Feasibility of Blood Pressure Measurement With a Wearable (Watch-Type) Monitor During Impending Syncopal Episodes

BACKGROUND: We assessed the reliability and feasibility of blood pressure (BP) measurements by means of a new wearable<br> watch-type<br> BP monitor (HeartGuide) in detecting episodes of hypotensive (pre)syncope induced by tilt table test.<br> METHODS AND RESULTS: An intrapatient comparison between systolic BP (SBP) measured by means of the HeartGuide device<br> and noninvasive finger beat-to-<br> beat<br> BP monitoring was undertaken both at baseline in supine position and repeatedly during<br> tilt table test in patients evaluated for reflex syncope. Intrapatient fall of systolic BP from baseline was measured. Eighty-one<br> patients (mean age, 61±19 years; 46 women) were included. Overall, HeartGuide was able to yield BP values at the time of<br> BP nadir in 58 (72%) patients (average HeartGuide SBP 102±18 mm Hg, versus finger SBP 101±19 mm Hg). Compared with<br> baseline, the maximum SBP decrease was on average −28.5±27.8 and −30.3±33.9 mm Hg respectively (Lin’s concordance<br> correlation coefficient=0.78, r=0.79, P=0.001). In the subgroup of 38 patients with tilt table test induced (pre)syncope, the average<br> HeartGuide SBP during symptoms was 97±16 mm Hg, and the finger SBP was 94±18 mm Hg. Compared with baseline,<br> the maximum SBP decrease was on average −35.2±29.3 and −43.3±31.8 mm Hg, respectively (Lin’s concordance correlation<br> coefficient=0.83, r=0.87, P=0.001).<br> CONCLUSIONS: Our data indicate that the HeartGuide BP monitor can detect low BP during presyncope and that its measure<br> of SBP change is consistent with that simultaneously obtained through continuous BP monitoring, despite some intrapatient<br> variability. Thus, this device might be useful in determining the hypotensive nature of spontaneous (pre)syncopal symptoms, a<br> possibility that should be verified by field studies.