PURPOSE Physical activity and a healthy lifestyle play an essential role in optimizing long-term health in patients with Fontan physiology. Wrist-worn activity trackers may be useful in medically directed exercise programs for patients with Fontan physiology. The objective of this study was to measure the validity of Garmin and Fitbit activity tracker heart rate detection in patients with Fontan circulation when compared to electrocardiogram (ECG) during cardiopulmonary exercise testing (CPET). METHODS 47 Fontan patients undergoing CPET for clinical indications were included and wore activity trackers during CPET. Heart rate via the activity tracker was collected at baseline, maximal exercise, and recovery. Patient heart rates, peak VO2, and peak respiratory exchange ratio (RER) were collected using standard CPET protocols and equipment. Heart rate at each time point was compared between the activity trackers and CPET ECG. RESULTS Median age of participants was 17.1 years, 15.1 years since Fontan completion. Mean percent of predicted peak VO2 was 56.8%, z-score -3.2 with 61.7% of participants completing a maximal CPET (RER ≥ 1.09). Baseline oxygen saturation mean was 92.9%, 90.0% at maximal exercise. Activity trackers demonstrated mean absolute percentage error < 10% at most time points, comparable with other studies. Demographics, Fontan-associated comorbidities, and echocardiogram findings did not impact the accuracy. CONCLUSIONS Consumer-oriented wrist-worn activity trackers show promising accuracy for heart rate monitoring in medically directed exercise programs for adolescents and young adults with Fontan physiology. Further validation across different exercise modalities is needed.

中文翻译：

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Fontan 患者运动期间腕戴式活动追踪器心率检测的有效性。


目的 身体活动和健康的生活方式对于优化 Fontan 生理学患者的长期健康起着至关重要的作用。腕戴式活动追踪器可能有助于 Fontan 生理学患者的医学指导锻炼计划。本研究的目的是衡量 Garmin 和 Fitbit 活动追踪器心率检测在 Fontan 循环患者中与心肺运动测试 (CPET) 期间心电图 (ECG) 进行比较的有效性。方法 47 名因临床适应症而接受 CPET 的 Fontan 患者被纳入研究，并在 CPET 期间佩戴活动追踪器。通过活动追踪器收集基线、最大运动量和恢复时的心率。使用标准 CPET 方案和设备收集患者心率、峰值摄氧量和峰值呼吸交换比 (RER)。比较活动追踪器和 CPET 心电图之间每个时间点的心率。结果 参与者的中位年龄为 17.1 岁，Fontan 完成后为 15.1 岁。预测峰值 VO2 的平均百分比为 56.8%，z 得分为 -3.2，其中 61.7% 的参与者完成了最大 CPET（RER ≥ 1.09）。基线氧饱和度平均值为 92.9%，最大运动时为 90.0%。活动追踪器在大多数时间点显示平均绝对百分比误差为 < 10%，与其他研究相当。人口统计学、Fontan 相关合并症和超声心动图结果不会影响准确性。结论面向消费者的腕戴式活动追踪器在针对患有 Fontan 生理学的青少年和年轻人的医学指导运动计划中显示出令人鼓舞的心率监测准确性。需要对不同运动方式进行进一步验证。