Measurements of pulse rate using facial video cameras from smart devices in patients diagnosed with atrial fibrillation

Non-contact video monitoring of pulse rate (PR) was first proposed >15 years ago [1,2]. The term “VideoPlesthymoGraphy” (VPG) was proposed by Couderc et al. in 2014 in their pioneering article describing the concept of contactless video-based detection of AF [3]. VPG relies on a monitoring technique extracting the photoplethysmographic-like signal from a facial video recording. Like reflective photoplethysmographic (PPG) technologies, the VPG signal describes the absorption peak of ambient light through the skin by the underlying hemoglobin. Most of the existing PPG technologies rely on devices with embedded sensors that are directly in contact with the patient's skin (bracelets, patches, belts, garments, etc.). The changes to the daily routine necessitated by these devices may pose specific utilization constraints for the users. The inconvenience, irritation, and extra effort of using, wearing, and maintaining the monitoring device lead to a lack of compliance and device abandonment. Yingling et al. showed that a third of people provided with activity trackers do not use them after 30 days [4]. The attrition rates depend on study length and are high: 56% for a 10-week study [5], 61% for a 12-week study [6], and 72% for a 3-month study [7]. These attrition rates are worse in patients with chronic diseases. Shawn et al. reported 24% of healthy individuals abandoned wearable devices after a month, while 84% of patients living with chronic diseases stopped using their devices during the same time period [8].

VPG Medical Inc. developed the software called HealthKam® AFib (HK) which was designed to address the challenge of patient compliance with cardiac monitoring. It is a passive, effortless, and unobtrusive cardiac monitoring solution [9]. Specifically, HK is designed to help patients seamlessly know if their pulse rate is regular [[10], [11], [12], [13], [14], [15]] with their smartphone and without the need for new devices. The performance of the technology in detecting the presence of AFib is >90% in terms of sensitivity and specificity [10]. In addition, the technology can be used by patients for monitoring their resting PR and optimizing the titration of their rate control medication.

We describe a study that aims to 1) assess the PR accuracy of the VPG technology in patients with a history of atrial fibrillation (AF), and 2) understand and quantify the impact of environmental factors (illumination levels, camera angle, etc.) on HK PR accuracy.

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