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ECG App Algorithms Clinical Validation Study

Primary Purpose

Atrial Fibrillation

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
1-lead ECG
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:

  • Subjects must meet all the following inclusion criteria to be enrolled:

    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. Individuals who are 22 years of age and older at time of screening
    4. Able to communicate effectively with and follow instructions from the study staff
    5. Have a wrist circumference between 130 mm and 245 mm (Measured at "band center" on the preferred wrist).
    6. Subjects enrolled into Cohort 1 must have no known medical history of AF and in normal sinus rhythm at the time of screening.
    7. Subjects enrolled into Cohort 2 must have a known diagnosis of persistent or permanent AF and be in AF at the time of screening.

Exclusion Criteria:

  • Subjects must meet none of the following criteria to be enrolled:

    1. Physical disability that precludes safe and adequate testing
    2. Physical or medical impairments that preclude exercise testing such as musculoskeletal back pain, arthritis, leg claudication, etc.
    3. Mental impairment as determined by the Investigator
    4. Pregnant women at the time of the screening visit.
    5. Subjects with any Medical History, Physical exam, vital sign or any other study procedure finding/assessment that in the opinion of the investigator could compromise subject safety during study participation or interfere with the study integrity and/or the accurate assessment of the study objectives. This includes patients with known untreated medical conditions that are considered clinically significant by the Investigator, such as but not limited to significant anemia, important electrolyte imbalance and untreated or uncontrolled thyroid disease. Physical exam limitations include but not limited to open wound(s) on the wrist and forearm where the subject will be wearing the watch.
    6. Any history of wrist surgery with scarring in the area of the sensor location on the wrist where the subject will be wearing the watch
    7. Vital signs measurement, medical history, or physical exam finding that makes the subject inappropriate for participation according to the Investigator.
    8. Tattoos or moles in the area of the sensor location on the wrist where the subject will be wearing the watch.
    9. Skin conditions on either wrist that would preclude subject from wearing watch on either wrist. Severe symptomatic (or active) overly dry/injured skin, skin disorders, or allergic skin reactions such as eczema, rosacea, impetigo, dermatomyositis or allergic contact dermatitis on wrist and locations where the electrodes will be placed (e.g. chest, forearms, stomach), as determined by the investigator.
    10. Known allergy or significant sensitivity to medical adhesives, isopropyl alcohol, or ECG patch
    11. Known allergy or sensitivity to fluorocarbon-based synthetic rubber, such as fluoroelastomer bands primarily used in the wrist worn fitness devices.
    12. Clinically significant hand tremors as judged by the Investigator.
    13. Participation in a previous study that involved a wrist-worn ECG device.
    14. Subjects with implanted cardiac devices such as a Pacemaker or an automated Implantable Cardioverter - Defibrillator

Sites / Locations

  • Hope Research Institute
  • Clinical Research of South Florida
  • American Health Network of Indiana LLC
  • Heartland Cardiology

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Other

Arm Label

Cohort 1

Cohort 2

Arm Description

This will include subjects with no known history of AF and are in normal sinus rhythm at time of screening

This will include subjects with known persistent or permanent AF who are in AF at the time of screening

Outcomes

Primary Outcome Measures

Percentage of Trials With Correct Classification of Normal Sinus Rhythm on Simultaneous 12-lead ECG as "Sinus Rhythm" or "High Heart Rate" on a Readable and Classifiable ECG App Strip.
Specificity of sinus rhythm classification
Percentage of Trials With Correct Classification of AF on Simultaneous 12-lead ECG as "AF" on a Readable and Classifiable ECG App Strip.
Sensitivity of sinus rhythm classification

Secondary Outcome Measures

Percentage of Trials With Correct Classification of Normal Sinus Rhythm at Normal Heart Rates as "Sinus Rhythm" on a Readable and Classifiable ECG App Strip
Percentage of Trials With Correct Classification of AF at Normal Heart Rates as "AF" on a Readable and Classifiable ECG App Strip
Percentage of Trials With Correct Classification of Sinus Tachycardia at High Heart Rates as "High Heart Rate" on a Readable and Classifiable ECG App Strip
Percentage of Trials With Correct Classification of AF at High Heart Rates as "AF (High Heart Rate)" on a Readable and Classifiable ECG App Strip
Percentage of Trials With Equivalence of the ECG App Waveform to Lead I From a 12-lead ECG as Measured by Acceptable Morphology of PQRST Complexes
A "pass" rating is given when the waveforms of the ECG tracings generated by the algorithm and the Lead 1 of the 12-Lead ECG appear to overlay to the unaided eye. The morphology of the waveforms will be considered equivalent if at least 80% of the paired waveforms for the first 6 PQRST complexes are given a "pass" rating.
Percentage of Trials With Equivalence of the ECG App Waveform to Lead I From a 12-lead ECG as Measured by R-Wave Amplitude Agreement
A "pass" rating is given when the difference of the R-wave amplitudes (typically the highest peak of one cardiac rhythm cycle) between the ECG tracings generated by the algorithm and the Lead 1 of the 12-Lead ECG is <= 2mm. The R-wave amplitude agreement will be considered equivalent if at least 80% of the largest R-wave amplitudes of the paired waveforms are given a "pass" rating.

