A wearable sensors dataset for stress & boredom associated activity recognition.

This article presents a dataset of activities associated with stress and boredom obtained through wearable sensors. Data was collected from 40 right-handed participants aged 20 to 25, evenly split between males and females. Each individual wore a smart device on their dominant arm's wrists to facilitate the capture of data. This dataset covers five activities associated with stress and boredom, namely, smoking, eating, nail biting, face touching, and staying still. These activities were selected for their potential psychological implications and captured in an uncontrolled environment to mimic real-life scenarios. The data provides a unique resource for developing machine learning models aimed at recognizing these behaviors, which could lead to real-time analysis and interventions for stress. A custom holder was used to hold the device on the wrists in order to ensure that all participants had consistent orientation and placement. This holder was situated just above the wrist joint, a location typically associated with the placement of smartwatches. The dataset provides a unique opportunity for developing machine learning models for stress & boredom associated activities recognition apart from real-time symptomatic analysis of stress and boredom.

A Robust End-to-End IoT System for Supporting Workers in Mining Industries.

The adoption of the Internet of Things (IoT) in the mining industry can dramatically enhance the safety of workers while simultaneously decreasing monitoring costs. By implementing an IoT solution consisting of a number of interconnected smart devices and sensors, mining industries can improve response times during emergencies and also reduce the number of accidents, resulting in an overall improvement of the social image of mines. Thus, in this paper, a robust end-to-end IoT system for supporting workers in harsh environments such as in mining industries is presented. The full IoT solution includes both edge devices worn by the workers in the field and a remote cloud IoT platform, which is responsible for storing and efficiently sharing the gathered data in accordance with regulations, ethics, and GDPR rules. Extended experiments conducted to validate the IoT components both in the laboratory and in the field proved the effectiveness of the proposed solution in monitoring the real-time status of workers in mines.

A Systematic Review and Meta-analysis of Mobile Health Applications and Telemonitoring in Atopic Dermatitis Self-Management.

INTRODUCTION: Up to 25% of children and 5.6% of adults in the USA have atopic dermatitis (AD), with substantial impacts on quality of life. Effective control can be challenging despite therapy efforts. The emergence of information and communication technologies (ICT) in AD management prompted this study to assess its impact on self-management. We conducted a meta-analysis to assess outcomes from peer-reviewed clinical trials evaluating the effectiveness of teledermatology, mobile health (mHealth) apps, and electronic devices for managing AD. METHODS: We searched PubMed, Web of Science, Scopus, and Embase for articles written in English and published until May 2023. RESULTS: Twelve trials with 2424 participants were selected from 811 studies. A meta-analysis of 1038 individuals reported a mean difference (MD) of -1.57 [95% confidence interval (CI): -2.24, -0.91] for the Patient Oriented Eczema Measure (POEM). A meta-analysis of 495 individuals reported a Dermatology Life Quality Index (DLQI) MD of -0.59 [95% CI: -0.95, -0.23]. Despite heterogeneity (I2 = 47% and I2 = 74%), the impact was significant (P ≤ 0.001). SCORing Atopic Dermatitis (SCORAD) showed an insignificant MD of -0.12 (P = 0.91). CONCLUSION: mHealth applications and telemonitoring show significant improvement in patients' quality of life (DLQI) and self-management (POEM) but no significant impact on AD severity (SCORAD).

Carbon dots as versatile nanomaterials in sensing and imaging: Efficiency and beyond.

Carbon dots (CDs) have emerged as a versatile and promising carbon-based nanomaterial with exceptional optical properties, including tunable emission wavelengths, high quantum yield, and photostability. CDs are appropriate for various applications with many benefits, such as biocompatibility, low toxicity, and simplicity of surface modification. Thanks to their tunable optical properties and great sensitivity, CDs have been used in sensing as fluorescent probes for detecting pH, heavy metal ions, and other analytes. In addition, CDs have demonstrated potential as luminescence converters for white organic light-emitting diodes and light emitters in optoelectronic devices due to their superior optical qualities and exciton-independent emission. CDs have been used for drug administration and bioimaging in the biomedical field due to their biocompatibility, low cytotoxicity, and ease of functionalization. Additionally, due to their stability, efficient charge separation, and low recombination rate, CDs have shown interesting uses in energy systems, such as photocatalysis and energy conversion. This article highlights the growing possibilities and potential of CDs as adaptable nanomaterials in a variety of interdisciplinary areas related to sensing and imaging, at the same time addressing the major challenges involved in the current research and proposing scientific solutions to apply CDs in the development of a super smart society.

