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The proposed clinical study aims to validate the diagnostic performance, compared to a reference ECG, of the ECG-SW1 software and the PPG-SW1 software integrated into the HWA09 watch developed by Withings for the automatic identification of atrial fibrillation (AF).
HWA09 is a wrist-worn watch that enables to record a single-lead ECG similar to the standard lead I configuration, and a photoplethysmogram (PPG).
Primary objective :
To validate the diagnostic performance of the ECG-SW1 software integrated into the HWA09 watch for the automatic identification of atrial fibrillation (AF) compared to a simultaneous 12-lead ECG (hereinafter referred to as the "gold standard" or "reference method").
The algorithm classifies the watch signals into four categories: normal sinus rhythm (RSN), AF, arrhythmia other than AF, or non-interpretable. The latter category includes signals of insufficient quality to be interpreted with confidence.
This classification will be compared to the diagnosis made by three independent, blinded cardiologists based on a 12-lead ECG. The final diagnosis retained will be decided by majority with adjudication by a consensus of 3 to 6 cardiologists. The sensitivity and specificity of the device will then be estimated.
First secondary objectives:
The first secondary objective is to validate the diagnostic performance, compared to a simultaneous 12-lead ECG, of the PPG-SW1 software integrated in the HWA09 watch for the automatic identification of atrial fibrillation (AF) from the photoplethysmography (PPG) signal.
Three independent blinded cardiologists will issue a diagnosis based on the ECG recording of the HWA09 watch. The final diagnosis retained will be decided by majority with adjudication by a consensus of 3 to 6 cardiologists. Sensitivity and specificity will be calculated in relation to the reference ECG.
Second secondary objective:
To evaluate the quality of the single-channel strips measured with the HWA09 watch, as follows:
The sponsor will ensure that no cardiologist makes a diagnosis on both a signal from the HWA09 watch and the reference ECG fomr the same patient. The sponsor will centralize diagnostics on the HWA09 and reference ECG signals and perform agreement calculations on the associated pairs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Atrial Fibrillation (AF) | Patients diagnosed with AF during reference ECG |
| |
| Normal Sinus Rhythm (NSR) | Patients with NSR during reference ECG |
| |
| Other Arrythmia | Patients diagnosed with an arrhythmia other than AF during the reference ECG |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AF Detection | Device | Recording PPG and single-lead ECG signals with the Withings HWA09 and ECG signal for the reference 12-lead ECG |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of the automatic classification in AF by ECG-SW1 of HWA09 single-lead ECG against reference 12-lead ECG | sensitivity from the 2x2 confusion matrix AF vs 'non-AF' | 1 year |
| Sensitivity of the automatic classification in NSR by ECG-SW1 of HWA09 single-lead ECG against reference 12-lead ECG | sensitivity from the 2x2 confusion matrix NSR vs 'non-NSR' | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of the automatic classification in AF by PPG-SW1 of the HWA09 PPG against reference 12-lead ECG | sensitivity from the 2x2 confusion matrix AF vs 'non-AF' | 1 year |
| Sensitivity of the automatic classification in NSR by PPG-SW1 of the HWA09 PPG against reference 12-lead ECG |
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Inclusion Criteria:
Exclusion Criteria:
Vulnerable individuals according to the regulation in force :
Individuals having refused to take part in the study
Individuals linguistically or mentally unable to express their non-opposition
Individuals physically unable to wear a watch
Individuals with an electrical pacing by a pacemaker
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Every eligible patient doing a medical examination at the investigation center will be asked to take part in the study.
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| Name | Affiliation | Role |
|---|---|---|
| David CAMPO | Withings | Study Director |
| Julien NAHUM | Centre Cardiologique du Nord | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Cœur Paris Centre Turin | Paris | Île-de-France Region | 75008 | France | ||
| Hopital Europeen Georges Pompidou |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35481559 | Derived | Campo D, Elie V, de Gallard T, Bartet P, Morichau-Beauchant T, Genain N, Fayol A, Fouassier D, Pasteur-Rousseau A, Puymirat E, Nahum J. Atrial Fibrillation Detection With an Analog Smartwatch: Prospective Clinical Study and Algorithm Validation. JMIR Form Res. 2022 Nov 4;6(11):e37280. doi: 10.2196/37280. |
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Individual patient data (IPD) are considered as confidential in this study. After the end the final quality control, the database will be frozen and all the IPD will be archived .
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| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| D001145 | Arrhythmias, Cardiac |
| D002318 | Cardiovascular Diseases |
| D006331 | Heart Diseases |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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sensitivity from the 2x2 confusion matrix NSR vs 'non-NSR' |
| 1 year |
| Sensitivity of the cardiologists' classification in AF from the HWA09 ECG | sensitivity from the 2x2 confusion matrix AF vs 'non-AF' | 1 year |
| Sensitivity of the cardiologists' classification in SR from the HWA09 ECG | sensitivity from the 2x2 confusion matrix NSR vs 'non-NSR' | 1 year |
| Accuracy of the visibility of P-waves of single-lead ECG from HWA09 | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| Accuracy of the positivity of P-waves of single-lead ECG from HWA09 | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| Accuracy of the visibility of QRS-complexes of single-lead ECG from HWA09 | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| Accuracy of the positivity of QRS-complexes of single-lead ECG from HWA09 | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| Accuracy of the visibility of T-waves of single-lead ECG from HWA09 | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| Accuracy of the positivity of T-waves of single-lead ECG from HWA09 | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| RMSE between cardiologist's estimate of heart rate from the HWA09 single-lead ECG and the lead I reference ECG | Root Mean Squared Error | 1 year |
| RMSE between cardiologist's estimate of heart rate from the HWA09 single-lead ECG and the heart rate calculated by ECG-SW1 | Root Mean Squared Error | 1 year |
| Paris |
| Île-de-France Region |
| 75015 |
| France |
| Centre Cardiologique du Nord | Saint-Denis | Île-de-France Region | 93200 | France |