Can Smartwatches Detect Atrial Fibrillation – AFib
Can Smartwatches Detect Atrial Fibrillation – AFib – Researchers say that smart watches can detect many cases of atrial fibrillation (AFib).
However, they added that there are limitations to its use and that it is not as accurate as diagnostic tools in medical settings.
Experts say that smart watches are used as screening tools and any abnormalities should be accompanied by a visit to the doctor.
Smartphones can now detect atrial fibrillation (AFib) using an electrocardiogram (ECG) app.
A new study published in the Canadian Journal of Cardiology reports that smartwatches may actually improve detection of atrial fibrillation.
However, the researchers say limited battery life and lack of instant feedback can reduce the app’s effectiveness.
A study earlier this year found that the Apple Watch diagnosis of atrial fibrillation was accurate when evaluating people with similar clinical profiles. A recent study examined the accuracy of evaluating people with abnormal ECGs.
“Given that 50 million Apple Watches will be sold this year alone, and because automatic [AFib] detection is performed every time a user takes an ECG, this technology is already widely used,” the said doctor Mark Strick, lead author of the study. And cardiologist at the University of Bordeaux in France, specializing in electronic devices implanted in the heart.
“More and more medical professionals are using this technology. However, its use in clinical practice remains limited due to reimbursement issues, lack of organization, and algorithm limitations,” he said.
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Study Details
Can Smartwatches Detect Atrial Fibrillation – The study included 734 hospitalized participants who underwent a 12-lead ECG followed by a 30-second ECG recording on an Apple Watch. The smart watch classifies images as:
- No signs of atrial fibrillation
- Atrial fibrillation
- Inconclusive reading
The smartphone recordings were then blindly reviewed by an electrophysiologist who classified them as follows:
- Atrial fibrillation
- Absence of AFib
- Diagnosis unclear
A second electrophysiologist interpreted 100 randomly selected ECG recordings to determine the degree of agreement between the two readings.
In one in five (20%) cases, the Apple Watch was unable to perform the self-test. The researchers reported that the risk of false negatives was higher in people with atrial and ventricular premature contractions, sinus node dysfunction, and second- or third-degree AV block.
“The accuracy of smartwatch monitoring is unmatched by other clinical methods,” said Adrian Baranchuk, MD, FACC, professor of medicine at Queen’s University of Ontario, Canada, and co-author of the editorial accompanying the published study. “12-lead surface ECG remains the ‘gold standard of care’ with the highest accuracy of 98 to 99 percent.”
Some of the reasons stated for inaccurate readings are:
- Premature contractions of the atria and ventricles are common forms of cardiac arrhythmias. Both can cause an extra heartbeat.
- Sinus node dysfunction, also called sick sinus syndrome, results in an abnormal atrial rate.
- People with AV block may have a fast heartbeat, an irregular heartbeat, or feel like they have no heartbeat.
- They may also experience dizziness, shortness of breath, fainting, chest pain, and fatigue.
The risk of false-negative results is also higher in people with other cardiac arrhythmias and implanted pacemakers.
The researchers reported that the smartphone app correctly identified 78% of people who had an episode of atrial fibrillation and 81% of those who did not. By comparison, electrophysiologists identified 97% of people with atrial fibrillation and 89% of people without atrial fibrillation.
Smartwatch apps are more likely to give false positives in people with premature ventricular contractions. It also does not detect atrial tachycardia (a heart rate greater than 100 beats per minute) and atrial flutter (when the upper chambers of the heart contract too quickly).
“These devices have the potential to play an important role in health,” said Dr. Adam Skolnick, a pediatric cardiologist and assistant professor of medicine at NYU Langone Health. “But they have a long way to go before stand-alone cardiac monitoring tools like [AFib] are considered.”
The researchers suggest that better algorithms and machine learning will improve smartwatches’ ability to identify and distinguish between heart conditions.
“I recommend it to my patients for several reasons,” says Brian Kolsky, MD, DFACC, FSCAI, an interventional cardiologist and vascular specialist at Orange County Heart Institute in California.
“While this is not definitive in determining the cause of an abnormal heart rhythm, it is very predictable and lets people know they have a normal rhythm, which helps. It is also very accurate regarding heart rate. Insurance that pays for your health.
The watch as a verification tool
Can Smartwatches Detect Atrial Fibrillation – “Smartwatch apps are consumer apps. The Apple Watch is a testing tool, not a diagnostic tool. Diagnostic tools in healthcare settings are medical grade,” explained Dr. Andrew M. Freeman, a cardiologist in the Department of Cardiology and School of Medicine at National Jewish Health. “Apps have gotten better, but they don’t exist yet. However, there are several ways smartwatch apps can help.”
“The app encourages people to become more involved with their health,” Freeman told. “When people see results, they are more likely to change their behavior.
This app encourages people to do more for their health and consult their doctor in case of uneven results. I recommend the use of the device to my patients because of the benefits, it is better to make lifestyle changes and adopt healthier habits.”
He added that one of the problems with using the device is that someone could misinterpret the results.
“Smartwatch apps are good at identifying [AFib] when there are no other reasons for an abnormal heart rate,” Freeman said. “However, it is not so good when other heart conditions cause problems.
When non-medical people try to interpret the results, there is the potential for misinterpretation or panic. doctors about any decisions they are unsure about and regularly share them with their doctors.”