Cardiac arrest and cardiopulmonary resuscitation in the next decade: Predicting and shaping the impact of technological innovations.

INTRODUCTION: Cardiac arrest (CA) is the third leading cause of death, with persistently low survival rates despite medical advancements. This article evaluates the potential of emerging technologies to enhance CA management over the next decade, using predictions from the AI tools ChatGPT-4 and Gemini Advanced. METHODS: We conducted an exploratory literature review to envision the future of cardiopulmonary arrest (CA) management. Utilizing ChatGPT-4 and Gemini Advanced, we predicted implementation timelines for innovations in early recognition, CPR, defibrillation, and post-resuscitation care. We also consulted the AI to assess the consistency and reproducibility of the predictions. RESULTS: We extrapolate that healthcare may embrace new technologies, such as comprehensive monitoring of vital signs to activate the emergency system (wireless detectors, smart speakers, and wearable devices), use new innovative early CPR and early AED devices (robot CPR, wearable AEDs, and immersive reality), and post-resuscitation care monitoring (brain-computer interface). These technologies could enhance timely life-saving interventions for cardiac arrest. However, there are many ethical and practical challenges, particularly in maintaining patient privacy and equity. The two AI tools made different predictions, with a horizon for implementation ranging between three and eight years. CONCLUSION: Integrating advanced monitoring technologies and AI-driven tools offers hope in improving CA management. A balanced approach involving rigorous scientific validation and ethical oversight is necessary. Collaboration among technologists, medical professionals, ethicists, and policymakers is crucial to use these innovations ethically to reduce CA incidence and enhance outcomes. Further research is needed to enhance the reliability of AI predictive capabilities.

Life-saving fall detection by a smartwatch in a case of ventricular fibrillation.

New smart devices that have the potential to support the health and well-being of their owners have become available. In particular, smart watches are able to identify a fall by the person who is wearing the watch and report it to pre-defined contacts and the local emergency control center. Falls in older people are common and only rarely caused by malignant cardiac arrhythmia. The case of an elderly male whose smart watch automatically reported his fall due to ventricular fibrillation to the local emergency control center is described. Through the intervention of the wearer's device, the activated dispatcher called the patient's wife, who found her husband lying unresponsive on the floor. Emergency medical services responded immediately and were able to successfully resuscitate the patient. A hospital discharge without any long-term complications was achieved.

Integrating smartwatches in community mental health services for severe mental illness for detecting relapse and informing future intervention: A case series.

OBJECTIVE: This case series explored the integration of smartwatches in a community mental health service to support severe mental illness (SMI) management and intervention. We examined whether biometric data provided by smartwatches could help to predict relapse and inform treatment decisions. METHOD: Four Australian SMI outpatients of mixed diagnoses (age range = 19-24) were selected from a prior study. Clinicians accessed patients' biometric data (activity, sleep, heart rate, and electrodermal activity) through smartwatches. RESULTS: Changes in circadian rhythm and electrodermal activity preceded hospitalization in two cases. Additionally, smartwatch data was effectively used to guide targeted interventions, improving patient treatment outcomes. CONCLUSION: Integrating smartwatches in community mental health services offers promise as adjunct tools for SMI management. However, ethical considerations on data privacy and technology reliance require further evaluation. Additionally, as this is a small case series, randomized controlled trials with larger sample sizes are required to provide evidence for generalisability of results.

Utilization of smart devices and the evolution of customized healthcare services focusing on big data: a systematic review.

