Interrogation of Patient Smartphone Activity Tracker to Assist Arrhythmia Management

doi:10.1016/j.annemergmed.2016.02.039

Annals of Emergency Medicine

Volume 68, Issue 3, September 2016, Pages 292-294

https://doi.org/10.1016/j.annemergmed.2016.02.039 Get rights and content

A 42-year-old man presented to the emergency department (ED) with newly diagnosed atrial fibrillation of unknown duration. Interrogation of the patient’s wrist-worn activity tracker and smartphone application identified the onset of the arrhythmia as within the previous 3 hours, permitting electrocardioversion and discharge of the patient from the ED.

Introduction

Activity trackers are becoming more commonplace as personal monitoring devices to record steps taken, distances covered, and pulse rates.1, 2 We report here the use of an activity tracker to determine the onset time of a patient’s arrhythmia to guide his emergency department (ED) management.

Section snippets

Case Report

A 42-year-old man presented to the ED after a self-limited grand mal seizure. The seizure occurred 20 minutes before arrival and was witnessed by coworkers and described as lasting approximately 1 minute, followed by a postictal period. The patient had a history of seizures managed with oxcarbazepine 900 mg twice daily, although he later admitted he had missed his morning dose that day. The patient had no other relevant medical history.

Emergency medical services providers reported that on their

Discussion

Activity trackers are best described as wearable electronic devices capable of monitoring physical activity and limited physiologic parameters. Elite athletes may use very sophisticated activity trackers as part of their training or competitive regimens, although most activity trackers in use are worn by individuals to record daily activities such as steps taken or distances covered. Wearable electronic devices may be self-contained but many synchronize with an enabled device such as a

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Acceptability of wristband activity trackers among community dwelling older adults
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D.W. Shin et al.
Design and baseline characteristics of participants in the Enhancing Physical Activity and Reducing Obesity Through Smartcare and Financial Incentives (EPAROSFI): a pilot randomized controlled trial
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Int J Behav Nutr Phys Act
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There are more references available in the full text version of this article.

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Smart watch recording of ventricular tachycardia: Case study
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Smartphones and connected devices allow patients to monitor their health in a variety of ways. We report the case of a patient presenting to the emergency department complaining of palpitations and syncope. Standard investigations were unremarkable. However, an electrocardiogram recorded through his Apple Watch® indicated ventricular tachycardia. This case highlights the importance of proactively requesting such information from patients, though normal recordings may not preclude cardiac arrhythmia. Controlled clinical studies are needed to validate such practices.
A hybrid model for predicting human physical activity status from lifelogging data
2020, European Journal of Operational Research
Citation Excerpt :
One trend is that people are encouraged to monitor and manage their health based on their daily eating and their physical activity habits based on people-centred healthcare and patient empowerment (World Health Organization, 2014b). For example, Rudner, McDougall, Sailam, Smith, and Sacchetti (2016) reported a case in which a doctor suggested that a patient who had a history of seizures should wear a Fitbit.2 This device is a wearable sensor that can track the patient’s pulse rate and record it through a mobile phone application.
One trend in the recent healthcare transformations is people are encouraged to monitor and manage their health based on their daily diets and physical activity habits. However, much attention of the use of operational research and analytical models in healthcare has been paid to the systematic level such as country or regional policy making or organisational issues. This paper proposes a model concerned with healthcare analytics at the individual level, which can predict human physical activity status from sequential lifelogging data collected from wearable sensors. The model has a two-stage hybrid structure (in short, MOGP-HMM) – a multi-objective genetic programming (MOGP) algorithm in the first stage to reduce the dimensions of lifelogging data and a hidden Markov model (HMM) in the second stage for activity status prediction over time. It can be used as a decision support tool to provide real-time monitoring, statistical analysis and personalized advice to individuals, encouraging positive attitudes towards healthy lifestyles. We validate the model with the real data collected from a group of participants in the UK, and compare it with other popular two-stage hybrid models. Our experimental results show that the MOGP-HMM can achieve comparable performance. To the best of our knowledge, this is the very first study that uses the MOGP in the hybrid two-stage structure for individuals’ activity status prediction. It fits seamlessly with the current trend in the UK healthcare transformation of patient empowerment as well as contributing to a strategic development for more efficient and cost-effective provision of healthcare.
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Thus this strategy is only applicable to that phenotype of persistent AF which has a “meaningful period” of sinus rhythm after successful cardioversion. The advent of smartphone technology enabling characterisation of AF onset is likely to aid implementation of a more aggressive CV strategy by emergency department physicians [18]. Close collaboration between cardiology and ED departments, appropriate patient selection, education of patients and physicians and resource allocation remain vital to successful implementation of ED-CV for intermittent PeAF.
Due to barriers to accessing timely elective electrical cardioversion (CV) for persistent AF (PeAF), we adopted a policy of instructing patients to present directly to the Emergency Department (ED) for CV.
We compare a strategy of Emergency CV (ED-CV) versus Elective CV (EL-CV) for treatment of symptomatic PeAF.
Between 2014 and 7, we evaluated 150 patients undergoing CV for PeAF. ED-CV patients were provided an AF action plan for recurrent symptoms and advised to present to ED within 36 h. EL-CV patients followed standard care, including cardiologist referral and placement on an elective hospital waiting list. Follow-up was 12 months.
We included 75 consecutive ED-CV patients and 75 consecutive EL-CV patients. ED-CV patients had a significantly shorter median AF duration prior to CV (1 day vs 3 months; p < 0.01) and less overall AF-related symptoms at 12 months (modified EHRA symptom score ≥ 2a in 44% vs 72%; p = 0.005). Time to next AF recurrence was longer in the ED-CV group (295 ± 15 vs 245 ± 15 days; logrank p = 0.001), as was time to AF ablation referral (314 ± 13 vs 276 ± 15 days; logrank p = 0.01). Baseline LA area was similar (ED-CV 27 ± 4 cm² vs EL-CV 28 ± 11 cm²; p = 0.67), however EL-CV had larger atria at follow-up (31 ± 8 vs 26 ± 6 cm²; p = 0.01). There were no complications in either group.
ED-CV is an acceptable strategy for symptomatic PeAF. In addition to reduced time spent in AF and improved symptom scores, this strategy may also slow progression of atrial substrate & delay onset of next AF episode.
Smartwatch detection of new-onset monomorphic ventricular tachycardia in pregnancy
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: Supervising editor: Tyler W. Barrett, MD, MSCI

: Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.

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Cardiology/case reportInterrogation of Patient Smartphone Activity Tracker to Assist Arrhythmia Management

Introduction

Section snippets

Case Report

Discussion

Geriatr Nurs

Design and baseline characteristics of participants in the Enhancing Physical Activity and Reducing Obesity Through Smartcare and Financial Incentives (EPAROSFI): a pilot randomized controlled trial

Contemp Clin Trials

Systematic review of the validity and reliability of consumer-wearable activity trackers

Int J Behav Nutr Phys Act

Cardiology/case report
Interrogation of Patient Smartphone Activity Tracker to Assist Arrhythmia Management