WASHINGTON – A huge study suggests the Apple Watch can detect a worrisome irregular heartbeat at least sometimes – but experts say more work is needed to tell if using wearable technology to screen for heart problems really helps.
More than 419,000 Apple Watch users signed up for the unusual study, making it the largest ever to explore screening seemingly healthy people for atrial fibrillation, a condition that if untreated eventually can trigger strokes.
Stanford University researchers reported Saturday that the watch didn’t panic flocks of people, warning just half a percent of participants – about 2,100 – that they might have a problem.
A user checks his Apple Watch (Photo: Apple)
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But even among those flagged, “it’s not perfect,” cautioned Dr. Richard Kovacs of the American College of Cardiology, who wasn’t involved with the study.
People who received an alert were supposed to consult a study doctor via telemedicine and then wear an EKG patch measuring cardiac activity for the next week to determine the watch’s accuracy. Some skipped the virtual check-up to consult their own doctors; overall, about 57 percent sought medical attention.
Among those who got EKG monitoring through the study, a third had atrial fibrillation, according to preliminary results being presented at an American College of Cardiology conference in New Orleans.
A-fib tends to come and go, and a week of monitoring might have missed some cases, said Stanford lead researcher Dr. Mintu Turakhia. But if the watch detected another irregular heartbeat while someone was wearing the EKG patch, 84 percent of the time it really was a-fib, he said.
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Google rebranded Android Wear as Wear OS in 2018 and has since rolled out updates that emphasize fitness features and actionable notifications. Wear OS watches can be used with both Android and iOS devices. Robert Hanashiro, Sean Dougherty, USA TODAY FullscreenTake action to improve yourself with Fitbit Charge 3—an advanced, swimproof fitness tracker with up to 7-day battery life. It’s priced at $149.95 on Fitbit.com Reviewed / Jackson RuckarFullscreenWith its focus on women’s health, the Fitbit Versa has been a popular smartwatch. FitbitFullscreenThe Apple Watch Series 3 is the third-generation model of the Apple Watch. Released in 2017, you can use the wearable to monitor your health, track your workouts, and get daily reminders to get moving. It starts at $279. Apple.comFullscreenThe Apple Watch Series 4 features a large display, an electrical heart sensor, and re-engineered digital crown with haptic feedback. It also has ECG and fall detection. The device starts at $399. AppleFullscreenThe swim-proof Fitbit Flex 2 is an automatic all-day activity and sleep tracking device. The discreet progress display uses color-coded LED lights to remind you to move. It’s priced around $60. Courtesy of FitbitFullscreenIf you can’t afford a Fitbit, the Step Gear is an inexpensive pedometer for your wrist. Dollarama Inc.FullscreenThe Fossil Gen 3 Venture with built-in activity tracking lets you track your everyday accomplishments: steps, distance and calories burned. It’s powered with OS by Google and is priced at $179 on Fossil.com Courtesy of TargetFullscreenThe LG Watch W7 is a Wear OS smartwatch with a classic watch design. You can go up to 100 days between charges when the device is in Just Watch Mode. Use the smartwatch to get proactive help from the Google Assistant and health coaching from Google Fit, an open ecosystem that makes it easy to store, access, and manage fitness data. It’s priced at $449.99 on BestBuy.com Courtesy of Best BuyFullscreenThe Gear Sport tracks your fitness and diet, keeping you on the right path to reach your goals. The wearable costs $279.99 on Samsung.com. Courtesy of Best BuyFullscreenInterested in this topic? You may also want to view these photo galleries:Replay1 of 102 of 103 of 104 of 105 of 106 of 107 of 108 of 109 of 1010 of 10AutoplayShow ThumbnailsShow CaptionsLast SlideNext Slide
“This study we believe provides very encouraging evidence that a device, the Apple Watch, can be used to detect a-fib and to point out to people when additional monitoring or testing may be needed,” said Dr. Lloyd Minor, Stanford’s dean of medicine.
Other cardiac experts said the study, which was funded by Apple, suggests screening with wearable technology might be technically feasible eventually, but needs lots more research.
“I would not advise this to the overall general population,” said Dr. Valentin Fuster, director of Mount Sinai Heart in New York and a former American Heart Association president, who wasn’t involved with the study. Instead, he’d like to see it tested in seniors with risk factors like high blood pressure.
What is atrial fibrillation?
A-fib occurs when the heart’s top chambers, called the atria, get out of sync with the bottom chambers’ pumping action. Sometimes patients feel a flutter or a racing heart but many times they’re not aware of an episode.
Sometimes the heart gets back into rhythm on its own. Other patients get an electric shock to get back into rhythm, or are prescribed blood thinners to counter the stroke-causing blood clots that untreated a-fib can spur. A-fib causes 130,000 deaths and 750,000 hospitalizations a year in the U.S.
How do doctors check for it?
A-fib is most common in older adults, and other risks include high blood pressure or a family history of arrhythmias. But routine screening isn’t recommended for people without symptoms. Studies haven’t yet proved that early detection from screening would prevent enough strokes to outweigh risks from unnecessary testing or overtreatment.
How does the Apple Watch check for it?
A mobile app uses the optical sensor on certain versions of the watch to analyze pulse rate data. If it detects enough variation from beat to beat over a 48-hour period, the user receives a warning of an irregular heart rhythm.
The latest version of the Apple Watch also allows wearers to push a button to take an EKG and share the reading with doctors. Saturday’s study didn’t include watches with that capability.
Does the new study show mass screening is a good idea?
No. The study was designed to tell how the watch compared to a week of standard EKG monitoring – not if the wearer’s health improved because the screening uncovered the arrhythmia. To prove if detecting a-fib early lowers risk of stroke would require years of study.
And since the study didn’t have a comparison group getting routine EKGs, there’s no way to know if the watch missed heartbeat problems, giving a false sense of security, Kovacs said.
The puzzling low numbers of alarms might be because most participants were young or middle-aged, not the seniors who are most at risk for a-fib, he said.
The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The ECG app on the Apple Watch Series 4 can detect AFib, a common cause of strokes. Robert Deutsch, USA TODAY