Background: Currently, smart devices can prevent diseases by continuously collecting user information and providing health-related feedback. Smart devices big data provide personalized, faster, and more accurate health care. By examining existing studies, we suggest a new healthcare evolution and health promotion through information technology (IT) convergence. A big data systematic review examined the evolution of new health care and their potential for health promotion by monitoring physical activities, preventing diseases, and analyzing health data smart devices. Methods: Therefore, this evaluates whether a new healthcare industry combining smart devices and big-data-based customized health care services can promote health. This study searched PubMed, Google Scholar, Scopus, and Research Information Sharing Service (RISS) for keywords related to big data, smart devices, healthcare, customized health services, health apps, and mobile health. This study comprised 43 of 453 publications from 2007 to 2023. Among them, a total of 43 articles were successfully completed in this study using the PRISMA flowchart in the final stage. Results: Smart devices centered on big data enable personalized health care, and app technologies that promote well-being to prepare for aging society have many applications in clinical, prevention, public health, and rehabilitation settings. Smart devices and tailored healthcare services using big data to inform individuals about exercise, health status, diagnosis, and health information will expand into major sectors. By reviewing previous studies, the convergence of the IT technology field, which allows you to easily identify individual health and receive faster and more accurate medical services through customized health care services, has future-oriented values as, new health care services evolve. The systematic review of big data herein can monitor physical activity and prevent diseases using smart devices, thus promoting a healthy lifestyle. Conclusions: Smart devices that analyze data to provide personal exercise and health conditions, checkups, and information, are making our lives easier. The information service using big data will continue to evolve into a personalized management service and provide basic healthcare data as it grows into an expected industry in the future.

Assessment of radio frequency fields in the 2.45 GHz band produced by smart home devices.

This paper describes the assessment of the electromagnetic fields produced by consumer "smart" devices used to control and monitor everyday equipment and appliances in a modern "smart" home. The assessment is based on the careful measurement of fields produced by a range of such devices in a laboratory environment configured to operate in a condition simulating high user activity. All devices included in this study operate in the 2.4 GHz band utilizing either Wi-Fi or Bluetooth connectivity. Overall results indicate very low levels of electromagnetic fields for all IoT smart devices in terms of human exposure safety standards (typically much less than 1%) with very low duty cycles (also less than 1%) resulting in even lower time-averaged exposure levels. These low levels of exposure, along with rapid reduction of levels with distance from the devices, suggests that the cumulative effect of multiple devices in a "smart" home are not significant.

Failure of Digital Device Performance in Monitoring Physical Exercise in a Pilot Study in Sedentary Persons with HIV.

Digital devices have gained popularity in the last 10 years as a tool for exercise prescription, the monitoring of daily physical activity, and nutrition for the management of a health-related parameter. Therefore, the aim of this study was to assess the effectiveness of the use of digital devices to monitor exercise data in sedentary persons with HIV who exercise following an individualized activity pacing (AP) protocol on cardiorespiratory fitness body composition, blood lipid profile, and psychological parameters. Twenty-four PLWH were enrolled in an 18-week randomized, open-label, pilot AP exercise protocol. All participants were monitored by a Health Band connected to a mobile app that transmitted the data to a server. At week 3, they were randomized either in an experimental group (EG), in which an open device configuration enabled them to receive training data feedback (n = 12), or continued with no data feedback (control group, n = 12). The primary endpoint was improvement from the baseline of 15% of steady-state oxygen consumption (V˙O2) during a 6-min walking test. Technical issues occurred when pairing the health band with the app, which prevented EG participants from regularly receiving data feedback, and with data transmission to the server, which enabled only 40% monitoring of the total training days. Consequently, the study outcomes could not be compared between the two groups, and participants also lost confidence in the study. However, 19 out of 24 participants completed the AP program. Overall, only 6 (32%) improved steady-state V˙O2, with no significant changes at W18 from the baseline. Significant reductions were observed of BMI (p = 0.040), hip circumference (p = 0.027), and total-(p = 0.049) and HDL-cholesterol (p = 0.045). The failure of digital device performance substantially affected study procedures, monitoring, and participants' engagement, and likely limited the potential benefits of the AP exercise program.

Wolf Creek XVII part 3: Automated cardiac arrest diagnosis.

