{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:09:07Z","timestamp":1792249747339,"version":"4.4.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although mobile health tools using photoplethysmography (PPG) technology have been validated for the detection of atrial fibrillation (AF), their utility for heart rate assessment during AF remains unclear. Therefore, we aimed to evaluate the accuracy of continuous PPG-based 1 min mean heart rate assessment during AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Persistent AF patients were provided with Holter electrocardiography (ECG) (for \u226524 h) simultaneously with a PPG-equipped smartwatch. Both the PPG-based smartwatch and Holter ECG automatically and continuously monitored patients\u2019 heart rate\/rhythm. ECG and PPG recordings were synchronized and divided into 1 min segments, from which a PPG-based and an ECG-based average heart rate estimation were extracted. In total, 47 661 simultaneous ECG and PPG 1 min heart rate segments were analysed in 50 patients (34% women, age 73 \u00b1 8 years). The agreement between ECG-determined and PPG-determined 1 min mean heart rate was high [root mean squared error (RMSE): 4.7 bpm]. The 1 min mean heart rate estimated using PPG was accurate within \u00b110% in 93.7% of the corresponding ECG-derived 1 min mean heart rate segments. PPG-based 1 min mean heart rate estimation was more often accurate during night-time (97%) than day-time (91%, P &amp;lt; 0.001) and during low levels (96%) compared to high levels of motion (92%, P &amp;lt; 0.001). A neural network with a 10 min history of the recording did not further improve the PPG-based 1 min mean heart rate assessment [RMSE: 4.4 (95% confidence interval: 3.5\u20135.2 bpm)]. Only chronic heart failure was associated with a lower agreement between ECG-derived and PPG-derived 1 min mean heart rates (P = 0.040).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>During persistent AF, continuous PPG-based 1 min mean heart rate assessment is feasible in 60% of the analysed period and shows high accuracy compared with Holter ECG for heart rates &amp;lt;110 bpm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euad011","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T15:50:00Z","timestamp":1674489000000},"page":"835-844","source":"Crossref","is-referenced-by-count":27,"title":["Accuracy of continuous photoplethysmography-based 1 min mean heart rate assessment during atrial fibrillation"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-1479","authenticated-orcid":false,"given":"Astrid N L","family":"Hermans","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3227-1131","authenticated-orcid":false,"given":"Jonas L","family":"Isaksen*","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , N\u00f8rregade 10, 1165 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-9062","authenticated-orcid":false,"given":"Monika","family":"Gawalko","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"},{"name":"Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen , Forsthausweg 2, 47057 Duisburg , Germany"},{"name":"1st Department of Cardiology, Medical University of Warsaw , \u017bwirki i Wigury 61, 02-091 Warsaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9663-6315","authenticated-orcid":false,"given":"Nikki A H A","family":"Pluymaekers","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-3333","authenticated-orcid":false,"given":"Rachel M J","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilco","family":"Snippe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn","family":"Evens","sequence":"additional","affiliation":[{"name":"Qompium NV , Kempische Steenweg 293\/16, 3500 Hasselt , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"De Witte","sequence":"additional","affiliation":[{"name":"Qompium NV , Kempische Steenweg 293\/16, 3500 Hasselt , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-2286","authenticated-orcid":false,"given":"Justin G L M","family":"Luermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"},{"name":"Department of Cardiology, Radboud University Medical Centre , Geert Grooteplein Zuid 10, 6525 GA Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0545-4373","authenticated-orcid":false,"given":"Martin","family":"Manninger","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Medical University of Graz , Auenbruggerpl. 2, 8036 Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8129-7384","authenticated-orcid":false,"given":"Joost","family":"Lumens","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University , Minderbroedersberg 4-6, 6211 LK Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3267-4910","authenticated-orcid":false,"given":"J\u00f8rgen K","family":"Kanters","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , N\u00f8rregade 10, 1165 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-0824","authenticated-orcid":false,"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht , P. Debyelaan 25, 6229 HX Maastricht , The Netherlands"},{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , N\u00f8rregade 10, 1165 Copenhagen , Denmark"},{"name":"Department of Cardiology, Radboud University Medical Centre , Geert Grooteplein Zuid 10, 6525 GA Nijmegen , The Netherlands"},{"name":"Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital , Port Rd, Adelaide SA 5000 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association of cardio-thoracic surgery (EACTS)","volume":"42","author":"Hindricks","year":"2020","journal-title":"Eur Heart J"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(00)03230-X","article-title":"Rhythm or rate control in atrial fibrillation\u2014pharmacological intervention in atrial fibrillation (PIAF): a randomised trial","volume":"356","author":"Hohnloser","year":"2000","journal-title":"Lancet"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1056\/NEJMoa1001337","article-title":"Lenient versus strict rate control in patients with atrial fibrillation","volume":"362","author":"Van Gelder","year":"2010","journal-title":"N Engl J Med"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/S0140-6736(16)31258-2","article-title":"Rate control in atrial fibrillation","volume":"388","author":"Van