Full Information

First Posted
January 28, 2020
Last Updated
September 1, 2021
Sponsor
Apple Inc.
Collaborators
Iqvia Pty Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04247581
Brief Title
ECG App Algorithms Clinical Validation Study
Official Title
ECG App Algorithms Clinical Validation Study
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
January 7, 2020 (Actual)
Primary Completion Date
March 20, 2020 (Actual)
Study Completion Date
March 20, 2020 (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.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to evaluate the performance of ECG classification algorithms and their ability to classify heart rhythms into multiple categories of rhythms and heart rates

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
546 (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 and are in normal sinus rhythm at time of screening
Arm Title
Cohort 2
Arm Type
Other
Arm Description
This will include subjects with known persistent or permanent AF who are in AF at the time of screening
Intervention Type
Device
Intervention Name(s)
1-lead ECG
Other Intervention Name(s)
12- lead ECG, Exercise
Intervention Description
1 lead ECG - All participants will record three single-lead ECGs at rest and three single-lead ECGs after exercise. Intervention Other: Exercise - All participants will undergo three trials of exercise. Other interventions: 12-lead ECG - All participants will simultaneously record 12-lead ECGs during rest and exercise sessions.
Primary Outcome Measure Information:
Title
Percentage of Trials With Correct Classification of Normal Sinus Rhythm on Simultaneous 12-lead ECG as "Sinus Rhythm" or "High Heart Rate" on a Readable and Classifiable ECG App Strip.
Description
Specificity of sinus rhythm classification
Time Frame
1 Day
Title
Percentage of Trials With Correct Classification of AF on Simultaneous 12-lead ECG as "AF" on a Readable and Classifiable ECG App Strip.
Description
Sensitivity of sinus rhythm classification
Time Frame
1 Day
Secondary Outcome Measure Information:
Title
Percentage of Trials With Correct Classification of Normal Sinus Rhythm at Normal Heart Rates as "Sinus Rhythm" on a Readable and Classifiable ECG App Strip
Time Frame
1 Day
Title
Percentage of Trials With Correct Classification of AF at Normal Heart Rates as "AF" on a Readable and Classifiable ECG App Strip
Time Frame
1 Day
Title
Percentage of Trials With Correct Classification of Sinus Tachycardia at High Heart Rates as "High Heart Rate" on a Readable and Classifiable ECG App Strip
Time Frame
1 Day
Title
Percentage of Trials With Correct Classification of AF at High Heart Rates as "AF (High Heart Rate)" on a Readable and Classifiable ECG App Strip
Time Frame
1 Day
Title
Percentage of Trials With Equivalence of the ECG App Waveform to Lead I From a 12-lead ECG as Measured by Acceptable Morphology of PQRST Complexes
Description
A "pass" rating is given when the waveforms of the ECG tracings generated by the algorithm and the Lead 1 of the 12-Lead ECG appear to overlay to the unaided eye. The morphology of the waveforms will be considered equivalent if at least 80% of the paired waveforms for the first 6 PQRST complexes are given a "pass" rating.
Time Frame
1 Day
Title
Percentage of Trials With Equivalence of the ECG App Waveform to Lead I From a 12-lead ECG as Measured by R-Wave Amplitude Agreement
Description
A "pass" rating is given when the difference of the R-wave amplitudes (typically the highest peak of one cardiac rhythm cycle) between the ECG tracings generated by the algorithm and the Lead 1 of the 12-Lead ECG is <= 2mm. The R-wave amplitude agreement will be considered equivalent if at least 80% of the largest R-wave amplitudes of the paired waveforms are given a "pass" rating.
Time Frame
1 Day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects must meet all the following inclusion criteria to be enrolled: Able to read, understand, and provide written informed consent Willing and able to participate in the study procedures as described in the consent form Individuals who are 22 years of age and older at time of screening Able to communicate effectively with and follow instructions from the study staff Have a wrist circumference between 130 mm and 245 mm (Measured at "band center" on the preferred wrist). Subjects enrolled into Cohort 1 must have no known medical history of AF and in normal sinus rhythm at the time of screening. Subjects enrolled into Cohort 2 must have a known diagnosis of persistent or permanent AF and be in AF at the time of screening. Exclusion Criteria: Subjects must meet none of the following criteria to be enrolled: Physical disability that precludes safe and adequate testing Physical or medical impairments that preclude exercise testing such as musculoskeletal back pain, arthritis, leg claudication, etc. Mental impairment as determined by the Investigator Pregnant women at the time of the screening visit. Subjects with any Medical History, Physical exam, vital sign or any other study procedure finding/assessment that in the opinion of the investigator could compromise subject safety during study participation or interfere with the study integrity and/or the accurate assessment of the study objectives. This includes patients with known untreated medical conditions that are considered clinically significant by the Investigator, such as but not limited to significant anemia, important electrolyte imbalance and untreated or uncontrolled thyroid disease. Physical exam limitations include but not limited to open wound(s) on the wrist and forearm where the subject will be wearing the watch. Any history of wrist surgery with scarring in the area of the sensor location on the wrist where the subject will be wearing the watch Vital signs measurement, medical history, or physical exam finding that makes the subject inappropriate for participation according to the Investigator. Tattoos or moles in the area of the sensor location on the wrist where the subject will be wearing the watch. Skin conditions on either wrist that would preclude subject from wearing watch on either wrist. Severe symptomatic (or active) overly dry/injured skin, skin disorders, or allergic skin reactions such as eczema, rosacea, impetigo, dermatomyositis or allergic contact dermatitis on wrist and locations where the electrodes will be placed (e.g. chest, forearms, stomach), as determined by the investigator. Known allergy or significant sensitivity to medical adhesives, isopropyl alcohol, or ECG patch Known allergy or sensitivity to fluorocarbon-based synthetic rubber, such as fluoroelastomer bands primarily used in the wrist worn fitness devices. Clinically significant hand tremors as judged by the Investigator. Participation in a previous study that involved a wrist-worn ECG device. Subjects with implanted cardiac devices such as a Pacemaker or an automated Implantable Cardioverter - Defibrillator
Facility Information:
Facility Name
Hope Research Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85018
Country
United States
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
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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ECG App Algorithms Clinical Validation Study

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