Introduction: Automated cardiac arrest diagnosis offers the possibility to significantly shorten the interval between onset of out-of-hospital cardiac arrest (OHCA) and notification of EMS, providing the opportunity for earlier resuscitation and possibly increased survival. Methods: Automated cardiac arrest diagnosis was one of six focus topics for the Wolf Creek XVII Conference held on June 14-17 2023 in Ann Arbor, Michigan, USA. Conference invitees included international thought leaders and scientists in the field of cardiac arrest resuscitation from academia and industry. Participants submitted via online survey knowledge gaps, barriers to translation and research priorities for each focus topic. Expert panels used the survey results and their own perspectives and insights to create and present a preliminary unranked list for each category that was debated, revised and ranked by all attendees to identify the top 5 for each category. Results: Top knowledge gaps include the accuracy of automated OHCA detection technologies and the feasibility and reliability of automated EMS activation. The main barriers to translation are the risk of false positives potentially overburdening EMS, development and application costs of technology and the challenge of integrating new technology in EMS IT systems. The top research priorities are large-scale evaluation studies to measure real world performance and user research regarding the willingness to adopt these technologies. Conclusion: Automated cardiac arrest diagnosis has the potential to significantly impact time to resuscitation and survival of OHCA because it could convert unwitnessed events into witnessed events. Validation and feasibility studies are needed. The specificity of the technology must be high not to overburden limited EMS resources. If adequate event classification is achieved, future research could shift toward event prediction, focusing on identifying potential digital biomarkers and signatures of imminent cardiac arrest. Implementation could be challenging due to high costs of development, regulatory considerations and instantiation logistics.

Associating Parental Efficacy with the Utility of Smart Devices: A Cross-Sectional Study of Their Role in Alleviating Maternal Parenting Concerns among Infants Aged 6-11 Months.

In digital societies, the use of smart devices to solve childcare problems has become commonplace. Mothers are influenced both positively and negatively by smart devices used to resolve childcare concerns. Focusing on parental self-efficacy, this study identified the factors associated with relief and anxiety caused by the use of smart devices to eliminate parenting concerns among mothers with infants. A random sampling cross-sectional survey was administered to 257 Japanese mothers with infants aged 6-11 months. Structural equation modeling was used to explain the relief and anxiety caused by their use of smart devices in terms of maternal demographics, parental self-efficacy, smart-device dependence, and confidence in their ability to discriminate information. Mothers with high parental self-efficacy experienced increased relief and reduced anxiety by using smart devices to address concerns about child-rearing practices. Mothers who were highly dependent on smart devices felt more secure with their use of smart devices. Homemakers and highly educated mothers who used smart devices because of concerns regarding child health and development experienced more anxiety. Parenting professionals need to recognize the effectiveness of smart devices as a tool to relieve anxiety in parenting and provide additional support for parents to improve their parenting self-efficacy.

Laboratory Results of a Real-Time SHM Integrated System on a P180 Full-Scale Wing-Box Section.

The final objective of the study herein reported is the preliminary evaluation of the capability of an original, real-time SHM system applied to a full-scale wing-box section as a significant aircraft component, during an experimental campaign carried out at the Piaggio Lab in Villanova D'Albenga, Italy. In previous works, the authors have shown that such a system could be applied to composite beams, to reveal damage along the bonding line between a longitudinal stiffening element and the cap. Utilizing a suitable scaling process, such work has then been exported to more complex components, in order to confirm the outcomes that were already achieved, and, possibly, expanding the considerations that should drive the project towards an actual implementation of the proposed architecture. Relevant topics dealt with in this publication concern the application of the structural health monitoring system to different temperature ranges, by taking advantage of a climatic room operating at the Piaggio sites, and the contemporary use of several algorithms for real-time elaborations. Besides the real-time characteristics already introduced and discussed previously, such further steps are essential for applying the proposed architecture on board an aircraft, and to increase reliability aspects by accessing the possibility of comparing different information derived from different sources. The activities herein reported have been carried out within the Italian segment of the RESUME project, a joint co-operation between the Ministry of Defense of Israel and the Ministry of Defense of Italy.

A technology-focused service within a rehabilitation setting: exploring the experiences and current technology demands of people with disabilities.

