WHAT WEARABLE TECH CAN — AND CANNOT — TELL US ABOUT OUR HEART HEALTH
“My granddaughter got me a smartwatch for Christmas, and now this thing keeps telling me I have atrial fibrillation!”
My patient, let’s call him Mr. Jones, was both amazed at the advancements in technology that enable his watch to track his heart rhythm and distraught by the fact that a gadget for telling time also was warning him that his heart wasn’t beating right.
Since the time I met Mr. Jones, when I was a cardiologist in training, I have specialized as a cardiac electrophysiologist. I treat heart rhythm disorders using medication, procedures and, above all, patient empowerment through education and engagement — which is why I am excited by the wearable sensor driven technologies that have taken health care by storm. From monitoring trends in heart rate and sleep quality to helping diabetics manage their blood glucose, wearable devices (both clinical and consumeroffer a range of functionalities with the promise of promoting healthand wellness.
But how useful is the data from ubiquitous devices like fitness trackers or Mr. Jones’s smartwatch? The answer is: It depends.
Say a person is healthy and is not getting any troubling heart-health alerts from their device. For them, everyday wearable tech can help keep track of their heart rate and how it adapts to physical activity, and do so fairly accurately. That person can then compare trends week to week and motivate themselves to maintain a certain level of physical activity and, in turn, decrease their longterm risk of having a heart attack or a stroke.
That person can be truly empowered to know their body and continue on their path to heart health. And in their case, there’s no need to share the device’s reams of data with their health care team.
On the other hand, if a device detects an abnormal heart rhythm — especially in someone who is older and/or has a known heart disease — it’s important to reach out to a health care provider. Confirming and addressing a clinical diagnosis like AFib, the most common type of abnormal heart rhythm, is crucial, because AFib increases a person’s risk of stroke, heart failure, heart attack and death. Managing AFib requires conscientious planning, which could include blood-thinner medication, procedures or — most importantly — lifestyle changes.
Unfortunately, data gathered by fitness trackers and smartwatches are not always accurate. For a small percentage of people, the device may tell them they have an abnormal heart rhythm when they really don’t, or miss an abnormal heart rhythm when there really is one. There are ongoing studies testing well-known
wearable devices’ ability to detect and clock abnormal heart rhythms, and to track physical activity more accurately.
Over time, sensor technology has been improving, butwe are not yet living in a world where these devices alone are sufficient for a diagnosis. A gadget does not, by any means, replace a health care professional.
And it’s worth noting: Wearable tech is, unfortunately, expensive. Not everyone has access to it. As the technology continues to improve, ensuring that it’s implemented equitably is paramount to unlocking its potential.
As for my patient, Mr. Jones? His watch’s tracings did indeed show AFib, which our health care team confirmed using a clinical-grade monitor. We discussed that his risk of stroke was high and worked together to plan next steps, which in his case included starting him on blood thinners.
And then, with Mr. Jones’s permission, we got on the phone and called his granddaughter. Together we told her that her present may have saved him from having his abnormal heart rhythm go undetected. He was not much of a complainer and probably would have written off his recurrent palpitations to caffeine. (By the way, don’t do that! If you have palpitations, whether persistent or onand-off, take it seriously, regardless of whether you
have a device reading to back you up, and see a health care provider.)
That said, wearables aren’t for everyone. I have plenty of patients who’ve had their watches tell them they have abnormal heart rhythms when they actually do not, and in those cases the gadget is more of a nuisance.
The bottom line: Right now, heart-health data from wearable tech is not perfect. For some people, it can be a useful tool in motivating them to maintain healthy habits. And if your device detects an abnormal rhythm, speak to your health care provider.