Gelder","year":"2016","journal-title":"Lancet"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"e11606","DOI":"10.2196\/11606","article-title":"The current state of Mobile phone apps for monitoring heart rate, heart rate variability, and atrial fibrillation: narrative review","volume":"7","author":"Li","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1093\/europace\/euac142","article-title":"Reimbursement practices for use of digital devices in atrial fibrillation and other arrhythmias: a European heart rhythm association survey","volume":"24","author":"Boriani","year":"2022","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/europace\/euab064","article-title":"Current perspectives on wearable rhythm recordings for clinical decision-making: the wEHRAbles 2 survey","volume":"23","author":"Manninger","year":"2021","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"ii46","DOI":"10.1093\/europace\/euaa424","article-title":"Early atrial fibrillation detection and the transition to comprehensive management","volume":"23","author":"Linz","year":"2021","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1093\/europace\/euaa201","article-title":"Implementation of an on-demand app-based heart rate and rhythm monitoring infrastructure for the management of atrial fibrillation through teleconsultation: TeleCheck-AF","volume":"23","author":"Pluymaekers","year":"2021","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1080\/07853890.2018.1531144","article-title":"The validation of smartphone applications for heart rate measurement","volume":"50","author":"Pipitprapat","year":"2018","journal-title":"Ann Med"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"e12284","DOI":"10.2196\/12284","article-title":"Mobile phone-based use of the photoplethysmography technique to detect atrial fibrillation in primary care: diagnostic accuracy study of the FibriCheck app","volume":"7","author":"Proesmans","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1162\/neco.1997.9.8.1735","article-title":"Long short-term memory","volume":"9","author":"Hochreiter","year":"1997","journal-title":"Neural Comput"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"065007","DOI":"10.1088\/1361-6579\/aac9a9","article-title":"Monitoring of heart rate and inter-beat intervals with wrist plethysmography in patients with atrial fibrillation","volume":"39","author":"Harju","year":"2018","journal-title":"Physiol Meas"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1093\/ehjdh\/ztab050","article-title":"The photoplethysmography dictionary: practical guidance on signal interpretation and clinical scenarios from TeleCheck-AF","volume":"2","author":"van der Velden","year":"2021","journal-title":"Eur Heart J Digital Health"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ijcard.2018.02.073","article-title":"Smart watches for heart rate assessment in atrial arrhythmias","volume":"266","author":"Koshy","year":"2018","journal-title":"Int J Cardiol"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1016\/j.jacc.2020.02.025","article-title":"Atrial fibrillation: JACC council perspectives","volume":"75","author":"Chung","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1093\/europace\/euac038","article-title":"How to use digital devices to detect and manage arrhythmias: an EHRA practical guide","volume":"24","author":"Svennberg","year":"2022","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1088\/0967-3334\/36\/9\/1873","article-title":"Heart rate dynamics distinguish among atrial fibrillation, normal sinus rhythm and sinus rhythm with frequent ectopy","volume":"36","author":"Carrara","year":"2015","journal-title":"Physiol Meas"},{"key":"2023033021231079400_","first-page":"2851","article-title":"Effect of motion artifact on digital camera based heart rate measurement","volume":"2017","author":"Hassan","year":"2017","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"04nt1","DOI":"10.1088\/1361-6579\/ab840a","article-title":"Feasible assessment of recovery and cardiovascular health: accuracy of nocturnal HR and HRV assessed via ring PPG in comparison to medical grade ECG","volume":"41","author":"Kinnunen","year":"2020","journal-title":"Physiol Meas"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"634","DOI":"10.3109\/03091900903150998","article-title":"A comparison of photoplethysmography and ECG recording to analyse heart rate variability in healthy subjects","volume":"33","author":"Lu","year":"2009","journal-title":"J Med Eng Technol"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/europace\/euac062","article-title":"Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation: the 8th AFNET\/EHRA consensus conference","volume":"25","author":"Schnabel","year":"2023","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1093\/europace\/euac052","article-title":"Wearables, telemedicine, and artificial intelligence in arrhythmias and heart failure: proceedings of the European society of cardiology cardiovascular round table","volume":"24","author":"Leclercq","year":"2022","journal-title":"Europace"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s00399-022-00839-x","article-title":"Artificial intelligence for the detection, prediction, and management of atrial fibrillation","volume":"33","author":"Isaksen","year":"2022","journal-title":"Herzschrittmacherther Elektrophysiol"},{"key":"2023033021231079400_","doi-asserted-by":"crossref","first-page":"H493","DOI":"10.1152\/ajpheart.00392.2021","article-title":"Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet","volume":"322","author":"Charlton","year":"2022","journal-title":"Am J Physiol Heart Circ Physiol"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/3\/835\/49704006\/euad011.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/3\/835\/49704006\/euad011.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T02:44:59Z","timestamp":1701744299000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/25\/3\/835\/7030202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,7]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2,7]]},"published-print":{"date-parts":[[2023,3,30]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euad011","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,3,1]]},"published":{"date-parts":[[2023,2,7]]}}}