Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Validation of smartwatch electrocardiogram intervals in children compared to standard 12 lead electrocardiograms

Ernstsson, Julia ; Svensson, Birgitta LU ; Liuba, Petru LU and Weismann, Constance G LU orcid (2024) In European Journal of Pediatrics
Abstract

UNLABELLED: Lay people are now able to obtain one-lead electrocardiograms (ECG) using smartwatches, which facilitates documentation of arrhythmias. The accuracy of smartwatch derived ECG intervals has not been validated in children though. Home-based monitoring of ECG intervals using a smartwatch could improve monitoring of children, e.g. when taking QTc prolonging medications. The aim of this study was to validate the ECG intervals measured by smartwatch in comparison to standard 12-lead ECGs in children and adolescents. Prospective study of children (age 5-17 years) at the outpatient clinic of a national pediatric heart center. Patients underwent a smartwatch ECG (ScanWatch, Withings) and a simultaneous standard 12-lead ECG. ECG... (More)

UNLABELLED: Lay people are now able to obtain one-lead electrocardiograms (ECG) using smartwatches, which facilitates documentation of arrhythmias. The accuracy of smartwatch derived ECG intervals has not been validated in children though. Home-based monitoring of ECG intervals using a smartwatch could improve monitoring of children, e.g. when taking QTc prolonging medications. The aim of this study was to validate the ECG intervals measured by smartwatch in comparison to standard 12-lead ECGs in children and adolescents. Prospective study of children (age 5-17 years) at the outpatient clinic of a national pediatric heart center. Patients underwent a smartwatch ECG (ScanWatch, Withings) and a simultaneous standard 12-lead ECG. ECG intervals were measured both automatically and manually from the smartwatch ECG and the 12-lead ECG. Intraclass correlation coefficients and Bland-Altman plots were performed. 100 patients (54% male, median age 12.9 (IQR 8.7-15.6) were enrolled. The ICC calculated from the automated smartwatch and automated 12-lead ECG were excellent for heart rate (ICC 0.97, p < 0.001), good for the PR and QT intervals (ICC 0.86 and 0.8, p < 0.001), and moderate for the QRS duration and QTc interval (ICC 0.7 and 0.53, p < 0.001). When using manual measurements for the smartwatch ECG, validity was improved for the PR interval (ICC 0.93, p < 0.001), QRS duration (ICC 0.92, p < 0.001), QT (ICC 0.95, p < 0.001) and QTc interval (ICC 0.84, p < 0.001).

CONCLUSION: Automated smartwatch intervals are most reliable measuring the heart rate. The automated smartwatch QTc intervals are less reliable, but this may be improved by manual measurements.

WHAT IS KNOWN: In adults, smartwatch derived ECG intervals measured manually have previously been shown to be accurate, though agreement for automated QTc may be fair.

WHAT IS NEW: In children, automated smartwatch QTc intervals are less reliable than RR, PR, QRS and uncorrected QT interval. Accuracy of the QTc can be improved by peroforming manual measurements.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
European Journal of Pediatrics
publisher
Springer
external identifiers
  • pmid:38918230
ISSN
1432-1076
DOI
10.1007/s00431-024-05648-7
language
English
LU publication?
yes
additional info
© 2024. The Author(s).
id
c354b6ed-259d-4afa-86a2-34482bc96caa
date added to LUP
2024-07-13 09:55:13
date last changed
2024-07-15 11:20:35
@article{c354b6ed-259d-4afa-86a2-34482bc96caa,
  abstract     = {{<p>UNLABELLED: Lay people are now able to obtain one-lead electrocardiograms (ECG) using smartwatches, which facilitates documentation of arrhythmias. The accuracy of smartwatch derived ECG intervals has not been validated in children though. Home-based monitoring of ECG intervals using a smartwatch could improve monitoring of children, e.g. when taking QTc prolonging medications. The aim of this study was to validate the ECG intervals measured by smartwatch in comparison to standard 12-lead ECGs in children and adolescents. Prospective study of children (age 5-17 years) at the outpatient clinic of a national pediatric heart center. Patients underwent a smartwatch ECG (ScanWatch, Withings) and a simultaneous standard 12-lead ECG. ECG intervals were measured both automatically and manually from the smartwatch ECG and the 12-lead ECG. Intraclass correlation coefficients and Bland-Altman plots were performed. 100 patients (54% male, median age 12.9 (IQR 8.7-15.6) were enrolled. The ICC calculated from the automated smartwatch and automated 12-lead ECG were excellent for heart rate (ICC 0.97, p &lt; 0.001), good for the PR and QT intervals (ICC 0.86 and 0.8, p &lt; 0.001), and moderate for the QRS duration and QTc interval (ICC 0.7 and 0.53, p &lt; 0.001). When using manual measurements for the smartwatch ECG, validity was improved for the PR interval (ICC 0.93, p &lt; 0.001), QRS duration (ICC 0.92, p &lt; 0.001), QT (ICC 0.95, p &lt; 0.001) and QTc interval (ICC 0.84, p &lt; 0.001).</p><p>CONCLUSION: Automated smartwatch intervals are most reliable measuring the heart rate. The automated smartwatch QTc intervals are less reliable, but this may be improved by manual measurements.</p><p>WHAT IS KNOWN: In adults, smartwatch derived ECG intervals measured manually have previously been shown to be accurate, though agreement for automated QTc may be fair.</p><p>WHAT IS NEW: In children, automated smartwatch QTc intervals are less reliable than RR, PR, QRS and uncorrected QT interval. Accuracy of the QTc can be improved by peroforming manual measurements.</p>}},
  author       = {{Ernstsson, Julia and Svensson, Birgitta and Liuba, Petru and Weismann, Constance G}},
  issn         = {{1432-1076}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Springer}},
  series       = {{European Journal of Pediatrics}},
  title        = {{Validation of smartwatch electrocardiogram intervals in children compared to standard 12 lead electrocardiograms}},
  url          = {{http://dx.doi.org/10.1007/s00431-024-05648-7}},
  doi          = {{10.1007/s00431-024-05648-7}},
  year         = {{2024}},
}