ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Accuracy of continuous photoplethysmography-based 1 min mean heart rate assessment during atrial fibrillation.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 25 citations in OpenAlex.
- Improving atrial fibrillation or flutter detection and management by smartphone-based photoplethysmography rhythm monitoring following cardiac surgery: a pragmatic randomized trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Trial
- Monitoring of ventricular rate in atrial fibrillation patients through an app based on pulse-plethysmography.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Heart rate dynamics in polyendocrine metabolic ovarian syndrome: from heterogeneity to wearable digital phenotyping.Frontiers in endocrinology · 2026Review
- Evaluating artificial intelligence-enabled medical tests in cardiology: Best practice.International journal of cardiology. Heart & vasculature · 2025Review
- The Validation and Accuracy of Wearable Heart Rate Trackers in Children With Heart Disease: Prospective Cohort Study.JMIR formative research · 2025Article
- Accuracy of smartwatches for measuring heart rate and oxygen saturation in cynomolgus macaques compared to clinical standards.Laboratory animals · 2025Article
- Artificial Intelligence and ECG: A New Frontier in Cardiac Diagnostics and Prevention.Biomedicines · 2025Review
- Ultra-short-term heart rate variability using a photoplethysmography-based smartphone application: a TeleCheck-AF subanalysis.European heart journal. Digital health · 2025Article
- Photoplethysmography in recent-onset atrial fibrillation: automatic detection of rhythm change and burden.European heart journal. Digital health · 2025Article
- A Survey on the Perceptions of Puerto Rican Cardiologists on the Use of Smartwatches and Implantable Loop Recorders.Cureus · 2025Article
- External validation of a machine learning-based classification algorithm for ambulatory heart rhythm diagnostics in pericardioversion atrial fibrillation patients using smartphone photoplethysmography: the SMARTBEATS-ALGO study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Physician Preferences in Using Novel Digital Devices for the Management of Atrial Fibrillation-A DAS-CAM III Survey.Clinical cardiology · 2024Article
- Intelligent Detection Method of Atrial Fibrillation by CEPNCC-BiLSTM Based on Long-Term Photoplethysmography Data.Sensors (Basel, Switzerland) · 2024Article
- Remote rhythm monitoring using a photoplethysmography smartphone application after cardioversion for atrial fibrillation.European heart journal. Digital health · 2024Article
- [Characterization of atrial fibrillation burden using wearables].Herzschrittmachertherapie & Elektrophysiologie · 2024Review
- Longer and better lives for patients with atrial fibrillation: the 9th AFNET/EHRA consensus conference.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Real-world validation of smartphone-based photoplethysmography for rate and rhythm monitoring in atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Atrial fibrillation: epidemiology, screening and digital health.The Lancet regional health. Europe · 2024Review
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsAlthough mobile health tools using photoplethysmography (PPG) technology have been validated for the detection of atrial fibrillation (AF), their utility for heart rate assessment during AF remains unclear. Therefore, we aimed to evaluate the accuracy of continuous PPG-based 1 min mean heart rate assessment during AF. METHODS AND
resultsPersistent AF patients were provided with Holter electrocardiography (ECG) (for ≥24 h) simultaneously with a PPG-equipped smartwatch. Both the PPG-based smartwatch and Holter ECG automatically and continuously monitored patients' heart rate/rhythm. ECG and PPG recordings were synchronized and divided into 1 min segments, from which a PPG-based and an ECG-based average heart rate estimation were extracted. In total, 47 661 simultaneous ECG and PPG 1 min heart rate segments were analysed in 50 patients (34% women, age 73 ± 8 years). The agreement between ECG-determined and PPG-determined 1 min mean heart rate was high [root mean squared error (RMSE): 4.7 bpm]. The 1 min mean heart rate estimated using PPG was accurate within ±10% in 93.7% of the corresponding ECG-derived 1 min mean heart rate segments. PPG-based 1 min mean heart rate estimation was more often accurate during night-time (97%) than day-time (91%, P < 0.001) and during low levels (96%) compared to high levels of motion (92%, P < 0.001). A neural network with a 10 min history of the recording did not further improve the PPG-based 1 min mean heart rate assessment [RMSE: 4.4 (95% confidence interval: 3.5-5.2 bpm)]. Only chronic heart failure was associated with a lower agreement between ECG-derived and PPG-derived 1 min mean heart rates (P = 0.040).
conclusionDuring persistent AF, continuous PPG-based 1 min mean heart rate assessment is feasible in 60% of the analysed period and shows high accuracy compared with Holter ECG for heart rates <110 bpm.
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