PURPOSE: To understand and combat the challenges in taking up and implementing technology in rehabilitation settings, the HabITec Lab, a clinical service focused on technology, was piloted for 12-months within a tertiary hospital. This article reports on its preliminary impacts as a clinical service and on clients, including the types of assistive technology (AT) in demand. MATERIALS AND METHODS: Referral and administrative data from 25 individuals who attended the HabITec Lab were collated and analysed using descriptive statistics. For those who attended more than once (n = 12), goal attainment was assessed using the Modified Goal Attainment Measure (MGAM). Post-intervention semi-structured interviews were completed with participants to understand their experience at the HabITec Lab. Interviews were analysed using thematic analysis. RESULTS: Most attendees (92%) were undergoing inpatient rehabilitation following a spinal cord injury (SCI). The majority (73%) of goals related to improving entertainment and connection. All participants who completed the MGAM showed improved goal attainment following their HabITec Lab attendance. Qualitative data highlighted appreciation for the service and suggestions for its future. CONCLUSIONS: This study revealed a high level of demand for support to use AT amongst individuals with SCI, particularly consumer-grade smart devices that could assist communication. This finding may have been influenced by the impacts of the COVID-19 pandemic and frequent lockdowns during this period. This study indicated that the HabITec Lab was able to address important goals for attendees, but also illuminate a new future and trigger enthusiasm about future goals. Attendance was liberating, but resourcing barriers were frustrating.IMPLICATIONS FOR REHABILITATIONDedicated socio-technological spaces such as HabITec are an important way to provide access to expertise and develop consumer knowledge of technology not adequately addressed elsewhere in the rehabilitation continuum.Access to technological support for individuals in the inpatient setting facilitates access to technology in the present and capacity building to foster ongoing use of technology in the future.Dedicated socio-technological spaces should be adequately resourced, funded, staffed and promoted to ensure optimal outcomes.Access to Smart devices within the inpatient rehabilitation setting is critical for people with spinal cord injury to foster communication with family, friends and communities.

A smart devices based secondary prevention program for cerebrovascular disease patients.

Background: Commercially available health devices are gaining momentum and represent a great opportunity for monitoring patients for prolonged periods. This study aimed at testing the feasibility of a smart device-based secondary prevention program in a cohort of patients with cryptogenic stroke. Methods: In this proof-of-principle study, patients with non-disabling ischemic stroke and transient ischemic attacks (TIA) in the subacute phase were provided with a smartwatch and smart devices to monitor several parameters - i.e., oxygen saturation, blood pressure, steps a day, heart rate and heart rate variability - for a 4-week period (watch group). This group was compared with a standard-of-care group. Our primary endpoint was the compliance with the use of smart devices that was evaluated as the number of measures performed during the observation period. Results: In total, 161 patients were recruited, 87 in the WATCH group and 74 in the control group. In the WATCH group, more than 90% of patients recorded the ECG at least once a day. In total, 5,335 ECGs were recorded during the study. The median blood pressure value was 132/78 mmHg and the median oxygen saturation value was 97%. From a clinical standpoint, although not statistically significant, nine atrial fibrillation episodes (10.3%) in the WATCH group vs. 3 (4%) in the control group were detected. Conclusion: Our study suggests that prevention programs for cerebrovascular disease may benefit from the implementation of new technologies.

Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI.

This descriptive article explores the use of smart devices for health and wellness in the context of telehealth, highlighting rapidly evolving technologies such as the Internet of Things (IoT) and Artificial Intelligence (AI). Key innovations, benefits, challenges, and opportunities related to the adoption of these technologies are outlined. The article provides a descriptive and accessible approach to understanding the evolution and impact of smart devices in the tele-exercise reality. Nowadays, technological advances provide solutions that were unthinkable just a few years ago. The habits of the general population have also changed over the past few years. Hence, there is a need to investigate this issue and draw the attention of the scientific community to this topic by describing the benefits and challenges associated with each topic. If individuals no longer go to exercise, the exercise must go to their homes instead.

An investigation into the use of smart home devices, user preferences, and impact during COVID-19.

With the goal of designing smart environments that can support users' physical/mental well-being, we studied users' experiences and different factors that can influence success of smart home devices through an online study conducted during and after the COVID-19 restrictions in June 2021 (109 participants) and March 2022 (81 participants). We investigated what motivates users to buy smart home devices, and if smart home devices may have the potential to improve different aspects of users' well-being. As COVID-19 emphasized a situation where people spent a significant amount of time at home in Canada, we also asked if/how COVID-19 motivated purchase of smart-home devices and how these devices affected participants during the pandemic. Our results provide insights into different aspects that may motivate the purchase of smart home devices and users' concerns. The results also suggest that there may be correlations between the use of specific types of devices and psychological well-being.

Impact of VA's video telehealth tablets on substance use disorder care during the COVID-19 pandemic.

