What car­di­ol­o­gists think about the Ap­ple Watch’s heart-track­ing fea­ture

Heart rhythms nat­u­rally vary, mean­ing that it’s likely that Ap­ple Watch or any heart mon­i­tor could sig­nal a prob­lem when there isn’t one - and send some­one run­ning to the doc­tor for no rea­son.

The Borneo Post - Nature and health - - Vital Signs - By Hay­ley Tsukayama

THE NEW­EST Ap­ple Watch can now flag po­ten­tial prob­lems with your heart­beat - a fea­ture that’s been cleared by the Food and Drug Ad­min­is­tra­tion and that Ap­ple is mark­ing as a ma­jor achieve­ment.

But some doc­tors said that in­clud­ing heart-mon­i­tor­ing tools in such a pop­u­lar con­sumer prod­uct could prompt un­nec­es­sary anx­i­ety and med­i­cal vis­its.

The com­pany touted its heart-track­ing fea­ture as proof that the watch can help peo­ple proac­tively man­age their health “The Ap­ple Watch has be­come the in­tel­li­gent guardian for your health,” Ap­ple Chief Op­er­at­ing Of­fi­cer Jeff Wil­liams, who over­sees the de­vel­op­ment of the Ap­ple Watch, said in the com­pany’s pre­sen­ta­tion of new Ap­ple prod­ucts.

The FDA has cleared Ap­ple’s de­vice as a Class II med­i­cal de­vice, mean­ing that it is in­tended to di­ag­nose or treat a med­i­cal con­di­tion and poses a min­i­mal risk to use. Physi­cians say the watch could be good for pa­tients who have ir­reg­u­lar heart rhythms but may not re­alise it. Some peo­ple who have atrial fib­ril­la­tion, the con­di­tion for which the watch is screen­ing, don’t al­ways have no­tice­able symp­toms. In an ideal sit­u­a­tion, some­one who doesn’t know they have a prob­lem could get a warn­ing from their watch and take that data to their doc­tor.

But there is also con­cern that wide­spread use of elec­tro­car­dio­grams with­out an equally broad ed­u­ca­tion ini­tia­tive could bur­den an al­ready taxed health-care sys­tem. Heart rhythms nat­u­rally vary, mean­ing that it’s likely that Ap­ple Watch or any heart mon­i­tor could sig­nal a prob­lem when there isn’t one - and send some­one run­ning to the doc­tor for no rea­son. “Peo­ple are scared; their heart scares them,” John Man­drola, a car­di­ol­o­gist at Bap­tist Health in Louisville, said.

“That leads to more in­ter­ac­tion with the health-care sys­tem.” An ex­tra visit to your doc­tor may not sound like a bad thing, but Man­drola said it would po­ten­tially lead to an­other round of tests or even un­nec­es­sary treat­ment if there are other signs that can be mis­in­ter­preted. And doc­tors might wind up fac­ing a crowd of anx­ious Ap­ple Watch users get­ting false sig­nals - some­thing physi­cians have al­ready had to deal with as fit­ness track­ers that mon­i­tor heart rates have be­come pop­u­lar.

“I’ve had to tell pa­tients: Just take off the Fit­bit and don’t look at the data,” said Gre­gory Mar­cus, a car­di­ol­o­gist and di­rec­tor of clin­i­cal re­search in car­di­ol­ogy at the Univer­sity of Cal­i­for­nia San Fran­cisco. But he recog­nises there could be pos­i­tive med­i­cal and fi­nan­cial out­comes from a watch-trig­gered doc­tor visit - es­pe­cially if the ECG is ac­cu­rate enough to al­low for a di­ag­no­sis with­out the need for other tests.

“It’s too early to tell from a pub­lic health per­spec­tive whether the costs will out­weigh the ben­e­fits,” Mar­cus said. What could help calm anx­i­ety, he said, would be more gen­eral ed­u­ca­tion about con­di­tions such as atrial fib­ril­la­tion. “Gen­er­ally, physi­cians talk about these things among them­selves,” he said. “Per­haps this move­ment into the con­sumer realm means ed­u­cat­ing the pub­lic about these is­sues, as well.”

Mar­cus - whose Health eHeart study is eval­u­at­ing how tech­nol­ogy can help pa­tients - and Man­drola say they are op­ti­mistic about how data col­lected from Ap­ple Watch from peo­ple who’ve opted in to stud­ies can help re­searchers. But for those who wear the watch and get spooked by an alert, the con­cern that the warn­ings will cause un­nec­es­sary anx­i­ety is real. “I see pa­tients; I see nor­mal peo­ple come in, and most peo­ple are scared out of their wits,” Man­drola said. With the wide­spread ap­peal of the Ap­ple Watch, he said, that’s only likely to in­crease. “You could get a tsunami of peo­ple com­ing in.” – Wash­ing­ton Post.

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