Two different smartwatches exhibit high accuracy in evaluating heart rate and peripheral oxygen saturation in cats when compared with the electrocardiography and transmittance pulse oximetry

Latif Emrah Yanmaz Department of Surgery, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey

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Sitkican Okur Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey

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Ugur Ersoz Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey

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Mumin Gokhan Senocak Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey

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Ferda Turgut Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey

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Abstract

OBJECTIVE

To evaluate the accuracy for 2 smartwatches with oximetry technology and optical wrist heart rate (HR) or single-lead Electrocardiography (ECG) technology (Fenix 5X Plus [GF5xp], Garmin Ltd and Apple Watch 6 [AppW6], Apple Inc, respectively) versus reference methods (ECG and transmittance pulse oximetry [TPO], respectively) in measuring HR and peripheral oxygen saturation of hemoglobin (SpO2) in cats.

ANIMALS

10 male client-owned cats aged 8 to 12 months and weighing 3.2 to 4.5 kg.

PROCEDURES

All cats that were presented for elective castration at the Atatürk University Animal Hospital between March 10 and April 15, 2022, were considered for enrollment. Monitoring of HR and SpO2 during anesthesia was performed with a 3-lead ECG and transmittance pulse oximetry, respectively, connected to a multiparameter monitor (reference methods) along with a GF5xp and a AppW6. Agreement between reference methods and the smartwatches were assessed by the Bland-Altman plot, in which the differences (%) between methods were plotted against their mean HR or SpO2 (reference method measurement – test device measurement) and the limits of agreement (mean ± 1.96 × SD).

RESULTS

Compared with ECG measurements of HR, GF5xp had superior bias (–0.1%) and limit of agreement (LoA, 3.0 to –3.3%) versus those of the AppW6 (bias, 0.2%; LoA, 3.7 to –3.4%). Compared with TPO measurements of SpO2, AppW6 had superior bias (0.2%) and LoA (3.0% and –2.5%) versus those of the GF5xp (bias, –2.1%; LoA, 0.2 to –4.4%).

CLINICAL RELEVANCE

Results indicated that the GF5xp and AppW6 exhibited high accuracy in evaluating HR and SpO2 in cats when compared with the reference methods. However, it should be noted that these comparisons were made in anesthetized patients without any systemic disease.

Abstract

OBJECTIVE

To evaluate the accuracy for 2 smartwatches with oximetry technology and optical wrist heart rate (HR) or single-lead Electrocardiography (ECG) technology (Fenix 5X Plus [GF5xp], Garmin Ltd and Apple Watch 6 [AppW6], Apple Inc, respectively) versus reference methods (ECG and transmittance pulse oximetry [TPO], respectively) in measuring HR and peripheral oxygen saturation of hemoglobin (SpO2) in cats.

ANIMALS

10 male client-owned cats aged 8 to 12 months and weighing 3.2 to 4.5 kg.

PROCEDURES

All cats that were presented for elective castration at the Atatürk University Animal Hospital between March 10 and April 15, 2022, were considered for enrollment. Monitoring of HR and SpO2 during anesthesia was performed with a 3-lead ECG and transmittance pulse oximetry, respectively, connected to a multiparameter monitor (reference methods) along with a GF5xp and a AppW6. Agreement between reference methods and the smartwatches were assessed by the Bland-Altman plot, in which the differences (%) between methods were plotted against their mean HR or SpO2 (reference method measurement – test device measurement) and the limits of agreement (mean ± 1.96 × SD).

RESULTS

Compared with ECG measurements of HR, GF5xp had superior bias (–0.1%) and limit of agreement (LoA, 3.0 to –3.3%) versus those of the AppW6 (bias, 0.2%; LoA, 3.7 to –3.4%). Compared with TPO measurements of SpO2, AppW6 had superior bias (0.2%) and LoA (3.0% and –2.5%) versus those of the GF5xp (bias, –2.1%; LoA, 0.2 to –4.4%).

CLINICAL RELEVANCE

Results indicated that the GF5xp and AppW6 exhibited high accuracy in evaluating HR and SpO2 in cats when compared with the reference methods. However, it should be noted that these comparisons were made in anesthetized patients without any systemic disease.

Supplementary Materials

    • Supplementary Figure S1 (PDF 510 KB)
  • 1.

