Atrial fibrillation (AF) is the world?s most common serious heart rhythm problem and causes 15% of all strokes, a major cause of disability and death among Americans.1 Long-term monitoring for early AF detection and treatment is recommended for many stroke patients, but although existing cardiac monitors are accurate, they suffer from methodologic and cost limitations that preclude their long-term use. In the proposed, ?Smartwatch Monitoring for Atrial Fibrillation Real-Time in Stroke,? Study, our overall objective is to enhance paroxysmal AF (pAF) detection by enhancing and testing Pulsewatch, an innovative, smartwatch-based technology for long-term rhythm monitoring of stroke patients.
For Aim 1, we embed our state-of-the art AF detection algorithms, interactive messaging to promote adherence, and novel contact and motion noise correction capabilities into a smartwatch to enable near-continuous pulse waveform analysis. We will further refine Pulsewatch through focus groups and a Hack-a-thon with stroke patients and their medical providers.
For Aim 2, we will enroll 90 stroke survivors and provide them with a smartphone and smartwatch, both encoded with Pulsewatch. We will compare the performance of Pulsewatch when worn daily for 7 days to conventional 7-day cardiac monitoring for pAF detection.
For Aim 3, we will determine the acceptability and usability of Pulsewatch through follow-up interviews and focus groups in 30 randomly selected participants from Aim 2 asked to continue wearing smartwatch daily for an additional 30 days. We will identify patient factors associated with adherence and evaluate the impact of Pulsewatch use on disease-specific quality of life, anxiety, and self- activation among the 30 users compared to 30 stroke patients treated with usual care through baseline and 1- month assessments. Our research will lead to the development of a highly acceptable, enabling cardiovascular monitoring technology designed by, and for, stroke patients that facilitates long-term non-invasive screening for pAF, as well as communication between stroke patients and their medical providers. !

Public Health Relevance

Atrial fibrillation (AF) is the world?s most common serious heart rhythm problem and causes 15% of all strokes, a major cause of disability and death among Americans.1,2 Long-term monitoring for early AF detection and treatment is recommended for many stroke patients, but although existing cardiac monitors are accurate, they suffer from methodologic and cost limitations. Accordingly, we propose a series of prospective investigations involving stroke patients and their medical providers focused on developing, validating, and field-testing a new smartwatch-based AF detection platform, Pulsewatch, to create a mobile technology that can detect paroxysms of AF, accelerate their treatment, is user-centric, and is of great intrinsic acceptability.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL137734-01A1
Application #
9523887
Study Section
Biomedical Computing and Health Informatics Study Section (BCHI)
Program Officer
Iturriaga, Erin
Project Start
2018-04-15
Project End
2022-02-28
Budget Start
2018-04-15
Budget End
2019-02-28
Support Year
1
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
603847393
City
Worcester
State
MA
Country
United States
Zip Code
01655