Smartwatches Can Detect Arrhythmias in Children

Apple watches may detect irregular heart rhythms in children better than traditional monitoring methods, a study suggests.

Abnormal heart rhythm, or an arrhythmia, occurs when the heart beats too fast, too slow, or irregularly. This prevents the heart from pumping the blood to the body efficiently. As a result, the brain, lungs, and other organs may not get enough blood and oxygen.

As standard monitoring is not always able to detect arrhythmia in children, using Apple watches to monitor the heart rhythm may improve the diagnosis rates, according to a study by Stanford University researchers published in Communications Medicine.

The scientists used data from the survey of electronic medical records for pediatric cardiology patients receiving care at Stanford Medicine Children’s Health. Over four years, the "Apple watch" was mentioned 145 times.

Among patients whose medical records mentioned the smartwatch, 41 had arrhythmias confirmed by traditional diagnostic methods. Of these, 18 patients had collected an ECG with their watches, while 23 patients had received a high heart rate notification from the watch.

The data from the smartwatch prompted a workup, resulting in a new arrhythmia diagnosis in 29 patients. In 10 patients, traditional monitoring methods did not pick up the smartwatch-diagnosed arrhythmias.

Among 73 patients who used the smartwatch for recreational or self-directed heart rate monitoring, 18 sought care due to device findings without any arrhythmias identified.

"It’s awesome to see that newer technology can really make a difference in how we’re able to care for patients," Scott Ceresnak, M.D., professor of pediatrics and a pediatric cardiologist at Stanford Medicine, said in a statement.

Using the electrical heart sensor or the Apple Watch, the ECG app allows the users to take electrocardiograms and then check the recording for atrial fibrillation (AFib), the most common form of serious arrhythmia.

The U.S. Food and Drug Administration has approved Apple’s Irregular Rhythm Notification and the ECG app for people 22 years and older. The high heart rate notification is available only to users who are 13 or older.

Detection is still challenging

Most arrhythmias in children are harmless and go away after treating the underlying cause, such as fever or infection, but some types can be serious.

An arrhythmia may not cause any symptoms. However, symptomatic children may experience:

• Weakness
• Tiredness
• Heart palpitations
• Low blood pressure
• Dizziness
• Fainting
• Lack of appetite

Although cardiac diagnostic devices have improved in recent years, they still can miss arrhythmias in children.

Nowadays, kids can wear an event monitor in the form of a sticker placed on the chest for a few weeks. However, these monitors sometimes fall off early or cause problems such as skin irritation from adhesives.

Moreover, a few weeks may not be enough to capture the irregular rhythm, as arrhythmias are unpredictable in children and may not occur for months.

Using smartwatches to monitor children’s heart rhythms is also limited because existing algorithms have not been optimized to detect heart problems in pediatric patients.

Children have faster heartbeats than adults, and they tend to experience different types of abnormal rhythms than adults.

Nevertheless, smartwatches can be useful in detecting abnormal heart rhythms in children, especially if new versions of the smartwatch algorithms based on real-world heart rhythm data from children are developed.