Wearable tech is helpful, but it’s not all quite there yet
Health devices can prompt you to get yourself checked out — but don’t jump to conclusions if your Fitbit readings jump off the chart
In recent years I’ve been impressed by the way Fitbits and other “wearable” health monitors help patients manage their heart conditions. The technology of these over-the-counter devices still isn’t as sophisticated as what you would get from your doctor, but I’ve seen them motivate patients to take better care of their hearts.
There’s a huge variety of devices on the market now. There are even tiny scan- ners you can stick on the back of your cellphone that will give you a near-medical grade ECG just by putting your thumbs on them. But at this point, I still think the most important function of wearable technology is the most basic — to show you how many steps you’ve taken in a day and what your average heart rate is.
Many people seem to think they exercise more than they actually do.
Data from wearables can motivate patients to move more, which improves their heart health. Right now, wearables typically monitor activity and give a rough guide of heart rate when you’re exercising. If someone has a rhythm problem where their heart unexpectedly goes too slow or fast, data from these devices may be helpful. For example, if it records their heart rate suddenly jumping up, and the patient recalls they were just sitting on the couch, that’s quite helpful information.
But it’s important to know that none of these technologies is quite there yet, and none have been subjected to rigorous study. Sometimes a wearable can give you a falsely elevated or depressed heart rate. The ECG devices, too, are subject to error: if you don’t put your thumbs on them exactly right, for example, the results can be impossible to interpret.
Therefore, wearable devices are mostly useful for motivation and offering information that may prompt you to get yourself checked out by a doctor, if you see problems. But don’t jump to conclusions just because your wearable said your heart rate suddenly elevated to 120 beats per minute. Take note of how you felt and what you were doing at the time, and do a quick manual check of your pulse to ensure the reading is correct. Take note of it and share that information with your doctor; but keep in mind that the information can sometimes be misleading and does not always mean there is a medical problem.
In the future, wearable devices are only going to get more accurate, more user-friendly and likely less expensive. When that happens, I’m excited about the possibilities for fully patient-driven care similar to what we have now with diabetes. One day, patients will use the day-to-day changes in their heart rate, blood pressure and more to make micro-adjustments in their medications and lifestyles — rather than waiting for their next doctor’s appointment. This kind of careful monitoring and incremental adjustment could lower the risk of heart attacks and strokes by treating problems quickly before they get worse.
Already, there are very small heart monitors that a cardiologist can inject under the skin. Today, these are being used for people with rarely occurring heart irregularities that are tough to diagnose. When someone faints or experiences a rapid heartbeat, these monitors detect it, and they can even interact with your cellphone so that you are prompted to check off symptoms.
These, along with accurate recording of the heart incident, are sent through your phone directly to your doctor. Just last September at Southlake Regional Health Centre, I per- formed a North American-first insertion of a Bluetooth-enabled cardiac monitor compatible with a cellphone app, enabling the patient to conveniently and discreetly record and transmit symptoms.
While there’s no over-thecounter device that can do these things yet, the day is coming when this will be the reality, and that is a very good thing. The more patients are involved in their own care, the more we can improve heart health and prevent heart attacks and strokes.
Dr. Atul Verma is an assistant professor in the Department of Surgery and Medicine at U of T and serves as staff cardiologist at the Southlake Regional Health Centre in Newmarket. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine.