Early Monitoring of Arrhythmias in Patients on Hemodialysis with Wearable Devices: A Multicenter, Cross-Sectional Observational Study

Background: To further test the applicability of wearable devices for arrhythmia monitoring and early warning in HD patients Methods: This study was a multicenter cross-sectional investigation involving five tertiary general hospitals from March 2022 to December 2023. This portion of the study mainly involved validating the reliability and feasibility of the use of wearable devices with long-term ECG monitoring capabilities (Lepu ER1 single-lead ambulatory ECG recorders and ECG chest belts) for the real-time dynamic detection of arrhythmia and heart rate variability, with ambulatory ECG recorders (CT-086S) that are used in clinical practice taken as the gold standard. Results: A total of 538 maintenance HD patients from 5 tertiary general hospitals, were included in the study. 1. Reliability assessment: In the feasibility analysis of monitoring arrhythmia, a total of 185 patients with HD were included in the study. This study revealed that the heart rate variability metric measured by the Lpepu ER1 was positively correlated with others measured by ct-086S. 1.3 The sensitivity, specificity, and accuracy of diagnosing atrial fibrillation in HD patients were 88.9%, 93.8%, and 93.5%, respectively. The positive predictive value was 42.1%, and the negative predictive value was 99.4%. 2. Feasibility Assessment: A total of 353 HD patients from 4 medical centers wore Lepu ER1 single-lead dynamic electrocardiogram recorders. 72.5% of HD patients were monitored by Lepu ER1 single-lead dynamic electrocardiographic recorder with arrhythmia during dialysis. It is worth noting that among the 47 patients with clinical symptoms, 91.5% of them were also monitored by wearable devices for the occurrence of arrhythmia, and only 8.5% of patients were not monitored for arrhythmia when clinical symptoms appeared. However, among patients without clinical symptoms, 69.6% were still monitored with arrhythmia. There was a statistically significant difference in the correlation between the occurrence of clinical symptoms and arrhythmia monitored by wearable devices in the two groups. Conclusion: Wearable devices equipped have the ability to continuously and dynamically monitor arrhythmias in patients with heart disease, particularly for the detection of atrial fibrillation. Heart rate variability parameters show a positive correlation with dynamic electrocardiogram assessments. Funding: Government Support – Non-U.S.