Can Your Smartwatch with ECG Capability Really Warn You About an Irregular Heartbeat? (2023)

You've probably heard or read a story about someone who was first alerted about their irregular heartbeat by their watch — specifically, a smartwatch with ECG capability built in. With an increasing number of people wearing these devices, the accounts of how they helped someone detect a health issue are becoming more and more common.

But these stories can sound almost too good to be true.

It's easy to believe that a smartwatch can improve your overall health — that's why you wear one. But can it really warn you of a heart condition silently developing?

It's just a watch, after all.

According to Dr. Maged Amine, an interventional cardiologist at Houston Methodist, it turns out that smartwatches with ECG capability can play a role in screening for and monitoring at least one heart condition — atrial fibrillation (AFib), one of the most common types of arrhythmia.

"AFib occurs when the rhythm of the heart becomes irregular, usually too fast," says Dr. Amine. "This leads to reduced function of the heart. It's a common heart condition that is often asymptomatic, meaning it doesn't always manifest with obvious symptoms. Unfortunately, the first presentation of AFib is often having a stroke due to blood clots in the heart."

(Video) The Apple Watch ECG found something unexpected about my heart

In fact, AFib increases a person's risk of having a stroke five-fold, making it one of the leading causes of stroke.

"Now, with people wearing devices with built-in ECG capability all day, every day, we're seeing the emergence of a convenient way to broadly screen for AFib," explains Dr. Amine. "And this technology can also help improve how we monitor this condition long-term, too."

What is an ECG and what is its role in detecting AFib?

"Ideally, we catch AFib before it leads to stroke," explains Dr. Amine. "And whether performed in a doctor's office or via a portable device worn at home for a few days, we've used electrocardiogram (ECG) to help detect AFib for decades."

An ECG measures how fast the heart is beating, providing clues whether a person's heart rhythm is normal or irregular. Traditionally, this test uses electrodes attached to your chest and other parts of your body. The information collected by these electrodes is sent to a computer, then reviewed by your doctor to determine whether your heart rhythm might be irregular.

Your doctor may recommend an ECG if you're noticing heart palpitations, chest pain or shortness of breath as well as the more subtle signs of AFib such as lightheadedness and extreme fatigue. An ECG is also part of the screening practice for those who are at high risk for heart disease or have a family history of heart disease.

"But, given that AFib is fairly common and can present without symptoms, a simpler and more broad way of screening for it would be very beneficial — helping catch AFib in people who are asymptomatic and not eligible for traditional ECG screening," adds Dr. Amine. "The thought is that smartwatches with ECG capability could perhaps help fill this gap."

(Video) ECG Watch: How it Works (Apple, Samsung A fib Watches / EKG)

There is a precedent — not with a smartwatch, but with a device that functions very similarly. A 2017 study assessing whether regular use of an at-home ECG device could more effectively help screen for AFib found that it uncovered more cases than standard screening guidelines.

Are smartwatches with ECG capability really smart enough to detect AFib, though?

The ECG technology in a smartwatch uses LEDs flashed against your skin to detect blood flow and measure your heart rate. Sensors collect this information and algorithms process it to make sense of your heart's rhythm. Your smartwatch takes these measurements throughout the day, and, if an irregular rhythm is detected, it sends you an alert.

Because it's so different from the traditional ECG technology used in the clinic, you might be skeptical about whether what's crammed inside a tiny watch is truly sophisticated enough to detect if you're in AFib. But Dr. Amine gives these devices high marks.

"The ECG technology in smartwatches is very accurate," Dr. Amine explains. "And people have options with these watches now. The Apple brand was the leader in this technology, but other brands have followed, including Fitbit and Samsung."

Their accuracy and utility haven't gone unnoticed. Certain series of smartwatches made by the brands mentioned above are FDA-approved to help users identify signs of AFib.

If you wear one of these devices and get an alert, don't brush it off. Your next step is to check in with your doctor. He or she can order the tests needed to confirm or rule out AFib.

(Video) FITBIT Smartwatch Upgrade: Now Detect Atrial Fibrillation - Unless you actually HAVE AFib. What?Why?

