In Austria there were almost 800,000 users of wearables in 2022 – and the trend is rising. Wearables are becoming increasingly useful for health. With some models, anyone can now make an ECG themselves.
SmartWATCH – this is only marginally a watch. Actually, they are more like wristwatch-style minicomputers that can now count steps and calories, and even create ECGs and measure blood pressure.
The German Society for Cardiology put the little all-rounders to the test. Can the medical data recorded by a smartwatch be trustworthy? The answer is: yes. The Apple Watch correctly diagnosed 95 percent of the patients examined with clinically documented atrial fibrillation. The “Watch AF” study with a Samsung Gear Fit II smartwatch delivered similarly good values for detecting atrial fibrillation. And the scientists at the German Center for Cardiovascular Research also came to the same conclusion after their study, in which over 500 people with and without atrial fibrillation took part: Smartwatches can record serious medical data.
The cardiologist Priv.-Doz. Dr. Max-Paul Winter (works at the Heart Center Währing, kardiologe-winter.at) still warns: “When it comes to important diagnoses such as atrial fibrillation, we have to check the results again with the doctor.” He strongly advises against self-diagnosis with the smartwatch. A big risk lies with people themselves. As average consumers, we can easily make mistakes when measuring: the sensors can be dirty, we are not completely calm, etc.
So no matter how accurate the smartwatch is, it can only work with what we give it. At the same time, the new technological development of wearables also brings great advantages for cardiology. Dr. In an interview with healthy&fit, Winter reveals how medicine can benefit from smartwatch measurement data and what experiences he has had with it in his practice.
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Smartwatches are increasingly being used to record personal health parameters. How useful do you think this development is?
Dr. Winter: This is indeed a double-edged sword. On the one hand, I think it’s positive that people use smartwatches to become more aware of their health. On the other hand, there is a risk that users will become so immersed in this monitoring that they will overinterpret small anomalies and become unnecessarily worried.
Which functions of wearables do you consider to be particularly relevant and useful?
Dr. Winter: One feature that I find very helpful is the ECG. Many patients come to us with cardiac arrhythmias. If nothing abnormal occurs during our exams, we don’t know exactly what’s going on. With a smartwatch with an ECG function, you can record data more regularly. Patients then take these with them to their next appointment. We have the most experience with data from the Apple Watch, as this is the most widely used. However, it is important to note that the recordings are not diagnostic. They are far inferior to professional ECGs. When it comes to important diagnoses like atrial fibrillation, we need to double-check the results with a medical device. What works very well with the Apple Watch, however, is the automatic detection of irregular heartbeats. We have already seen some patients in whom the watch correctly detected atrial fibrillation during screening.
How is the smartwatch ECG different from a medical one?
Dr. Winter: The smartwatch ECG is a single-channel ECG, while in the clinic we use 12-channel (standard) or three-channel (long-term) ECGs. The recording duration also varies greatly. Those of the smartwatches only last 30 seconds – that is significantly shorter than our examinations, which can last up to 24 hours. We also have special software to support the diagnosis. With wearables, the ECG is “simply” saved as a PDF. By the way, it doesn’t make sense to interpret this yourself, because interpreting a well-recorded ECG requires a lot of experience. If someone has concerns, they should show their ECG to a doctor.
If we take a look into the future: As a cardiologist, what do you expect from future developments in smartwatches?
Dr. Winter: To be honest, with the currently available functions of smartwatches we have already reached the upper edge of what makes sense. The derivations are relatively simple. When it comes to specific diagnoses, we will continue to have to go to the doctor in the future. However, one area that will become increasingly important is blood pressure measurement.
Measuring blood pressure with a smartwatch? How does this work?
Dr. Winter: Smartwatches can record pulse waves by using the oxygen sensor. You can clearly see how a pulse wave passes through, and based on the properties of this pulse wave, the software can calculate how high the blood pressure must have been. However, this only works if the watch has previously been calibrated using a conventional device. This means that you measure your blood pressure with a blood pressure monitor and tell the watch at that time: “I had 120/80 mmHg.” This calibration must be done regularly. However, we do not yet recommend these devices because the technology is very new and we only have a few patients so far – mostly young people who are particularly tech-savvy.
