Current perspectives on wearable rhythm recordings for clinical decision-making: the wEHRAbles 2 survey
Current perspectives on wearable rhythm recordings for clinical decision-making: the wEHRAbles 2 survey
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DOI：
10.1093/europace/euab064
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发表时间：
2021-04-11
期刊：
影响因子：
6.1
通讯作者：
Duncker, David
中科院分区：
文献类型：
--
作者：
Manninger, Martin;Zweiker, David;Duncker, David
新型可穿戴设备用于使用光电容积脉搏图（PPG）或心电图（ECG）进行心律分析，已在日常临床实践中得到应用。本调查旨在评估这些技术对医生临床决策的影响，并定义如何将这些设备的数据呈现并整合到临床实践中。在线调查包括22个问题，重点关注基于可穿戴节律设备记录的房颤（AF）诊断、可穿戴节律设备的合适适应症、数据呈现和处理、报销以及未来前景。来自全球51个国家的539名受访者（中位年龄38岁[四分位数范围34-46]岁，29%为女性）完成了调查。虽然大多数应答者会诊断房颤（83%），但很少有人会基于单导联心电图追踪开始口服抗凝治疗。更少的人（27%）会根据基于ppg的追踪做出诊断。可穿戴心电图技术用于心律失常患者的筛查、诊断、监测和随访是大多数受访者可以接受的，而PPG技术用于这些适应症的受访者则比较不愿意。大多数受访者（74%）主张从患者中位年龄60岁（IQR 50-65岁）开始，使用可穿戴节律设备系统筛查房颤。36%的受访者表示，在他们的国家，涉及可穿戴节律设备的诊断没有报销。大多数受访者（56.4%）认为可穿戴节律设备的成本应该由患者和保险公司共同承担。可穿戴式单导联或多导联心电图技术在目前的临床实践中被广泛接受用于多种适应症，并引发AF的诊断和治疗。需要采取行动的未满足需求是报销计划和将可穿戴节律设备数据集成到患者档案和医院信息系统中。
Novel wearable devices for heart rhythm analysis using either photoplethysmography (PPG) or electrocardiogram (ECG) are in daily clinical practice. This survey aimed to assess impact of these technologies on physicians' clinical decision-making and to define, how data from these devices should be presented and integrated into clinical practice. The online survey included 22 questions, focusing on the diagnosis of atrial fibrillation (AF) based on wearable rhythm device recordings, suitable indications for wearable rhythm devices, data presentation and processing, reimbursement, and future perspectives. A total of 539 respondents {median age 38 [interquartile range (IQR) 34-46] years, 29% female} from 51 countries world-wide completed the survey. Whilst most respondents would diagnose AF (83%), fewer would initiate oral anticoagulation therapy based on a single-lead ECG tracing. Significantly fewer still (27%) would make the diagnosis based on PPG-based tracing. Wearable ECG technology is acceptable for the majority of respondents for screening, diagnostics, monitoring, and follow-up of arrhythmia patients, while respondents were more reluctant to use PPG technology for these indications. Most respondents (74%) would advocate systematic screening for AF using wearable rhythm devices, starting at patients' median age of 60 (IQR 50-65) years. Thirty-six percent of respondents stated that there is no reimbursement for diagnostics involving wearable rhythm devices in their countries. Most respondents (56.4%) believe that costs of wearable rhythm devices should be shared between patients and insurances. Wearable single- or multiple-lead ECG technology is accepted for multiple indications in current clinical practice and triggers AF diagnosis and treatment. The unmet needs that call for action are reimbursement plans and integration of wearable rhythm device data into patient's files and hospital information systems.[GRAPHICS].