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BACKGROUND Consumer devices with broad reach may be useful in screening for atrial fibrillation (AF) in appropriate populations. However, currently no consumer devices are capable of continuous monitoring for AF.OBJECTIVE The purpose of this study was to estimate the sensitivity and specificity of a smartwatch algorithm for continuous detection of AF from sinus rhythm in a free-living setting.METHODS We studied a commercially available smartwatch with photoplethysmography (W-PPG) and electrocardiogram (W-ECG) capabilities. We validated a novel W-PPG algorithm combined with a W-ECG algorithm in a free-living setting, and compared the results to those of a 28-day continuous ECG patch (P-ECG).RESULTS A total of 204 participants completed the free-living study, recording 81,944 hours with both P-ECG and smartwatch measurements. We found sensitivity of 87.8% (95% confidence interval [CI] 83.6%-91.0%) and specificity of 97.4% (95% CI 97.1%-97.7%) for the W-PPG algorithm (every 5-minute classification); sensitivity of 98.9% (95% CI 98.1%-99.4%) and specificity of 99.3% (95% CI 99.1%-99.5%) for the W-ECG algorithm; and sensitivity of 96.9% (95% CI 93.7%-98.5%) and specificity of 99.3% (95% CI 98.4%-99.7%) for W-PPG triggered W-ECG with a single W-ECG required for confirmation of AF. We found a very strong correlation of W-PPG in quantifying AF burden compared to P-ECG (r 5 0.98).CONCLUSION Our findings demonstrate that a novel algorithm using a commercially available smartwatch can continuously detect AF with excellent performance and that confirmation with W-ECG further enhances specificity. In addition, our W-PPG algorithm can estimate AF burden. Further research is needed to determine whether this algorithm is useful in screening for AF in select atrisk patients.

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This study provides a detailed analysis of the invasion by Eupatorium adenophorum Spreng (Crofton weed) from Burma and Vietnam into Southern China since the 1940s. Currently, E. adenophorum's main colonisation area is located in the Yunnan-Guizhou Plateau of China, where it has caused prominent economic and ecological problems. Sixty-three years ago, Crofton weed appeared in Menghai county, Yunnan Province, from where it dispersed northwards and eastwards at an average speed of 20 km year -1 . The invasion of E. adenophorum nonetheless showed pronounced variations in both time and space. Spread was relatively slow in the initial invasion period between 1940 and 1950, while the most rapid range expansions occurred in the 1980s. Environmental conditions at native and invaded sites were significantly different, reflecting a great adaptability of the species during colonization. These changes were greater than habitat differences between colonized and many adjacent un-colonized sites in Southern China. Therefore, immediate measures are required to stop a further northward and eastward expansion of Crofton weed.