    Atkins CE, Gallo AM, Kurzman ID, Cowen P. Risk factors, clinical signs, and survival in cats with a clinical diagnosis of idiopathic hypertrophic cardiomyopathy: 74 cases (1985–1989). J Am Vet Med Assoc. 1992;201(4):613618.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Hoffmeister EH, Read MR, Brainard BM. Evaluating veterinarians’ and veterinary students’ knowledge and clinical use of pulse oximetry. J Vet Med Educ. 2005;32(2):272277.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Farrell KS, Hopper K, Cagle LA, Epstein SE. Evaluation of pulse oximetry as a surrogate for PaO2 in awake dogs breathing room air and anesthetized dogs on mechanical ventilation. J Vet Emerg Crit Care (San Antonio). 2019;29(6):622629.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Thawley V, Waddell LS. Pulse oximetry and capnometry. Top Companion Anim Med. 2013;28(3):124128.

  • 5.

    Rienzo MD, Mukkamala R. Wearable and nearable biosensors and systems for healthcare. Sensors (Basel). 2021;21(4):1291. doi:10.3390/s21041291

  • 6.

    Pipek LZ, Nascimento RF, Acencio MM, Teixeria LR. Comparison of SpO2 and heart rate values on Apple Watch and conventional commercial oximeters devices in patients with lung disease. Sci Rep. 2021;11(1):18901. doi:10.1038/s41598-021-98453-3

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Spaccarotella C, Polimeni A, Mancuso C, Pelaia G, Esposito G, Indolfi C. Assessment of non-invasive measurements of oxygen saturation and heart rate with an Apple smartwatch: comparison with a standard pulse oximeter. J Clin Med. 2022;11(6):1467. doi: 10.3390/jcm11061467

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Serantoni C, Zimatore G, Bianchetti G, Abeltino A, De Spirito M, Maulucci G. Unsupervised clustering of heartbeat dynamics allows for real time and personalized improvement in cardiovascular fitness. Sensors (Basel). 2022;22(11):3974. doi: 10.3390/s22113974

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Schiefer LM, Treff G, Treff F, et al. Validity of peripheral oxygen saturation measurements with the Garmin Fēnix 5X plus wearable device at 4559 m. Sensors (Basel). 2021;21(19):6363. doi: 10.3390/s21196363

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Yanmaz LE, Okur S, Ersoz U, Senocak MG, Turgut F. Accuracy of heart rate measurements of three smartwatch models in dogs. Top Companion Anim Med. 2022;49:100654.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    National Research Council. Guide for the Care and Use of Laboratory Animals. 8th ed. National Academy Press; 2011.

  • 12.

    Kraus MS, Gelzer AR, Rishniw M. Detection of heart rate and rhythm with a smartphone-based electrocardiograph versus a reference standard electrocardiograph in dogs and cats. J Am Vet Med Assoc. 2016;249(2):189194.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Mair A, Martinez-Taboada F, Nitzan M. Effect of lingual gauze swab placement on pulse oximeter readings in anaesthetised dogs and cats. Vet Rec. 2017;180(2):49.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135160.

  • 15.

    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307310.

  • 16.

    Hajj-Boutros G, Landry-Duval MA, Comtois AS, Gouspillou G, Karelis AD. Wrist-worn devices for the measurement of heart rate and energy expenditure: a validation study for the Apple Watch 6, Polar Vantage V and Fitbit Sense. Eur J Sport Sci. Published online January 31, 2022. doi:10.1080/17461391.2021.2023656

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Lauterbach CJ, Romano PA, Greisler LA, Brindle RA, Ford KR, Kuennen MR. Accuracy and reliability of commercial wrist-worn pulse oximeter during normobaric hypoxia exposure under resting conditions. Res Q Exerc Sport. 2021;92:549558.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Evenson KR, Goto MM, Furberg RD. Systematic review of the validity and reliability of consumer-wearable activity trackers. Int J Behav Nutr Phys Act. 2015;12:159. doi: 10.1186/s12966-015-0314-1

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Fuller D, Colwell E, Low J, et al. Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: systematic review. JMIR Mhealth Uhealth. 2020;8(9):e18694. doi: 10.2196/18694

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Raja JM, Elsakr C, Roman S, et al. Apple watch, wearables, and heart rhythm: where do we stand? Ann Transl Med. 2019;7(17):417. doi: 10.21037/atm.2019.06.79

  • 21.

    Castaneda D, Esparza A, Ghamari M, Soltanpur C, Nazeran H. A review on wearable PPG sensors and their potential future applications in health care. Int J Biosens Bioelectron. 2018;4(4):195202.

    • PubMed
    • Search Google Scholar
    • Export Citation

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