ECG-capable smartwatches can also help better monitor AFib

The implications of having on-demand ECG technology in a personal device that's worn frequently by many people is probably most readily apparent for screening of AFib.

"But these devices can also be very helpful for the long-term monitoring of those already diagnosed with AFib, too," explains Dr. Amine.

That's because AFib, unfortunately, can come and go. This means ECGs aren't just used for the initial detection of AFib, they're also an important part of regular checkups after treatment — used to help catch it in case it returns.

"What's been missing is a convenient way to continue monitoring a person's heart very closely so that we're able to quickly detect AFib if it comes back before their next checkup," says Dr. Amine.

In some cases, an implantable ECG device is used to monitor a person's rhythm for several years after treatment. But implanting this device is a medical procedure, and Dr. Amine points out that this option isn't right for everyone.

"Amazingly, these smartwatches are almost as accurate as implantable ECG devices — with the added benefit of not requiring a medical procedure," Dr. Amine adds. "They're amazing devices."

(Video) Apple Watch detects heart problem

Additionally, Dr. Amine points out that smartwatches might eventually help ease the reliance on blood thinners after AFib treatment.

"Treating AFib usually includes taking medications that help control the heart's rhythm or undergoing a procedure called ablation therapy," explains Dr. Amine. "It also almost always includes using blood thinners to reduce the risk of stroke. Once we get someone out of AFib and back into a normal rhythm, they often wonder when they can get off blood thinners. It's an important question to consider since there are risks to taking these medications."

But, there's risk in stopping blood thinners too soon since it leaves a person more vulnerable to stroke if AFib does return — especially if it returns without symptoms. But perhaps smartwatches may someday help safely discontinue blood thinners in some people.

"If we can rely on these devices for long-term monitoring of AFib, we can use them to help inform if and when we should re-initiate treatment," Dr. Amine adds.

A smartwatch doesn't substitute the healthy lifestyle behaviors that help manage AFib, though

Smartwatch aside, the best way for people with AFib to manage their condition is to regularly check in with their cardiologist and prioritize the healthy lifestyle behaviors proven to reduce the chances of AFib, such as:

  • Exercising
  • Getting plenty of sleep
  • Avoiding excessive alcohol

"Your smartwatch can be an added layer of protection, though," says Dr. Armine. "It can provide your doctor with more information that can help guide treatment, as well as help you better monitor your condition and avoid visits to the ER. I hope someday this can be something we prescribe to patients to help monitor AFib. These devices are costly, but they are powerful."

(Video) Top 5 Best Smartwatch with ECG


Can smartwatch watches detect irregular heartbeat? ›

Researchers say smartwatches can detect many cases of atrial fibrillation (AFib). However, they add that there are limitations to their use and they aren't as accurate as diagnostic tools in a medical facility.

Does an irregular heartbeat show up on an ECG? ›

The most effective way to diagnose an arrhythmia is with an electrical recording of your heart rhythm called an electrocardiogram (ECG). If the ECG doesn't find a problem, you may need further monitoring of your heart. This may involve wearing a small portable ECG recording device for 24 hours or longer.

Can a smart watch pick up heart palpitations? ›

Personal devices such as smartwatches produce a simpler EKG. Small electrodes on the back of a smartwatch or sensor monitor the heart's electrical activity with every heartbeat. If you experience some abnormal symptoms with your heart, such as fluttering or palpitations, your smart device can record a personal EKG.

How accurate are smart watches at detecting AFib? ›

Further, the Apple Watch app correctly identified 78 percent of the patients with AFib and 81 percent of those without the condition. Meanwhile, the electrophysiologists accurately determined 97 percent of the patients with AFib and 89 percent without.

How reliable is an ECG on a smartwatch? ›

"The ECG technology in smartwatches is very accurate," Dr. Amine explains. "And people have options with these watches now. The Apple brand was the leader in this technology, but other brands have followed, including Fitbit and Samsung."

Can an irregular heartbeat be nothing? ›

Many people are unaware of minor irregular heartbeats, and even completely healthy people have extra or skipped heartbeats once in a while. Palpitations are more common as you age. Usually, these occasional arrhythmias are nothing to worry about.

