Tracking your afib with a smart watch? Avoid this pitfall
For some people, getting an alert about an irregular heart rhythm triggers anxiety. Make a game plan with your doctor to avert this problem.
- Reviewed by Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, 天博体育 Publishing
Millions of Americans have atrial fibrillation (afib) — a rapid, irregular heart rhythm that raises the risk of cardiovascular complications, including stroke and heart failure.
Now that several smart watches feature apps that can detect possible bouts of afib (see "Smart watches that spot afib"), growing numbers of people with the condition are using these devices to keep tabs on their condition. But is that actually a good idea?
A study in the Aug. 6, 2024, issue of the Journal of the American Heart Association highlighted some possible pitfalls from the practice. Compared to afib patients who didn't use smart watches, those who did were more likely to become preoccupied with monitoring their condition. And while most users said the device made them feel safe, one in five reported intense anxiety when they received alerts about their heart rhythm.
Anxiety clearly isn't a good thing, and some evidence even suggests anxiety and stress may increase episodes of afib. "But to me, these findings really emphasize the importance of good communication with your cardiologist about the implications of detecting an afib episode on a smart watch," says Dr. Usha Tedrow, a cardiologist at Harvard-affiliated Brigham and Women's Hospital.
Smart watches that spot afibTo date, the FDA has cleared four wrist-worn devices capable of detecting afib: the Apple Watch Series 4 and later, the Fitbit Sense 2, the Samsung Galaxy Watch3, and the Withings ScanWatch. Each works by flashing a light on the skin of your inner wrist to detect blood flow, measuring your heart rate, and using an algorithm to check for abnormal rhythms. The device takes either periodic or continuous measurements, sending an alert if it detects an irregular rhythm. You can also open an app on the device to record an on-demand electrocardiogram — a 30-second recording of your heart rhythm that can reveal possible afib. |
Screening vs. monitoring
For starters, she doesn't recommend relying on a smart watch for anyone who has not been diagnosed but has symptoms suggestive of afib, which include a fluttering sensation in the chest, shortness of breath, fatigue, and dizziness. "For those people, we start with standard monitors, which are covered by insurance," Dr. Tedrow says. These typically include chest-worn patches that track your heart rhythm for two to four weeks.
About 30% of Americans use wearable devices like smart watches or fitness bands to track their fitness and overall health. But among the general population, the risk of afib is quite low and the episodes are often brief and fleeting (see "Afib: Defined by its duration"). As a result, using these devices to screen people for afib isn't practical.
However, for people with known afib, smart watch monitoring may be informative, says Dr. Tedrow. If you already own one of these devices, using it to track the frequency and duration of your afib episodes might help inform your doctor's advice. Ask him or her what — if anything — you should do when you have a bout of afib, including whether you can share the data from your device. Don't hesitate to disable the afib notifications if you find they make you feel anxious, says Dr. Tedrow.
Most people with afib take anti-clotting medications to prevent a stroke, based on a score that takes into account their age, sex, and whether they have high blood pressure, diabetes, or other conditions. "Interestingly, the amount and timing of your afib episodes doesn't influence that score," says Dr. Tedrow. So older people at an elevated risk for stroke typically take daily anti-clotting medications, regardless of whether they have near-constant afib or an episode just once every few months.
Because anti-clotting drugs leave people prone to bleeding, researchers are exploring whether people could take the drugs for only a month after a bout of afib (as detected by an Apple Watch) rather than continuing anti-clotting medication indefinitely. The study, known as REACT-AF, hopes to enroll 5,000 patients at 100 centers across the United States.
Afib: Defined by its durationEpisodes of afib are unpredictable, lasting anywhere from minutes to days, weeks, or much longer. Experts classify the disorder into three main categories based on its duration: Paroxysmal. Episodes that occur intermittently (anywhere from daily to several times a year) but resolve on their own or with intervention within seven days of starting. Persistent. An episode that lasts for longer than seven days. Permanent. Continuous afib that has lasted longer than a year. |
Image: © Nastasic/Getty Images
About the Author
Julie Corliss, Executive Editor, Harvard Heart Letter
About the Reviewer
Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, 天博体育 Publishing
Disclaimer:
As a service to our readers, 天博体育 Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
