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The proposed clinical study aims to validate the diagnostic performance, compared to a reference ECG, of the electrocardiographic function of the BPM Core developed by Withings for the automatic identification of atrial fibrillation (AF).
BPM Core is a blood-pressure monitor with an build-in single-channel electrocardiogram similar to a lead I.
Primary objective:
The primary objective is to demonstrate that Withings BPM Core has acceptable sensitivity and specificity in the automatic identification of AF and SR in comparison with a gold-standard diagnosis from a 12-lead ECG by board certified cardiologists.
The algorithm classifies the device 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.
Secondary objectives:
The first secondary objective is to assess the quality of tracings of the BPM Core armband thanks to a qualitative and quantitative comparison between BPM Core tracings and reference ECG ones, based on clinical evaluation criteria.
Firstly, three independent cardiologists who have not performed or read the reference ECG and do not know the patient's clinical files will make a diagnosis from the recordings from the BPM Core. There will be a majority vote to select the diagnosis. The cases where the three readers reached three different diagnosis will be reviewed by a panel of 3 to 6 board certified cardiologists who will decide by consensus. Sensitivity and specificity will be calculated relative to the reference ECG.
Secondly, quantitative analyses will be performed to assess the quality of ECG tracings provided by Withings BPM Core and its software, as follows:
The sponsor will make sure that the same cardiologist will not be asked to annotate both a Withings BPM Core signal and the corresponding lead I signal from the 12-channel ECG device. The sponsor will then centralize the annotations of Withings BPM Core tracings and of the ECG reference lead I signals and perform agreement calculations on synchronous pairs.
The second secondary objective is to verify the safety of use of the device by analyzing adverse effects.
The safety of use of the device will be assessed by the number of adverse effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| atrial fibrillation (AF) | Patients diagnosed with AF during reference ECG |
| |
| sinus rhythm (SR) | Patients diagnosed with SR during reference ECG |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ECG measurement | Diagnostic Test | Simultaneous recording of a single-lead ECG signal with the Withings BPM Core and ECG signal for the reference 12-lead ECG |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of the automatic classification in AF by BPM Core 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 AF by BPM Core 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 cardiologists' classification in AF from the BPM Core ECG | sensitivity from the 2x2 confusion matrix AF vs 'non-AF' | 1 year |
| Sensitivity of the cardiologists' classification in SR from the BPM Core ECG |
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Inclusion Criteria:
Exclusion Criteria:
Vulnerable subject with regard to regulations
Subject who refused to participate in the study,
Subject in linguistic or psychic incapacity to sign a written informed consent form,
Subject in physical incapacity to wear a blood pressure monitor
Subject with electrical stimulation by pacemaker
Significant tremor that prevents subject from being able to hold still
Known sensitivity to medical adhesives, isopropyl alcohol, or ECG electrodes
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in and out patients from cardiology services
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| Name | Affiliation | Role |
|---|---|---|
| David Campo, PhD | Withings | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ICPC Floréale | Bagnolet | 93170 | France | |||
| ICPC Turin |
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 |
| Accuracy of the visibility of P-waves of single-lead ECG from BPM Core | (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 BPM Core | (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 BPM Core | (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 BPM Core | (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 BPM Core | (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 BPM Core | (true positives + true negatives)/(sample size) from the 2x2 confusion matrix | 1 year |
| Paris |
| 75004 |
| France |