How to take an ECG taken with smartwatches?

How to take ECG taken with smartwatches?

Simply touch the ECG icon while the watch is on your wrist and touch the crown for 30 seconds. At the end, it produces a result as atrial fibrillation or not, bradycardia or not (Figure-1). Its algorithm is aimed at recognising these two diseases. Single channel ECG recording is performed. It is very useful in the detection of rhythm disorders and is being used with increasing frequency.

ECG recording with a smartwatch
ECG recording with a smartwatch

Do Smartwatches Show Rhythm Disorder?

Yes. The watch sends the ECG to the health app on your phone in PDF format. This ECG is a single-channel ECG. It records an ECG strip using the difference in electrical potential between the right arm and the left arm. This recording is very valuable in diagnosing rhythm disorders. Because it is very difficult to catch palpitations, especially short and rare palpitations, with a standard ECG or 24-48 hour Holter recording. The palpitations must coincide with that moment.

For example, imagine that you have palpitations that last 10 minutes twice a month. To record this ECG, you either need to go to the hospital immediately, which is often not possible, or you need to have a holter on you at that moment.

With smart watches, you can take an ECG within 6-7 seconds after the palpitations start. The person should be calm and keep their finger as still as possible during the scan. In this way it is possible to obtain an interference-free ECG. ECG taken with smartwatches very important for later interpretation by the physician.

The ECG below (Figure-2) is from a patient with short episodes of palpitations. Diagnosis is now very easy with this ECG, which we can record with a smartwatch. Atrial fibrillation (AF). AF is a disease that requires early intervention. If other risk factors are also present, it can cause clot formation in the heart and diseases such as stroke. It is a rhythm disorder that can significantly reduce quality of life. With the widespread use of technology, it has become easier to diagnose rhythm disorders earlier.

Does the ECG taken with smartwatches reliable?

Smartwatches use the voltage difference between the right and left arm to take a single-channel ECG. They are not used to diagnose heart attacks. But they are useful in diagnosing rhythm disturbances. ECG taken with smartwatches makes it very easy to detect short-term rhythm disturbances that cannot be detected by other diagnostic methods.

ECG taken with smartwatches
Sample ECG taken with smartwatches (Figure-2)

Can a smartwatch detect a heart attack?

The answer to this question is currently no. Because a heart attack means that the heart tissue, which occurs as a result of blockage of the vessels supplying the heart, cannot be blooded and nourished. This is a disease that is evaluated with standard 12-channel ECGs. The single-channel ECG taken by the smartwatch is not helpful in the diagnosis of a heart attack.

Can an ECG taken with smartwatch tell me if I have a rhythm problem?

Smartwatch algorithms are currently aimed at distinguishing between atrial fibrillation and bradycardia, which is a low heart rate. However, as mentioned above, being able to record the ECG during the complaint is the biggest advantage of such wearable products.

Reference: Apple Watch, Wearables and Heart Rhythm

Update: February 4, 2024

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Picture of Prof. Dr. Taylan Akgün
Prof. Dr. Taylan Akgün

He is a cardiologist specialised in the diagnosis and treatment of heart rhythm problems (ablation), pacemaker procedures.
He works in Istanbul province.

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