ArticleAmerican heart journal2019
Rationale and design of a large-scale, app-based study to identify cardiac arrhythmias using a smartwatch: The Apple Heart Study.
Article in American heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 198 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Apple Heart Study: Assessment of Wristwatch-Based Photoplethysmography to Identify Cardiac Arrhythmias
Rapid Development and Implementation of a Remote ECG-monitored Prospective Randomized Clinical Trial During a Pandemic: Hydroxychloroquine Prophylaxis in COVID-19 Household Contacts
Assessment of Decision Support System Software in Extraction and Anchorage Planning Among Adult Patients Using Computer Algorithm
Prospective Study of the Diagnostic Accuracy of a Smartphone Application to PREDICT Real-Time Cardiovascular Risk for Heart Attack and Stroke (PREDICT-HS)
Who cites it
198 citing papers in PubMed, 12 syntheses or guidelines pooled it, 467 citations in OpenAlex.
- A systematic review of eye-tracking technology in electrocardiogram interpretation research.European journal of medical research · 2025Pooled it
- Recommendations to promote equity, diversity and inclusion in decentralized clinical trials.Nature medicine · 2024Guideline
- Cardiorespiratory Sensors and Their Implications for Out-of-Hospital Cardiac Arrest Detection: A Systematic Review.Annals of biomedical engineering · 2024Pooled it
- Benefits and Challenges of Remote Patient Monitoring as Perceived by Health Care Practitioners: A Systematic Review.The Permanente journal · 2023Pooled it
- Arrhythmias Beyond Atrial Fibrillation Detection Using Smartwatches: A Systematic Review.Anatolian journal of cardiology · 2023Pooled it
- A Systematic Review of Time Series Classification Techniques Used in Biomedical Applications.Sensors (Basel, Switzerland) · 2022Pooled it
- Telemonitoring of Real-World Health Data in Cardiology: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Diagnostic Accuracy of Smartwatches for the Detection of Cardiac Arrhythmia: Systematic Review and Meta-analysis.Journal of medical Internet research · 2021Pooled it
- Recommendations for determining the validity of consumer wearable heart rate devices: expert statement and checklist of the INTERLIVE Network.British journal of sports medicine · 2021Guideline
- 2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021Guideline
- Accuracy of Smartphone Camera Applications for Detecting Atrial Fibrillation: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- Accuracy of mHealth Devices for Atrial Fibrillation Screening: Systematic Review.JMIR mHealth and uHealth · 2019Pooled it
- Testing the feasibility of operationalizing a prospective, randomized trial with remote cardiac safety EKG monitoring during a pandemic.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Trial
- Efficacy and safety of dronedarone by atrial fibrillation history duration: Insights from the ATHENA study.Clinical cardiology · 2020Trial
- Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation.The New England journal of medicine · 2019Trial
- Bucindolol for the Maintenance of Sinus Rhythm in a Genotype-Defined HF Population: The GENETIC-AF Trial.JACC. Heart failure · 2019Trial
- Digital Phenotyping in Health Research: Scoping Review of Methods, Gaps, and Opportunities.Journal of medical Internet research · 2026Article
- Wearable Devices and Machine Learning in Cardiovascular Monitoring: Current Evidence and Future Directions for Precision Medicine.Journal of personalized medicine · 2026Review
- Artificial Intelligence in Healthcare Administration and Clinical Informatics: A Critical Review and Governance Roadmap.Healthcare (Basel, Switzerland) · 2026Review
- An Adjustable Smart Ring to Monitor Pulse Rate and Peripheral Blood Oxygen Saturation.Annals of biomedical engineering · 2026Article
138 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundSmartwatch and fitness band wearable consumer electronics can passively measure pulse rate from the wrist using photoplethysmography (PPG). Identification of pulse irregularity or variability from these data has the potential to identify atrial fibrillation or atrial flutter (AF, collectively). The rapidly expanding consumer base of these devices allows for detection of undiagnosed AF at scale.
methodsThe Apple Heart Study is a prospective, single arm pragmatic study that has enrolled 419,093 participants (NCT03335800). The primary objective is to measure the proportion of participants with an irregular pulse detected by the Apple Watch (Apple Inc, Cupertino, CA) with AF on subsequent ambulatory ECG patch monitoring. The secondary objectives are to: 1) characterize the concordance of pulse irregularity notification episodes from the Apple Watch with simultaneously recorded ambulatory ECGs; 2) estimate the rate of initial contact with a health care provider within 3 months after notification of pulse irregularity. The study is conducted virtually, with screening, consent and data collection performed electronically from within an accompanying smartphone app. Study visits are performed by telehealth study physicians via video chat through the app, and ambulatory ECG patches are mailed to the participants.
conclusionsThe results of this trial will provide initial evidence for the ability of a smartwatch algorithm to identify pulse irregularity and variability which may reflect previously unknown AF. The Apple Heart Study will help provide a foundation for how wearable technology can inform the clinical approach to AF identification and screening.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.