The Apple Watch and other wearables are now able to monitor your heart rhythm. The Apple watch can detect irregular heart rhythms, and if it does so five times, it will prompt you to record your rhythm. In that way, it can also be used to diagnose atrial fibrillation.
Does that mean that if the Apple Watch says I have an irregular rhythm that I have Afib?
The simple answer is… not always.
If you have atrial fibrillation and your risk of stroke is high, then it’s a good thing to catch it earlier and get further testing. However, as with any screening program, using the apple watch to diagnose afib may have drawbacks.
The US Preventive Services Task Force does not recommend ECG screening for healthy adults at low risk of heart disease. The concern is that patients who do not have a condition may be falsely diagnosed by the apple watch as having an irregular heart rhythm, and end up undergoing series of tests to prove they do or do not have it.
If the watch says you have afib, what are the chances you do have it?
The majority of people wearing an Apple Watch, have a very low risk of having atrial fibrillation – most owners are 55 or younger.
In that group, the risk of having afib is low. So even if the apple watch is wrong only a small percent of time, physician-scientist Sekar Kathiresan estimates that the alerts by the watch will be wrong 45 percent of the time.
How do you diagnose Afib?
Atrial fibrillation is diagnosed with an analysis of your heart rhythm, done with an ECG (electrocardiogram). This can be done in the clinic, using 10 electrodes for a 12-lead EKG or with monitors that you can take home. There are also implantable monitors, with batteries that last up to 3 years, that can help in some situations.
Rhythm monitors are important tools for doctors to diagnose afib, because many patients have episodes of afib lasting minutes or hours (paroxysmal afib), and when they see a doctor, they may be in normal rhythm. Therefore, using a monitor for a few days or even weeks (or years with implantable monitors) can help in the quick and appropriate diagnosis of afib.
What should I do if my Apple Watch says I have an irregular heart rhythm?
You should contact your primary care physician or cardiologist. Many patients will end up needing evaluation by an electrophysiologist, who is a cardiologist specialized in heart rhythm problems.
The first step for most will be to use a patch monitor, which can record your heart rhythm continuously for weeks at a time. And it later can be analyzed for signs of afib or other irregular heart rhythms. Some patients will need further testing, such as an echocardiogram or stress testing – but that decision is individualized.
Jose Osorio, M.D. is the Medical Director, Atrial Fibrillation Clinic and Cardiac Electrophysiology, Grandview Medical Center.
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