Id: 4347234 Evaluation of Photoplethysmography-based Smartphone App Accuracy for Detecting Atrial Fibrillation After Ablation
Year: 2025
Type: article
Abstract: Objective: This study validates a novel non-invasive method using COR® ECG wearable to extract Ventricular Activation Time (VAT) as a dynamic conduction biomarker to guide real-time pacemaker optimization.Method: COR® integrates compact Einthoven triangle geometry with finite element thoracic interpolation to reconstruct frontal and precordial vectors, enabling precise VAT measurement from 3-lead surface ECG at 1000Hz sampling -comparable to high density BSM.Meshless stochastic resonance algorithm facilitates beat-to-beat VAT extraction, filtering motion artifacts and ectopy.Results: Across ongoing multicenter trials (EFACT, COR-INSIGHT) .90% of CRT-treated HFrEF patients exhibited abnormal VAT (.86 ms) or high-frequency oscillations (40-80 Hz), despite device-reported BiV pacing ≥95%.In 43% of patients, sustained VAT dyssynchrony .5 ms revealed residual electromechanical mismatch not captured by standard diagnostics.COR® VAT strongly correlated with mechanical dyssynchrony and matched high-density body surface mapping (BSM) fidelity in identifying failed fusion, rate-dependent conduction delays and progressive desynchronization.Conclusion: COR® enables continuous VAT surveillance in both advanced BiV and adaptive CRT devices, offering a scalable, non-invasive solution for optimizing therapy delivery, preventing PiCM, and identifying non-responders.This platform bridges the critical gap between static device metrics and evolving conduction physiology, redefining how dynamic tuning can be applied across modern pacing systems to guide reprogramming of AV/VV delays in adaptive CRT systems.
Source: Heart Rhythm O2
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $2,150
OpenAlex ID: W4413963606