Remote activity and rhythm monitoring using patient-owned consumer devices after first-time pulmonary vein isolation
Kyra Lachmann, Sandro Jaeckle, Christoph Al-Taie, Jan Leon Rieß, Marc D Lemoine, Niklas Schenker, Moritz Nies, Silke van Elferen, Jan Baumbach, Milaim Kas, Bruno Reißmann, Feifan Ouyang, Larissa Fabritz, Stefan Blankenberg, Andreas Rillig, Andreas Metzner, Paulus Kirchhof, Julius ObergasselStructured abstract
Background and Aims
Passively collected physical activity data from consumer devices could provide a scalable, objective measure of functional status in patients with atrial fibrillation (AF). This study assessed the feasibility of remotely collecting activity and rhythm data from patients undergoing index pulmonary vein isolation (PVI).
Methods
AF patients enrolled in the prospective TRUST registry who underwent index PVI and reported owning an eligible smartphone were re-contacted to provide informed consent and share their smartphone- and smartwatch-generated data. Pre-specified feasibility criteria were participation rate, technical success, and temporal data coverage. The primary functional outcome was the mean daily step-count change between the one-year pre-PVI and two-year post-PVI windows. Exploratory analyses examined associations of daily activity with AF recurrence and AF burden.
Results
Of 280 eligible patients, 172 (61%) attempted and 154/172 (90%) completed data transfer, of whom 123 met pre-specified completeness criteria. Median monitoring duration was 6.0 [3.6, 6.6] years, with 98% [77, 100] coverage. Mean daily step count increased from 5731±2808 to 6220±2816 steps/day after PVI (+488 steps/day [187, 789]; p=0.002). In 35 smartwatch users, AF burden decreased from 3.6% [1.6, 10.8] to 0.0% [0.0, 0.3] after PVI (p<0.001). Baseline AF burden was inversely correlated with daily step count (ρ=-0.36, p=0.035).
Conclusion
Remote collection of activity and rhythm data from consumer smartphones and smartwatches is feasible, yielding high-coverage, multi-year research data. This enables scalable, objective quantification of longitudinal functional outcomes. Daily step count increased after PVI in this exploratory cohort and was inversely related to baseline AF burden.