Smartwatches for Monitoring Atrial Fibrillation

In this podcast, Jeffrey Tabas, MD, shares his thoughts on the use of smartwatches and other devices that continuously monitor heart rhythm among patients with atrial fibrillation. 

For more parts of this series, visit our resource center for the American College of Emergency Physicians 2021 Scientific Assembly.

Additional Resource:

• About Million Hearts®. Million Hearts. Reviewed August 26, 2021. Accessed October 22, 2021. https://millionhearts.hhs.gov/about-million-hearts/index.html

Jeffrey Tabas, MD, is a professor of emergency medicine at the University of California, San Francisco’s School of Medicine, an emergency medicine physician at Zuckerberg’s San Francisco General Emergency Department, the director of faculty development for the Department of Emergency Medicine, and the director of Outcomes and Innovations for the UCSF Office of Continuing Medical Education.

TRANSCRIPTION:

Amanda Balbi: Hello and welcome to a special series of Podcasts360. I’m your moderator, Amanda Balbi. In this 6-part series, we will be speaking with Dr Jeffrey Tabas, who is a professor of emergency medicine at the University of California, San Francisco’s School of Medicine, an emergency medicine physician at Zuckerberg’s San Francisco General Emergency Department, the director of faculty development for the Department of Emergency Medicine, and the director of Outcomes and Innovations for the UCSF Office of Continuing Medical Education.

He recently presented a session on atrial fibrillation at the American College of Emergency Physicians 2021 Scientific Assembly. In part 5 of this podcast series, he shares his thoughts on using smartwatches for monitoring patients' heart rates.

Let’s listen in as he answers our questions.

So, I heard you mention smartwatch twice, and with all of this research and everything that's going on, do you advise your patients to use a smartwatch to track their heart rhythm?

Jeffrey Tabas: It's a great question. One of my colleagues at UCSF is really leading the world's research on this, Greg Marcus, who's in electrophysiology electrophysiologists and is involved in the million-person heart study, where they're trying to get a million people to study what happens to your heart and the risk factors for developing heart disease. Specifically, his focus is on atrial fibrillation.

My understanding is that smartwatches are pretty good at picking this up. They are very sensitive, like 98% sensitive, and they're fairly specific—80% to 85% specific, meaning that 5 out of every 6 times that they detect atrial fibrillation, it's truly atrial fibrillation.

You don't want to just rely on your smartwatch. You want to take the printout. I'm a Luddite; I don't have a smartwatch. I have an old Timex that I track my runs with. But everyone, including my 12-year-old and 14-year-old have a smartwatch. So, you want to track it, but you want to bring the reading to your doctor to review.

And you're supposed to, for the diagnosis to be robust, you're supposed to have 30 seconds of an irregular heart rate that's tracked on your smart device or an EKG, which captures it. We all know an EKG is much tougher to capture, so these smart devices, smart watches are pretty good. I mean 98% sensitivity, 85% specificity; that's as good as I am in the ED looking at anyone. So, yes, I would say they're good.

Amanda Balbi: Especially since it's always capturing data. It's not just that blink of time.

Jeffrey Tabas: Yes, and we know that a lot of Afib is silent. I can't remember the percentage, but something like 20% or 30% you don't sense. So, it captures all of those. A lot of people think they're having irregular heart rate, and it turns out they're not. And then, a lot of people think they're having an irregular heart rate, but they're just having premature atrial beats or premature ventricular beats, which do not confer nearly the same risk as atrial fibrillation. All those things can be helpful.

Even if the smartwatch is not diagnostic, if it just triggers you to get a monitor placed—these 30-day monitors that you can just paste onto your chest—to get it looked at it, I think it can be helpful. The reason I want to get a smartwatch is just to track my risk, whether I'm having Afib or not.

Because it's too complicated. I can't have another device that I have to charge every night. The medical and social benefits, I think, are pushing me to go there, and now that my kids have them…I don't know. 

Amanda Balbi: Thank you so much for speaking with me today. And for our listeners, stay tuned for the subsequent parts of this series.