Wearables in cardiology-Knowledge from current digital atrial fibrillation screening and management studies

The rapid development and dissemination of commercially available wearables and smartphones are accompanied by an increasing implementation of these devices in the healthcare sector. Wearables and smartphones are particularly used for the detection and monitoring of cardiac arrhythmias, such as atrial fibrillation (AF). Integrated sensors enable the photoplethysmographic detection of an irregular pulse wave sequence and can thus contribute to an early detection of AF. Studies have shown that in a high-risk population digital AF screening could double the detection of subclinical AF in comparison to routine screening measures; however, the prognostic implication of early digital detection of AF or a prophylactic prescription of oral anticoagulation after screening remains currently unclear. In patients with known AF a combined strategy of rhythm self-monitoring and application-based disease management could significantly reduce the rate of cardiovascular events and hospitalization. Due to the poor data situation on the health advantages of an early recognition of subclinical digitally diagnosed AF, a general digital AF screening is not routinely recommended in the current guidelines. Further randomized studies are needed to clarify in which patients digital screening should be recommended, when and to whom oral anticoagulation should be recommended after detection of subclinical AF and whether a reduction in morbidity and mortality could ultimately be achieved by digital screening for AF.