The use of a wearable electrocardiogram (ECG) monitor for up to 14 days after cardiac surgery may improve the detection of postoperative atrial fibrillation (poAF), potentially speeding up the detection of cases which may have gone unseen until up to three months’ follow-up, researchers have shown.
Preliminary results of a 100-patient study involving the use of the Vivalink wearable ECG patch following cardiac surgery procedures at Brigham and Women’s Hospital (Boston, USA), presented at Euroanaesthesia 2025 (25–27 May, Lisbon, Portugal), in which researchers analysed data from the wearable monitor after discharge.
Of the included patients, 42% experienced poAF during hospitalisation, and 27% showed signs of atrial fibrillation on the patch monitor recordings. In 24% of patients with AF detected on the patch monitor, the arrhythmia was first identified on the wearable monitor and had not been detected while hospitalised. In 80% of these cases, AF was not diagnosed using standard modalities until the three-month follow-up.
“We’re pretty good in general at continuously monitoring patients so that while they are in the operating room (OR) or while they’re in the intensive care unit (ICU) there are hardly any gaps in monitoring,” Jakob Wollborn, a cardiac anaesthesiologist and intensivist at Brigham and Women’s Hospital, who is a co-author of the research, tells Cardiovascular News. “The real gap occurs when patients are discharged home.”
“In the hospital it’s more or less simple, either they’re on continuous telemetry, if they don’t feel well and there’s enough suspicion for an irregular pulse you’ll probably do an intermittent 12-lead ECG. When you’re at home patients may just simply not feel great, but who has the opportunity to run an ECG or a smartwatch-based rhythm analysis at home? That’s certainly not all of our patients,” says Wollborn.
Vivalink’s wearable ECG monitor is a small, reusable, rechargeable patch that streams to a biometrics data platform in the cloud, which includes an arrhythmia detection algorithm and clinician portal.
“The device that we used from Vivalink is essentially an adhesive that is put on the chest, it’s probably a coin-sized device and doesn’t need to be recharged every day, it has continuous battery and connects to a patient’s smartphone that then transmits the data onwards,” says Wollborn of the device.
Wollborn notes that the study remains ongoing, and results may differ when the full study has been completed, but the researchers are optimistic about the utility of this device and other wearables in detecting AF after surgery.
“What we’re seeing is certainly that patients do develop AF after hospital discharge and we’ll ask them whether they noticed, and a lot of them say no,” he comments.
“It’s valuable to detect poAF when it occurs, because it’s obviously shown to increase the risk for stroke from embolic complications and AF in general is dangerous. There are studies showing that 24 hours of even subclinical AF does increase the risk for stroke. I think we have to make all efforts to pick it up.
“We’re working in a very vulnerable patient population in cardiac surgery where complications are unfortunately still higher than in other patient fields just given the nature of it being very invasive and somewhat dangerous. It is obviously our goal to get all of our patients through safely beyond hospital discharge. I think this is where this really comes in.”
The full study results are expected to be submitted for publication later this year.
