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Atrial Fibrillation Algorithms Clinical Validation Study

Primary Purpose

Atrial Fibrillation

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
ELECTROCARDIOGRAM (ECG) PATCH WEAR
Sponsored by
Apple Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for Atrial Fibrillation focused on measuring CARDIOVASCULAR DISEASES, HEART DISEASES, ARRHYTHMIA, CARDIAC

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Able to read, understand, and provide written informed consent
  2. Willing and able to participate in the study procedures as described in the consent form
  3. Be 22 years of age and older
  4. Able to communicate effectively with and follow instructions from the study staff
  5. Able to wear the wrist device for duration of study participation
  6. For Cohort 1, have no known medical history of AF
  7. For Cohort 2, have no known medical history of AF and active diagnosis of at least one of the following arrhythmias within the past 2 years:

    1. Frequent PACs, defined as at least 1% of total beats of atrial ectopic beats by 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder)
    2. Frequent PVCs, defined as at least 1% of total beats of ventricular ectopic beats by 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder
    3. SVT, which will include atrial tachycardia, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia by 12-lead ECG or 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder
    4. NSVT, defined as three or more consecutive ventricular beats at a rate of at least 100 beats per minute and lasting no more than 30 seconds, by 12-lead ECG or 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder
  8. For Cohorts 3 and 4, have a known diagnosis of AF at the time of screening (confirmed by electronic medical record (EMR) or self-report) and have had a recent episode of AF, or confirmed AF on ECG, in the past 12 months
  9. For Cohort 4, have a known diagnosis of permanent AF at the time of screening (confirmed by EMR or self-report) and have had a recent episode of AF, or confirmed AF on ECG, in the past 12 months
  10. Meet additional binning based on demographics.

Exclusion Criteria:

  1. Physical disability that precludes safe and adequate testing
  2. Mental impairment resulting in limited ability to cooperate
  3. Known uncontrolled medical conditions, such as (but not limited to) significant anemia, important electrolyte imbalance and untreated or uncontrolled thyroid disease
  4. Open wound(s) on the wrist and/or forearm
  5. Tattoos, large moles, or scars on the wrist at the wrist device location
  6. Skin conditions on either wrist that would preclude subject from wearing a wristband on either wrist
  7. Known allergy or sensitivity to medical adhesives, isopropyl alcohol, wristbands, or ECG patch
  8. Medical history or physical assessment finding that makes the subject inappropriate for participation according to investigator(s)
  9. Participation in a previous study that used a wrist-worn sensor device with a simultaneous ECG reference patch
  10. Implantable cardiac devices such as a Pacemaker or Implantable Cardioverter Defibrillator
  11. Clinically significant hand tremors, as judged by the investigator
  12. Acute illness including COVID and other respiratory illnesses
  13. Subjects with known history of AF on rhythm control medications with history of complete AF rhythm control (i.e history of zero AF burden) will be excluded from Cohorts 3 and 4

Sites / Locations

  • Clinical Research of South Florida
  • American Health Network of Indiana Llc
  • Heartland Cardiology Webb
  • Healtheast

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Other

Other

Other

Other

Arm Label

COHORT 1

COHORT 2

COHORT 3

COHORT 4

Arm Description

This will include subjects with no known history of AF

This will include subjects with no known history of aF, but with history of frequent premature atrial contractions (PACs), frequent premature ventricular contractions (PVCs), supraventricular tachycardia (SVT), or non-sustained ventricular tachycardia (NSVT)

This will include subjects with known history of paroxysmal, persistent, or chronic AF

Will include subjects with permanent AF

Outcomes

Primary Outcome Measures

SENSITIVITY OF IRREGULAR RHYTHM NOTIFICATION FEATURE [IRNF]
Sensitivity of the irregular rhythm notification for the identification of persons with AF by 13-day ambulatory ECG, with AF defined as at least 30 seconds of AF by ambulatory ECG. Sensitivity is defined as the percentage of subjects exhibiting AF on the ambulatory ECG who also received an irregular rhythm notification concordant with at least one episode of AF.
SPECIFICITY OF LACK OF IRREGULAR RHYTHM NOTIFICATIONS FEATURE [IRNF]
Specificity of the lack of irregular rhythm notification for the identification of persons without AF by 13-day ambulatory ECG, with AF defined as at least 30 seconds of AF by ambulatory ECG. Specificity is defined as the percentage of subjects not exhibiting AF on the ambulatory ECG who also did not receive any irregular rhythm notifications.
WEEKLY ATRIAL FIBRILLATION BURDEN FEATURE ESTIMATE [AFBF]
Weekly AF burden estimate defined as the percentage of time a subject is in Atrial Fibrillation during wrist device wear over the prior 7 consecutive days. The weekly AF burden was estimated by both the reference device and the algorithm and reported using the Bland-Altman limits of Agreement.

