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Structured abstract Background The Apple watch has the capability to record a lead 1 electrocardiogram, and can identify and report atrial fibrillation. The use for detecting myocardial ischemia is not endorsed by Apple but is documented in this case. Case Summary A 76-year old man made a lead 1 electrocardiogram with his Apple watch immediately after exercising on a cross trainer. He was fully asymptomatic. The electrocardiogram showed an unusual negative T wave in this lead 1, that deepened in a few minutes and returned to normal after 22 minutes. He consulted a cardiologist and a standard exercise electrocardiogram confirmed the negative T wave in lead 1 after maximal exercise and in addition showed widespread ST-depression indicating myocardial ischemia, again without any clinical symptoms. Further studies revealed severe obstructive three vessel coronary artery disease that was considered not suitable for percutaneous intervention. A coronary artery bypass operation on all involved vessels was performed successfully. Recovery was uneventful and an exercise electrocardiogram repeated 11 weeks later was normal. Discussion We demonstrated that the lead 1 electrocardiogram made with the Apple watch can reliably record T wave changes indicating myocardial ischemia. The use of the Apple watch to document ischemic changes should be studied systematically for its potential to identify myocardial ischemia, mainly triggered by symptoms but maybe for asymptomatic persons as well.
Structured abstract Background The Apple watch has the capability to record a lead 1 electrocardiogram, and can identify and report atrial fibrillation. The use for detecting myocardial ischemia is not endorsed by Apple but is documented in this case. Case Summary A 76-year old man made a lead 1 electrocardiogram with his Apple watch immediately after exercising on a cross trainer. He was fully asymptomatic. The electrocardiogram showed an unusual negative T wave in this lead 1, that deepened in a few minutes and returned to normal after 22 minutes. He consulted a cardiologist and a standard exercise electrocardiogram confirmed the negative T wave in lead 1 after maximal exercise and in addition showed widespread ST-depression indicating myocardial ischemia, again without any clinical symptoms. Further studies revealed severe obstructive three vessel coronary artery disease that was considered not suitable for percutaneous intervention. A coronary artery bypass operation on all involved vessels was performed successfully. Recovery was uneventful and an exercise electrocardiogram repeated 11 weeks later was normal. Discussion We demonstrated that the lead 1 electrocardiogram made with the Apple watch can reliably record T wave changes indicating myocardial ischemia. The use of the Apple watch to document ischemic changes should be studied systematically for its potential to identify myocardial ischemia, mainly triggered by symptoms but maybe for asymptomatic persons as well.
Smartwatches represent one of the most widely adopted technological innovations among wearable devices. Their evolution has equipped them with an increasing array of features, including the capability to record an electrocardiogram. This functionality allows users to detect potential arrhythmias, enabling prompt intervention or monitoring of existing arrhythmias, such as atrial fibrillation. In our research, we aimed to compile case reports, case series, and cohort studies from the Web of Science, PubMed, Scopus, and Embase databases published until 1 August 2023. The search employed keywords such as “Smart Watch”, “Apple Watch”, “Samsung Gear”, “Samsung Galaxy Watch”, “Google Pixel Watch”, “Fitbit”, “Huawei Watch”, “Withings”, “Garmin”, “Atrial Fibrillation”, “Supraventricular Tachycardia”, “Cardiac Arrhythmia”, “Ventricular Tachycardia”, “Atrioventricular Nodal Reentrant Tachycardia”, “Atrioventricular Reentrant Tachycardia”, “Heart Block”, “Atrial Flutter”, “Ectopic Atrial Tachycardia”, and “Bradyarrhythmia.” We obtained a total of 758 results, from which we selected 57 articles, including 33 case reports and case series, as well as 24 cohort studies. Most of the scientific works focused on atrial fibrillation, which is often detected using Apple Watches. Nevertheless, we also included articles investigating arrhythmias with the potential for circulatory collapse without immediate intervention. This systematic literature review provides a comprehensive overview of the current state of research on arrhythmia detection using smartwatches. Through further research, it may be possible to develop a care protocol that integrates arrhythmias recorded by smartwatches, allowing for timely access to appropriate medical care for patients. Additionally, continuous monitoring of existing arrhythmias using smartwatches could facilitate the assessment of the effectiveness of prescribed therapies.
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