{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:42:41Z","timestamp":1793659361241,"version":"4.5.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Wrist-worn wearables can detect irregular heart rhythms using photoplethysmography, but ECGs are required to confirm atrial fibrillation (AF). We sought to determine the frequency of a recurrent irregular heart rhythm detection (IHRD; \u226530 minutes of an irregular rhythm), estimate the potential diagnostic yield of different electrocardiographic monitoring strategies for confirming AF, and identify predictors of recurrent IHRDs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>The Fitbit Heart Study enrolled wrist-worn photoplethysmography device users without diagnosed AF. Of 455\u2005699 participants, 1057 who wore and returned a 1-week ECG patch monitor after receiving an IHRD were analyzed. Baseline clinical data, device-derived metrics, IHRDs during follow-up, and electrocardiographic patch data were used for analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 570 (53.9%) participants were aged 40 to 64 years, 422 (39.9%) were aged \u226565 years, and 510 (48.2%) were women. Median follow-up after ECG patch initiation was 80 days (interquartile range, 45\u2013122 days). The frequency of another IHRD was 57.2% (95% CI, 53.1%\u201360.9%) at 3 months. After an initial IHRD, the estimated diagnostic yield for AF with a 10-second ECG was 7.6% (95% CI, 6.2%\u20139.0%), twice-daily 30-second ECGs over 1 week 19.0% (95% CI, 16.7%\u201321.2%), 24-hour monitor 17.4% (95% CI, 15.5%\u201319.3%), 1-week monitor 32.2% (95% CI, 29.4%\u201335.0%), 2-week monitor 46.8% (95% CI, 42.7%\u201350.8%), and 4-week monitor 60.8% (95% CI, 56.5%\u201365.1%). The risk of a recurrent IHRD was greater with older age (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), male sex (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.001), vascular disease (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.03), longer initial runs of consecutive IHRDs at detection (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.02), and less nightly sleep (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.03).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Irregular heart rhythms are common after initial detection using a wrist-worn wearable device. Longer electrocardiographic monitoring periods increase the likelihood of confirming AF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04380415.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.124.013565","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T05:00:24Z","timestamp":1750827624000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Wearable Irregular Heart Rhythm Detection Recurrences and Electrocardiographic Atrial Fibrillation Confirmation: The Fitbit Heart Study"],"prefix":"10.1161","volume":"18","clinical-trial-number":[{"clinical-trial-number":"nct04380415","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-4866","authenticated-orcid":true,"given":"Steven A.","family":"Lubitz","sequence":"first","affiliation":[{"name":"Cardiac Arrhythmia Service and Cardiovascular Research Center, Boston, MA (S.A.L.)."},{"name":"Harvard Medical School, Boston, MA (S.A.L., S.J.A., D.E.S., A.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8743-0932","authenticated-orcid":true,"given":"Michael V.","family":"McConnell","sequence":"additional","affiliation":[{"name":"Fitbit LLC (Google LLC), San Francisco, CA (M.V.M.C., A.P., A.Z.F.)."},{"name":"Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA (M.V.M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Selvaggi","sequence":"additional","affiliation":[{"name":"Biostatistics Center, Boston, MA (C.S., A.K., A.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5758-966X","authenticated-orcid":true,"given":"Aparna","family":"Krishnamoorthy","sequence":"additional","affiliation":[{"name":"Biostatistics Center, Boston, MA (C.S., A.K., A.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2297-9614","authenticated-orcid":true,"given":"Steven J.","family":"Atlas","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA (S.A.L., S.J.A., D.E.S., A.S.F.)."},{"name":"Division of General Internal Medicine, Massachusetts General Hospital, Boston (S.J.A., D.E.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9343-6203","authenticated-orcid":true,"given":"David D.","family":"McManus","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester (D.D.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2462-8797","authenticated-orcid":true,"given":"Sherry","family":"Pagoto","sequence":"additional","affiliation":[{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs (S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6145-4848","authenticated-orcid":true,"given":"Daniel E.","family":"Singer","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA (S.A.L., S.J.A., D.E.S., A.S.F.)."},{"name":"Division of General Internal Medicine, Massachusetts General Hospital, Boston (S.J.A., D.E.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Pantelopoulos","sequence":"additional","affiliation":[{"name":"Fitbit LLC (Google LLC), San Francisco, CA (M.V.M.C., A.P., A.Z.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9520-0501","authenticated-orcid":true,"given":"Andrea S.","family":"Foulkes","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA (S.A.L., S.J.A., D.E.S., A.S.F.)."},{"name":"Biostatistics Center, Boston, MA (C.S., A.K., A.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4268-2365","authenticated-orcid":true,"given":"Anthony Z.","family":"Faranesh","sequence":"additional","affiliation":[{"name":"Fitbit LLC (Google LLC), San Francisco, CA (M.V.M.C., A.P., A.Z.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01698-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.015071"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1159\/000457809"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901183"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.060291"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2021.04.003"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044407"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.098079"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.000102"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000568"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.124.013565","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T18:00:34Z","timestamp":1752602434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.124.013565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":11,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1161\/CIRCEP.124.013565"],"URL":"https:\/\/doi.org\/10.1161\/circep.124.013565","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2024-11-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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