What device can detect irregular heartbeat? ›

A Holter monitor is a small, wearable device that records the heart's rhythm. It's used to detect or determine the risk of irregular heartbeats (arrhythmias). A Holter monitor test may be done if a traditional electrocardiogram (ECG or EKG) doesn't provide enough details about the heart's condition.

What can be mistaken for irregular heartbeat? ›

It's a common occurrence, especially when you're in a tense situation. But sometimes people mistake heart palpitations for a more serious condition called atrial fibrillation, or AFib. AFib occurs when rapid electrical signals cause the heart's two upper chambers to contract very fast and irregularly.

What is the most common cause of irregular heartbeat? ›

The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heart beat. Many factors can affect your heart's rhythm, such as having had a heart attack, smoking, congenital heart defects, and stress. Some substances or medicines may also cause arrhythmias.

What smartwatch can detect AFib? ›

Fitbit garnered FDA clearance for AFib detection this past April. The watch also provides sleep insights, along with breathing rate, heart rate variability and more. It has compatibility with Pixel phones, as well as other Android 8.0+ phones.

Which smartwatch is best for heart? ›

Best smartwatches for heart health monitoring
  • Samsung Galaxy Watch 5, $240 and up (reduced from $280) ...
  • Google Pixel Watch, $300 (reduced from $350) ...
  • Garmin Venu 2 Plus, $450. ...
  • Fitbit Charge 5, $100 (reduced from $150) ...
  • Fitbit Versa 3, $154 (reduced from $230)
Dec 20, 2022

What is the difference between heart palpitations and heartbeat? ›

Summary. An arrhythmia is an abnormal heart rhythm, where the heart beats irregularly, too fast or too slowly. A palpitation is a short-lived feeling of your heart racing, fluttering, thumping or pounding in your chest.

Can smart watches detect PVCS? ›

The most common arrhythmias detected were premature atrial contractions, premature ventricular contractions, atrial tachycardia and nonsustained ventricular tachycardia.

Is ECG heart rate accurate? ›

An electrical heart rate sensor, also called an ECG, measures your heart rate by measuring electrical signals in your blood. Based on these electrical signals, an ECG heart rate monitor measures the timing and strength of your heart rate. An ECG heart rate monitor is more accurate than an optical heart rate monitor.

What is the best watch for monitoring AFib? ›

Choosing the right device for your Atrial Fibrillation
  • Apple Watch Series 4.
  • Apple Watch Series 5.
  • Apple Watch Series 6.
  • Apple Watch Series 7.
  • Apple Watch Series 8.

Can you feel your own irregular heartbeat? ›

You may feel it in your chest, neck or throat. Your heartbeat may feel like it is: racing or beating very fast. irregular, with skipped or extra beats (ectopic beats)

How can you detect an irregular heartbeat rhythm at home? ›

To check your pulse, place the second and third fingers of your right hand on the edge of your left wrist. Slide your fingers to the center of your wrist until you find your pulse. While taking your pulse, it's important to remember that you're checking your heart rhythm, not your heart rate.

Can a smartphone detect irregular heartbeat? ›

Smartphone applications can allow self-detection of arrhythmias, allowing for patient self-care and involvement. 6 Photoplethysmography (PPG) technology found in smartphone cameras can be used for AF screening by patients in the community.

How can I monitor my irregular heartbeat at home? ›

firmly place the index and middle finger of your right hand on your left wrist, at the base of the thumb (between the wrist and the tendon attached to the thumb) using the second hand on a clock or watch, count the number of beats for 30 seconds, and then double that number to get your heart rate in beats per minute.

What is the difference between an irregular heartbeat and atrial fibrillation? ›

The difference between atrial fibrillation and irregular heartbeat is that irregular heartbeat is a general term to describe any abnormal heart rhythm and atrial fibrillation is a specific diagnosis. Irregular heartbeat could include heartbeats that are too fast, too slow or irregular for any reason.