BACKGROUND: Telehealth has the potential to improve health care access for patients but it has been underused and understudied for examining patients with substance use disorders (SUD). VA began distributing video-enabled tablets to veterans with access barriers in 2016 to facilitate participation in home-based telehealth and expanded this program in 2020 due to the coronavirus COVID-19 pandemic. OBJECTIVE: Examine the impact of VA's video-enabled telehealth tablets on mental health services for patients diagnosed with SUD. METHODS: This study included VA patients who had ≥1 mental health visit in the calendar year 2019 and a documented diagnosis of SUD. Using difference-in-differences and event study designs, we compared outcomes for SUD-diagnosed patients who received a video-enabled tablet from VA between March 15th, 2020 and December 31st, 2021 and SUD-diagnosed patients who never received VA tablets, 10 months before and after tablet-issuance. Outcomes included monthly frequency of SUD psychotherapy visits, SUD specialty group therapy visits and SUD specialty individual outpatient visits. We examined changes in video visits and changes in visits across all modalities of care (video, phone, and in-person). Regression models adjusted for several covariates such as age, sex, rurality, race, ethnicity, physical and mental health chronic conditions, and broadband coverage in patients' residential zip-code. RESULTS: The cohort included 21,684 SUD-diagnosed tablet-recipients and 267,873 SUD-diagnosed non-recipients. VA's video-enabled tablets were associated with increases in video visits for SUD psychotherapy (+3.5 visits/year), SUD group therapy (+2.1 visits/year) and SUD individual outpatient visits (+1 visit/year), translating to increases in visits across all modalities (in-person, phone and video): increase of 18 % for SUD psychotherapy (+1.9 visits/year), 10 % for SUD specialty group therapy (+0.5 visit/year), and 4 % for SUD specialty individual outpatient treatment (+0.5 visit/year). CONCLUSIONS: VA's distribution of video-enabled tablets during the COVID-19 pandemic were associated with higher engagement with video-based services for SUD care among patients diagnosed with SUD, translating to modest increases in total visits across in-person, phone and video modalities. Distribution of video-enabled devices can offer patients critical continuity of SUD therapy, particularly in scenarios where they have heightened barriers to in-person care.

Ok Google, Start a Fire. IoT devices as witnesses and actors in fire investigations.

Fire incidents are amongst the most destructive events an investigator might encounter, completely transforming a scene with most of the objects left in ashes or highly damaged. Until now, fire investigations relied heavily on burn patterns and electrical artifacts to find possible starting locations, as well as witness statements and more recently witness imagery. As Internet of Things (IoT) devices, often seen as connected smart devices, become more common, the various sensors embedded within them provide a novel source of traces about the environment and events within. They collect and store information in different locations, often not touched by the event, such as remote servers (cloud) or companion smartphones, widening the investigation field for fire incidents. This work presents two controlled fire incidents in apartments that we furnished, equipped with IoT devices, and subsequently burnt. We studied the traces retrievable from the objects themselves after the incident, the companion smartphone apps, and the cloud and assessed the value of the information they conveyed. This research highlighted the pertinence to consider traces from IoT devices in the forensic process of fire investigation.

Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Rising Entity of Severe Bradycardia.

Bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia (BRASH) syndrome is an entity recently coined to describe this clinical pentad. Although the condition is rare, early recognition is paramount. It ensures prompt appropriate intervention is administered, as conventional management for bradycardia as guided by advanced cardiac life support (ACLS) is ineffective in the BRASH syndrome. Here, we describe a case of an elderly lady with hypertension and chronic kidney disease presenting to the emergency department with dyspnoea and confusion. She was found to have bradycardia, hyperkalemia, and acute kidney injury. Notably, she had recent changes in her medications in view of poorly controlled hypertension two days before the presentation. Her Bisoprolol 5mg every morning was changed to Carvedilol 12.5mg twice daily, and Amlodipine 10mg every morning was changed to Nifedipine long-acting 60mg twice daily. Initial treatment with atropine for bradycardia was ineffective. However, when the BRASH syndrome was identified and treated, the patient's condition improved, and she averted complications such as multiorgan failure without the need for dialysis or cardiac pacing. Early detection of bradycardia via smart devices could be considered in patients at higher risk of BRASH syndrome.