Secondary Outcome Measures

POSITIVE PREDICTIVE VALUE OF IRREGULAR RHYTHM NOTIFICATION FEATURE [IRNF]
Notification-level positive predictive value (PPV) with AF by ambulatory ECG at the time of any tachogram comprising the notification.
TACHOGRAM ALERT SENSITIVITY [IRNF]
Tachogram-level sensitivity performance for tachograms comprising alerts.
TACHOGRAM ALERT SPECIFICITY [IRNF]
Tachogram-level specificity performance for tachograms comprising alerts.
Tachogram Alert False Positive Rate [IRNF]
Tachogram-level False Positive rate performance for tachograms comprising alerts.
Tachogram Alert Positive Predictive Value [IRNF]
Tachogram-level Positive Predictive value performance for tachograms comprising alerts.
Tachogram Alert Negative Predictive Value [IRNF]
Tachogram-level Negative Predictive value performance for tachograms comprising alerts.
TACHOGRAM SENSITIVITY [IRNF]
Tachogram-level sensitivity performance for all generated tachograms.
TACHOGRAM SPECIFICITY [IRNF]
Tachogram-level specificity performance for all generated tachograms.
TACHOGRAM FALSE POSITIVE RATE [IRNF]
Tachogram-level false positive rate performance for all generated tachograms.
TACHOGRAM POSITIVE PREDICTIVE VALUE [IRNF]
Tachogram-level positive predictive value performance for all generated tachograms.
TACHOGRAM NEGATIVE PREDICTIVE VALUE [IRNF]
Tachogram-level negative predictive value performance for all generated tachograms.
TACHOGRAM SENSITIVITY [AFBF]
Sensitivity of tachograms for the identification of AF by ambulatory ECG.
TACHOGRAM SPECIFICITY [AFBF]
Specificity of tachograms for the identification of AF by ambulatory ECG.
TACHOGRAM POSITIVE PREDICTIVE VALUE [AFBF]
Positive Predictive Value of tachograms for the identification of AF by ambulatory ECG.
TACHOGRAM NEGATIVE PREDICTIVE VALUE [AFBF]
Negative Predictive Value of tachograms for the identification of AF by ambulatory ECG.
DAY-SPECIFIC AF BURDEN ESTIMATE [AFBF]
Day-specific AF burden estimate defined as the percentage of time a subject is in Atrial Fibrillation during a specific day of the week.
FOUR-HOUR SEGMENT SPECIFIC AF BURDEN ESTIMATE [AFBF]
Four-hour segment-specific AF burden estimate defined as the percentage of time a subject is in Atrial Fibrillation during a specific four-hour segment of a day

Full Information

First Posted
December 4, 2020
Last Updated
August 1, 2022
Sponsor
Apple Inc.
Collaborators
Iqvia Pty Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04699812
Brief Title
Atrial Fibrillation Algorithms Clinical Validation Study
Official Title
Atrial Fibrillation Algorithms Clinical Validation Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
November 16, 2020 (Actual)
Primary Completion Date
April 19, 2021 (Actual)
Study Completion Date
December 17, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Apple Inc.
Collaborators
Iqvia Pty Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to evaluate the performances of investigational Irregular Rhythm Notification Feature (version 2.0) and Atrial Fibrillation History Feature algorithms.
Detailed Description
The purpose of the study is to evaluate the performances of investigational Irregular Rhythm Notification Feature (version 2.0) and Atrial Fibrillation History Feature algorithms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atrial Fibrillation
Keywords
CARDIOVASCULAR DISEASES, HEART DISEASES, ARRHYTHMIA, CARDIAC

7. Study Design

Primary Purpose
Screening
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
573 (Actual)

