Smartwatch-Detected Atrial Fibrillation on the Morning After a Nocturnal Sleep-Disordered Breathing Notification: A Case Report
Abstract
Smartwatches have been gaining popularity, and smartwatch-based patient-activated recordings have been widely used for screening atrial fibrillation (AF) and sleep-disordered breathing. We encountered a 79-year-old man who routinely activated a smartwatch ECG in the morning. He had documented paroxysms of AF while working as a businessman a decade ago. Thereafter, the paroxysms were not documented after he retired from work; therefore, pulsed field ablation was deferred. However, the smartwatch repeatedly detected AF paroxysms the following morning, only after the smartwatch had issued a breathing-disturbance notification during sleep. Smartwatch ECG cannot completely substitute for conventional ECG, and smartwatch-detected breathing disturbance is not equivalent to polysomnography (PSG)-detected obstructive sleep apnea (OSA). However, this case suggests that nocturnal respiratory disturbance may be associated with daily AF paroxysms and that this possibility may be detected using a single smartwatch. Accumulation of similar cases with simultaneous polysomnographic and ECG monitoring may help clarify the mechanistic relationship between nocturnal hypoxemia and AF paroxysms.
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