{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:23:58Z","timestamp":1787761438198,"version":"build-2784847793"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Commission for Research and Innovation","award":["E!12427\u2014SmartAF"],"award-info":[{"award-number":["E!12427\u2014SmartAF"]}]},{"name":"European Commission for Research and Innovation","award":["FKZ:01QE1859A"],"award-info":[{"award-number":["FKZ:01QE1859A"]}]},{"name":"German Federal Ministry of Education and Research","award":["E!12427\u2014SmartAF"],"award-info":[{"award-number":["E!12427\u2014SmartAF"]}]},{"name":"German Federal Ministry of Education and Research","award":["FKZ:01QE1859A"],"award-info":[{"award-number":["FKZ:01QE1859A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Atrial fibrillation (AF) remains a major risk factor for stroke. It is often asymptomatic and paroxysmal, making it difficult to detect with conventional electrocardiography (ECG). While photoplethysmography (PPG)-based devices like smartwatches have demonstrated efficacy in detecting AF, they are rarely integrated into hospital infrastructure. The study aimed to establish a seamless system for real-time AF screening in hospitalized high-risk patients using a wrist-worn PPG device integrated into a hospital\u2019s data infrastructure. Methods: In this investigator-initiated prospective clinical trial conducted at the University Hospital Basel, patients with a CHA2DS2-VASc score \u2265 2 and no history of AF received a wristband equipped with a PPG sensor for continuous monitoring during their hospital stay. The PPG data were automatically transmitted, analyzed, stored, and visualized. Upon detection of an absolute arrhythmia (AA) in the PPG signal, a Holter ECG was administered. Results: The analysis encompassed 346 patients (mean age 72 \u00b1 10 years, 175 females (50.6%), mean CHA2DS2-VASc score 3.5 \u00b1 1.3)). The mean monitoring duration was 4.3 \u00b1 4.4 days. AA in the PPG signal was detected in twelve patients (3.5%, CI: 1.5\u20135.4%), with most cases identified within 24 h (p = 0.004). There was a 1.3 times higher AA burden during the nighttime compared to daytime (p = 0.03). Compliance was high (304\/346, 87.9%). No instances of AF were confirmed in the nine patients undergoing Holter ECG. Conclusions: This study successfully pioneered an automated infrastructure for AF screening in hospitalized patients through the use of wrist-worn PPG devices. This implementation allowed for real-time data visualization and intervention in the form of a Holter ECG. The high compliance and early AA detection achieved in this study underscore the potential and relevance of this novel infrastructure in clinical practice.<\/jats:p>","DOI":"10.3390\/diagnostics15101233","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T08:44:58Z","timestamp":1747212298000},"page":"1233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fully Automated Photoplethysmography-Based Wearable Atrial Fibrillation Screening in a Hospital Setting"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6197-3453","authenticated-orcid":false,"given":"Khaled","family":"Abdelhamid","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Reissenberger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-3301","authenticated-orcid":false,"given":"Diana","family":"Piper","sequence":"additional","affiliation":[{"name":"Preventicus GmbH, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Koenig","sequence":"additional","affiliation":[{"name":"Preventicus GmbH, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Hoelz","sequence":"additional","affiliation":[{"name":"Innovation Management, Department of D&ICT, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Schlaepfer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Gysler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"McCullough","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ramin-Wright","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Lena","family":"Gabathuler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahnvi","family":"Khandpur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milene","family":"Meier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1693-9851","authenticated-orcid":false,"given":"Jens","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1161\/CIRCULATIONAHA.113.005119","article-title":"Worldwide Epidemiology of Atrial Fibrillation","volume":"129","author":"Chugh","year":"2014","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1093\/eurheartj\/ehs469","article-title":"All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995\u20132008: A Swedish nationwide long-term case\u2013control study","volume":"34","author":"Andersson","year":"2013","journal-title":"Eur. 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