8. Arms, Groups, and Interventions

Arm Title
COHORT 1
Arm Type
Other
Arm Description
This will include subjects with no known history of AF
Arm Title
COHORT 2
Arm Type
Other
Arm Description
This will include subjects with no known history of aF, but with history of frequent premature atrial contractions (PACs), frequent premature ventricular contractions (PVCs), supraventricular tachycardia (SVT), or non-sustained ventricular tachycardia (NSVT)
Arm Title
COHORT 3
Arm Type
Other
Arm Description
This will include subjects with known history of paroxysmal, persistent, or chronic AF
Arm Title
COHORT 4
Arm Type
Other
Arm Description
Will include subjects with permanent AF
Intervention Type
Device
Intervention Name(s)
ELECTROCARDIOGRAM (ECG) PATCH WEAR
Other Intervention Name(s)
CARDEASOLO
Intervention Description
ALL PARTICIPANTS WILL WEAR AN ECG PATCH ON THEIR UPPER LEFT CHEST THROUGHOUT THE STUDY PARTICIPATION
Primary Outcome Measure Information:
Title
SENSITIVITY OF IRREGULAR RHYTHM NOTIFICATION FEATURE [IRNF]
Description
Sensitivity of the irregular rhythm notification for the identification of persons with AF by 13-day ambulatory ECG, with AF defined as at least 30 seconds of AF by ambulatory ECG. Sensitivity is defined as the percentage of subjects exhibiting AF on the ambulatory ECG who also received an irregular rhythm notification concordant with at least one episode of AF.
Time Frame
13 DAYS
Title
SPECIFICITY OF LACK OF IRREGULAR RHYTHM NOTIFICATIONS FEATURE [IRNF]
Description
Specificity of the lack of irregular rhythm notification for the identification of persons without AF by 13-day ambulatory ECG, with AF defined as at least 30 seconds of AF by ambulatory ECG. Specificity is defined as the percentage of subjects not exhibiting AF on the ambulatory ECG who also did not receive any irregular rhythm notifications.
Time Frame
13 DAYS
Title
WEEKLY ATRIAL FIBRILLATION BURDEN FEATURE ESTIMATE [AFBF]
Description
Weekly AF burden estimate defined as the percentage of time a subject is in Atrial Fibrillation during wrist device wear over the prior 7 consecutive days. The weekly AF burden was estimated by both the reference device and the algorithm and reported using the Bland-Altman limits of Agreement.
Time Frame
13 DAYS
Secondary Outcome Measure Information:
Title
POSITIVE PREDICTIVE VALUE OF IRREGULAR RHYTHM NOTIFICATION FEATURE [IRNF]
Description
Notification-level positive predictive value (PPV) with AF by ambulatory ECG at the time of any tachogram comprising the notification.
Time Frame
13 DAYS
Title
TACHOGRAM ALERT SENSITIVITY [IRNF]
Description
Tachogram-level sensitivity performance for tachograms comprising alerts.
Time Frame
13 DAYS
Title
TACHOGRAM ALERT SPECIFICITY [IRNF]
Description
Tachogram-level specificity performance for tachograms comprising alerts.
Time Frame
13 DAYS
Title
Tachogram Alert False Positive Rate [IRNF]
Description
Tachogram-level False Positive rate performance for tachograms comprising alerts.
Time Frame
13 DAYS
Title
Tachogram Alert Positive Predictive Value [IRNF]
Description
Tachogram-level Positive Predictive value performance for tachograms comprising alerts.
Time Frame
13 DAYS
Title
Tachogram Alert Negative Predictive Value [IRNF]
Description
Tachogram-level Negative Predictive value performance for tachograms comprising alerts.
Time Frame
13 DAYS
Title
TACHOGRAM SENSITIVITY [IRNF]
Description
Tachogram-level sensitivity performance for all generated tachograms.
Time Frame
13 DAYS
Title
TACHOGRAM SPECIFICITY [IRNF]
Description
Tachogram-level specificity performance for all generated tachograms.
Time Frame
13 DAYS
Title
TACHOGRAM FALSE POSITIVE RATE [IRNF]
Description
Tachogram-level false positive rate performance for all generated tachograms.
Time Frame
13 DAYS
Title
TACHOGRAM POSITIVE PREDICTIVE VALUE [IRNF]
Description
Tachogram-level positive predictive value performance for all generated tachograms.
Time Frame
13 DAYS
Title
TACHOGRAM NEGATIVE PREDICTIVE VALUE [IRNF]
Description
Tachogram-level negative predictive value performance for all generated tachograms.
Time Frame
13 DAYS
Title
TACHOGRAM SENSITIVITY [AFBF]
Description
Sensitivity of tachograms for the identification of AF by ambulatory ECG.
Time Frame
13 days
Title
TACHOGRAM SPECIFICITY [AFBF]
Description
Specificity of tachograms for the identification of AF by ambulatory ECG.
Time Frame
13 days
Title
TACHOGRAM POSITIVE PREDICTIVE VALUE [AFBF]
Description
Positive Predictive Value of tachograms for the identification of AF by ambulatory ECG.
Time Frame
13 days
Title
TACHOGRAM NEGATIVE PREDICTIVE VALUE [AFBF]
Description
Negative Predictive Value of tachograms for the identification of AF by ambulatory ECG.
Time Frame
13 days
Title
DAY-SPECIFIC AF BURDEN ESTIMATE [AFBF]
Description
Day-specific AF burden estimate defined as the percentage of time a subject is in Atrial Fibrillation during a specific day of the week.
Time Frame
13 DAYS
Title
FOUR-HOUR SEGMENT SPECIFIC AF BURDEN ESTIMATE [AFBF]
Description
Four-hour segment-specific AF burden estimate defined as the percentage of time a subject is in Atrial Fibrillation during a specific four-hour segment of a day
Time Frame
13 DAYS

