Accuracy of Detecting Atrial Fibrillation: A Systematic Review and Meta-Analysis of Wrist-Worn Wearable Technology

Objective Our systematic review and meta-analysis qualitatively and quantitatively analyzes available literature on wrist-worn wearable devices (Apple Watch, Samsung, and KardiaBand) and their sensitivity and specificity in detecting AF compared to conventional methods. Background Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia, and ECG remains the gold standard for diagnosing AF. Wrist-worn technologies are appealing for their ability to passively process near-continuous pulse signals. Methods PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed, yielding 9 studies (N=1,581). Observational studies assessing the sensitivity and specificity of wrist-worn wearables in detecting AF in patients with and without a history of AF were included and analyzed using a fixed effect model with an inverse-variance method. Results In patients with a history of AF, the overall sensitivity between device groups was not statistically significant (sensitivity: 96.83%; p=0.207). The overall specificity between device groups was statistically significant (specificity: 99.02%; p Conclusions Wrist-worn wearable devices demonstrate promising results in detecting AF in patients with paroxysmal AF. However, more rigorous prospective data is needed to understand the limitations of these devices in regards to varying specificity which may lead to unnecessary downstream medical testing and cost.