ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Wearable smartwatches for atrial fibrillation detection and burden estimation after ablation: comparison with continuous monitoring.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Oral anticoagulation discontinuation after atrial fibrillation ablation: a systematic review and meta-analysis of randomized trials.European heart journal open · 2026Article
- Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches.Journal of clinical medicine · 2025Review
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7 authors.
Funding
Abstract
aimsWearable ECG-enabled smartwatches have been validated for atrial fibrillation (AF) screening, but their accuracy for monitoring AF recurrence and quantifying AF burden after catheter ablation is uncertain. To evaluate the simulated performance of three commercial smartwatch algorithms for AF recurrence detection and AF burden estimation compared with implantable cardiac monitors (ICMs). METHODS AND
resultsUsing continuous ICM data from 346 patients in the CIRCA-DOSE trial, we simulated three smartwatch algorithms, assuming daytime wear (8:00 AM-10:00 p.m.). We also simulated commonly-used non-invasive intermittent rhythm monitoring strategies. Primary endpoints were sensitivity for arrhythmia recurrence and correlation with ICM-derived AF burden. Analyses were stratified by daily wear time and patient activity. AF recurrence occurred in 47.1% of patients. Simulated detection sensitivities were 82.2% (Apple Watch AF Burden), 70.6% (Apple Watch IRN), and 64.4% (Fitbit IHRD), compared with 15.8-64.6% for simulated intermittent AECG monitors. Wearables outperformed commonly-used Holter/patch monitoring strategies. AF burden correlation with ICM exceeded r = 0.97 for all algorithms. Among missed recurrences, median AF burden was <0.02%. Longer daily wear improved sensitivity (>90% with 24-hour use), whereas patient activity modestly reduced detection.
conclusionSmartwatch-based AF detection algorithms demonstrate strong correlation with ICM-derived AF burden and clinically good sensitivity for recurrence detection, outperforming conventional non-invasive strategies. These findings support the integration of wearables as a scalable alternative for post-ablation rhythm monitoring.
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