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. 2024 Aug 6;13(15):e033750.
doi: 10.1161/JAHA.123.033750. Epub 2024 Jul 16.

Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation

Lindsey Rosman  1 , Rachel Lampert  2 , Songcheng Zhuo  3 , Quefeng Li  3 , Niraj Varma  4 , Matthew Burg  2   5 , Allison E Gaffey  2   5 , Tiffany Armbruster  1 , Anil Gehi  1
Affiliations

Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation

Lindsey Rosman et al. J Am Heart Assoc. .

Abstract

Background: Wearables are increasingly used by patients with atrial fibrillation (AF) for symptom monitoring and health management, but their impact on patient health care use and psychological well-being is not well understood.

Methods and results: In this retrospective, propensity-matched study of patients with AF, survey and electronic health record data were merged to compare AF-specific health care use (outpatient/inpatient visits, rhythm-related testing, and procedures) and informal health care use (telephone calls and patient portal messages) over a 9-month period between wearable users and nonusers. We also examined the effects of wearable cardiac monitoring features (eg, heart rate alerts, irregular rhythm notification, and ECG) on patient behavior and well-being. Of 172 patients with AF in this analysis (age, 72.6±9.0 years; 42% women), 83 used a wearable. Compared with nonusers, wearable users reported higher rates of symptom monitoring and preoccupation (P=0.03) and more AF treatment concerns (P=0.02). Moreover, 20% of wearable users experienced anxiety and always contacted their doctors in response to irregular rhythm notifications. After matching, AF-specific health care use was significantly greater among wearable users compared with nonusers (P=0.04), including significantly higher rates of ECGs, echocardiograms/transesophageal echocardiogram, and ablation. Wearable users were also significantly more likely to use informal health care resources compared with nonusers (P=0.05).

Conclusions: Wearables were associated with higher rates of symptom monitoring and preoccupation, AF treatment concerns, AF-specific health care use, and use of informal health care resources. Prospective, randomized studies are needed to understand the net effects of wearables and their alerts on patients, providers, and the health care system.

Keywords: atrial fibrillation; digital health; wearables.

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Figures

Figure 1
Figure 1. Study flow diagram.
AF indicates atrial fibrillation; EHR, electronic health record; EP, electrophysiology; and UNC, University of North Carolina.
Figure 2
Figure 2. Behavioral and psychological responses to wearable features and notifications.
AF indicates atrial fibrillation; ED, emergency department; and HR, heart rate.
See this image and copyright information in PMC

Comment in

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