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Able to read, understand, and provide written informed consent Willing and able to participate in the study procedures as described in the consent form Be 22 years of age and older Able to communicate effectively with and follow instructions from the study staff Able to wear the wrist device for duration of study participation For Cohort 1, have no known medical history of AF For Cohort 2, have no known medical history of AF and active diagnosis of at least one of the following arrhythmias within the past 2 years: Frequent PACs, defined as at least 1% of total beats of atrial ectopic beats by 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder) Frequent PVCs, defined as at least 1% of total beats of ventricular ectopic beats by 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder SVT, which will include atrial tachycardia, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia by 12-lead ECG or 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder NSVT, defined as three or more consecutive ventricular beats at a rate of at least 100 beats per minute and lasting no more than 30 seconds, by 12-lead ECG or 24-48 hour Holter, ambulatory ECG monitor, or implantable loop recorder For Cohorts 3 and 4, have a known diagnosis of AF at the time of screening (confirmed by electronic medical record (EMR) or self-report) and have had a recent episode of AF, or confirmed AF on ECG, in the past 12 months For Cohort 4, have a known diagnosis of permanent AF at the time of screening (confirmed by EMR or self-report) and have had a recent episode of AF, or confirmed AF on ECG, in the past 12 months Meet additional binning based on demographics. Exclusion Criteria: Physical disability that precludes safe and adequate testing Mental impairment resulting in limited ability to cooperate Known uncontrolled medical conditions, such as (but not limited to) significant anemia, important electrolyte imbalance and untreated or uncontrolled thyroid disease Open wound(s) on the wrist and/or forearm Tattoos, large moles, or scars on the wrist at the wrist device location Skin conditions on either wrist that would preclude subject from wearing a wristband on either wrist Known allergy or sensitivity to medical adhesives, isopropyl alcohol, wristbands, or ECG patch Medical history or physical assessment finding that makes the subject inappropriate for participation according to investigator(s) Participation in a previous study that used a wrist-worn sensor device with a simultaneous ECG reference patch Implantable cardiac devices such as a Pacemaker or Implantable Cardioverter Defibrillator Clinically significant hand tremors, as judged by the investigator Acute illness including COVID and other respiratory illnesses Subjects with known history of AF on rhythm control medications with history of complete AF rhythm control (i.e history of zero AF burden) will be excluded from Cohorts 3 and 4
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Tsay, MD, PhD
Organizational Affiliation
Apple Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Research of South Florida
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33134
Country
United States
Facility Name
American Health Network of Indiana Llc
City
Avon
State/Province
Indiana
ZIP/Postal Code
46123
Country
United States
Facility Name
Heartland Cardiology Webb
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67226
Country
United States
Facility Name
Healtheast
City
Saint Paul
State/Province
Minnesota
ZIP/Postal Code
55012
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Atrial Fibrillation Algorithms Clinical Validation Study

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