaboration with the Society of Thoracic Surgeons. Circulation. 2019;140:e125. –e151. - PubMed
    1. Glotzer T.V., Daoud E.G., Wyse D.G., et al. The relationship between daily atrial tachyarrhythmia burden from implantable device diagnostics and stroke risk: the TRENDS study. Circ Arrhythm Electrophysiol. 2009;2:474–480. - PubMed
    1. Perez M.V., Mahaffey K.W., Hedlin H., et al. Large-scale assessment of a smartwatch to identify atrial fibrillation. N Engl J Med. 2019;381:1909–1917. - PMC - PubMed

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