Can you live with a constant irregular heartbeat? ›

You can certainly live a happy, healthy life with an irregular heartbeat. However, it's always a good idea to check with your doctor when you're experiencing new symptoms or discomfort.

Is it normal to have irregular heartbeat everyday? ›

A PVC happens when the heart beats too early, which causes a stronger second beat. This causes a fluttering or pounding sensation in the chest. Most people have at least one PVC every day, and many don't even notice it. Things like caffeine, alcohol and stress can cause small, temporary arrhythmias like PVCs.

Can anxiety cause irregular heartbeat? ›

Heart Palpitations and Anxiety. Heart palpitations due to anxiety feel like your heart is racing, fluttering, pounding or skipping a beat. Your heartbeat can increase in response to specific stressful situations. You may also have palpitations due to an anxiety disorder (excessive or persistent worry).

Which brand smartwatch is best? ›

  1. Fitbit FB507BKBK Versa 2.
  2. Noise ColorFit Pro 2.
  3. HONOR Band 5.
  4. Garmin Forerunner 245.
  5. Samsung Galaxy Watch.
  6. Amazfit Bip U Smart Watch.
  7. GOQii Vital.
  8. Fastrack Reflex 2.0 Watche.

Do smartwatches check blood pressure? ›

Yes, there are several smartwatches on the market that measure your blood pressure. Major smartwatch manufacturers like Apple and Fitbit are still developing their blood pressure tech for FDA clearance in the United States. In the meantime, other manufacturers like Omron offer blood pressure watches.

Do palpitations mean a weak heart? ›

Stress, exercise, medication or, rarely, a medical condition can trigger them. Although heart palpitations can be worrisome, they're usually harmless. Rarely, heart palpitations can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.

What is the heart rate in AFib? ›

The most obvious symptom of atrial fibrillation (AF) is palpitations caused by a fast and irregular heartbeat. A normal heart rate, when you are resting, should be between 60 and 100 beats a minute. In atrial fibrillation, it may be over 140 beats a minute.

What does mild AFib feel like? ›

The most obvious symptom of atrial fibrillation is heart palpitations – where the heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or possibly a few minutes.

Can Fitbit detect heart palpitations? ›

You can check for signs of an irregular heart rhythm that may be AFib just by wearing your Fitbit tracker or smartwatch. When you're still or sleeping, your device collects your heart rhythm data to check for irregularities in the beat to beat variation that may be signs of AFib.

Can Fitbit tell if you have irregular heartbeat? ›

Fitbit's ECG app records those electrical signals and looks for signs of AFib. To take a heart rhythm assessment, set up the ECG feature in the Fitbit app. With Irregular Heart Rhythm Notifications, Fitbit analyzes your heart rhythm while you're still or sleeping and looks out for potential signs of AFib.

Which smartwatch can detect atrial fibrillation? ›

Fitbit garnered FDA clearance for AFib detection this past April. The watch also provides sleep insights, along with breathing rate, heart rate variability and more. It has compatibility with Pixel phones, as well as other Android 8.0+ phones.

Are ECG accurate? ›

An ECG is pretty accurate at diagnosing many types of heart disease, although it doesn't always pick up every heart problem. You may have a perfectly normal ECG, yet still have a heart condition.

What is the accuracy of ECG? ›

A review of 78 articles found that physician accuracy of ECG interpretation is just over half at 54% and improves slightly to 67% with some additional training. Accuracy did improve with more advanced training, with medical students having lower accuracy at 55.8% and cardiologists having the greatest accuracy at 74.9%.

Can an irregular heartbeat be felt? ›

You may feel it in your chest, neck or throat. Your heartbeat may feel like it is: racing or beating very fast. irregular, with skipped or extra beats (ectopic beats)

What should you not do with an irregular heartbeat? ›

Mercy Clinic Cardiology has six things that can aggravate arrhythmia:
  1. Too much caffeine. One or two cups of coffee a day is probably fine. ...
  2. Alcohol. Heavy drinking can cause damage to your heart cells and cause extra heartbeats. ...
  3. Sodium. ...
  4. Tyramine. ...
  5. Herbal supplements. ...
  6. Oversized portions.


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