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© 2025. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

The prevalence of atrial fibrillation (AFib) continues to increase globally, posing a significant risk for serious cardiovascular complications, such as ischemic stroke and thromboembolism. Smartwatch single‐lead electrocardiogram (ECG) can be a practical and accurate early detection tool for AFib.

Objective

The aim of this study was to fill the research gap in evaluating the accuracy and interpretability of smartwatch ECG for early AFib detection.

Methods

Data derived from indexed literature in the Scopus, Scilit, PubMed, Google Scholar, Web of Science, IEEE, and Cochrane Library databases (as of June 1, 2024) were systematically screened and extracted. The quantitative synthesis was performed using a two‐level mixed‐effects logistic regression model, as well as a proportional analysis with Freeman‐Tukey double transformation on a restricted maximum‐likelihood model.

Results

The sensitivity and specificity of smartwatch ECG in algorithmic readings were 86% and 94%, respectively. In manual readings, the sensitivity and specificity reached 96% and 95%, respectively. In a brand‐specific subgroup analysis, the algorithmic reading reached a summary area under the curve (sAUC) of 96%, while another brand achieved the highest sAUC of 98% in manual reading. The level of manual interpretability was relatively high with Cohen's Kappa of 0.83, but 3% of ECG results were difficult to read manually.

Conclusion

This study shows that smartwatch ECG is able to detect AFib with high accuracy, especially through manual reading by trained medical personnel.

PROSPERO Registration

CRD42024548537 (May 29, 2024).

Details

Title
Accuracy and interpretability of smartwatch electrocardiogram for early detection of atrial fibrillation: A systematic review and meta‐analysis
Author
Iqhrammullah, Muhammad 1 ; Abdullah, Asnawi 2 ; Hermansyah 3   VIAFID ORCID Logo  ; Ichwansyah, Fahmi 4 ; Rani, Hafnidar A. 5 ; Alina, Meulu 6 ; Simanjuntak, Artha M. T. 7 ; Rampengan, Derren D. C. H. 8 ; Al‐Gunaid, Seba Talat 6 ; Gusti, Naufal 1 ; Damarkusuma, Arditya 9 ; Wikurendra, Edza Aria 10   VIAFID ORCID Logo 

 Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia 
 Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia, Faculty of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia 
 Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia, Department of Applied Nursing Program, Poltekkes Kemenkes Aceh, Banda Aceh, Indonesia 
 Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia, Health Polytechnic of Aceh, Ministry of Health‐Indonesia, Banda Aceh, Indonesia 
 Department of Civil Engineering, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia 
 Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia 
 Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia 
 Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia 
 Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia 
10  Department of Public Health, Faculty of Health, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia, Department of Health Science, Faculty of Humanities and Health Science, Curtin University, Miri, Malaysia 
Section
ORIGINAL ARTICLE
Publication year
2025
Publication date
Jun 1, 2025
Publisher
John Wiley & Sons, Inc.
ISSN
1880-4276
e-ISSN
1883-2148
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3224228888
Copyright
© 2025. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.