I7guy

macrumors Penryn
Nov 30, 2013
26,551
14,889
Gotta be in it to win it
As a personal anecdote, my Apple Watch ( needlessly? ) put me in the OR. I have had very mild arrhythmia for a few decades. My Apple Watch's ECG caught an episode of V-tach, which I showed to my doctor. He sent me to a cardiologist, who then sent me to an electrophysiologist. He took one look at the ECG and scheduled me for a heart study with possible ablation. This resulted in a ~$15,000 procedure which discovered that my heart was just fine. They were unable to recreate the arrhythmia in the cath lab and sent me home.

So I suppose my Apple Watch helped me rule out a potentially fatal heart disorder, but in this instance, ignorance would have been just as good and considerably cheaper.

View attachment 1785787
So all this was done on the basis of an AW EKG, with no other screening afterwards?

There is going to be more monitoring of important aspects of our bodies...and as a society we will have to figure out how to deal with pseudo-medical readings from non-approved devices.
 

jasonsewell

macrumors newbie
Apr 27, 2010
25
9
23226
So all this was done on the basis of an AW EKG, with no other screening afterwards?

There is going to be more monitoring of important aspects of our bodies...and as a society we will have to figure out how to deal with pseudo-medical readings from non-approved devices.
Yes. The specialist relied fully on the ECG generated by my Apple Watch and did not order a Holter monitor. A mistake in hindsight, I suppose.
 

rotax

macrumors regular
May 17, 2010
159
127
"It is also possible that wearable users could see their device detecting an abnormal heartbeat more often and therefore they worry that their atrial fibrillation is getting worse, even when it is not."

From the study: "Main Outcomes and Measures Mean pulse rates from measures taken in the clinic or hospital and a composite health care use score were recorded. The composite outcome included evaluation and management, ablation, cardioversion, telephone encounters, and number of rate or rhythm control medication orders."

I would argue that it is not fair to say "when it's not" as no separate monitoring function of pulse rates over extended periods of time from the watch was used to validate that statement. More like "...they worry that their atrial fibrillation is getting worse, even when it is not validated with independent data measurements over extended periods of time that are comparable to the Apple Watch"


Being one of these people and having recently had a consult and scheduled ablation. Anecdotally for me I noticed a significant increase in afib incidents over the last six months. I was diagnosed four years earlier and was only treating 2 of the 3 areas, heart rate, blood clot / stroke risk, but not rhythm.

Summarizing what my doc said: AFIB incidents typically start out infrequent and over time become more frequent and last longer in duration. Eventually a patient will not convert to normal rhythm on their own and will require an intervention to convert. If you stay in AFIB long enough, interventions will fail you will be in permanent AFIB. Presumably pacemakers etc, could be applied, but not an areas I focused on as I am in the increasing frequency stage.

The doctor advised of two options, on being rhythm medications or ablation surgery. He advised that eventually over a period of years (6+) these medications typically fail and that two years ago the guidance changed. It used to be 2 years prior that patients had to fail heart rhythm medication, which permanently change the electrophysiology of the heart and can have significant side-effects before being approved for ablation surgery. Now current guidance based on studies is that having an ablation first, instead of using rhythm medications is believed to improve the percentages of a positive ablation outcome and potentially stop the progression of AFIB earlier.

I would argue the change is due more to the change in surgical guidance and that Apple watch wearers are more informed about their changing frequency and progression despite a lack of formal medical study grade data from the watch that can be cited.
 
Last edited:

jmgregory1

macrumors 68020
Sounds like this study left too many variables unaddressed to come to a specific conclusion. From my own experience with the Watch, it’s definitely provided me with invaluable info specifically regarding my cardio health. When I initially got the series 5 in 2019, checking my heart rate was nothing more than a novelty. But when I got back into a daily regimen of cardio workouts last year, it became something I tracked on daily basis and continue to do now.

Beyond the obvious benefits of daily cardio workouts, I can actually track the improvements I’ve made in heart beats per minute, resting heart rate and the ability to recover from max heart rate workouts faster. Even if you’re going to see your doctor twice a year, that’s barely enough to track health trends (at least those related to cardio fitness), so the Apple Watch can be a game changer for better understanding your body and health, especially for those making an active effort to change their health.

I don’t have an Apple Watch saved my life story, but I did get an interesting alert a couple of weeks ago. It was mid-Saturday morning and I had been taking a cat nap after getting up early (4:30am), and my Watch starts buzzing and beeping enough to wake me. It was a low heart rate alert on the screen. My normal heart rate while sleeping has been in the low to mid-40’s (BPM) and the Watch said it had fallen to 38 BPM for more than 10 minutes. The low rate didn’t last, given the shock of being awakened by a low heart rate warning, and it was close enough to my normal rate that I wasn’t really worried. But now I watch to see how my nighttime sleep heart rate trends, just in case drops like this happen again, which I would then want to consult with a doctor about.

I’m definitely sold on the Watch and will upgrade as Apple continues to offer additional health related tracking.
 

jarman92

macrumors 6502a
Nov 13, 2014
857
1,978
As a personal anecdote, my Apple Watch ( needlessly? ) put me in the OR. I have had very mild arrhythmia for a few decades. My Apple Watch's ECG caught an episode of V-tach, which I showed to my doctor. He sent me to a cardiologist, who then sent me to an electrophysiologist. He took one look at the ECG and scheduled me for a heart study with possible ablation. This resulted in a ~$15,000 procedure which discovered that my heart was just fine. They were unable to recreate the arrhythmia in the cath lab and sent me home.

So I suppose my Apple Watch helped me rule out a potentially fatal heart disorder, but in this instance, ignorance would have been just as good and considerably cheaper.

View attachment 1785787

What do you mean the Watch "caught an episode of V-tach?" The Watch doesn't identify V-tach, only A-fib or general high heart rate.

And as many have already said, either we aren't getting the whole story or you need to get new doctors. No competent EP would order a heart study based solely on a single-lead EKG from a $400 watch.
 
  • Like
Reactions: centauratlas

centauratlas

macrumors 65816
Jan 29, 2003
1,407
2,396
Florida
Not sure of what this article is really saying. That if one wears an Apple watch statistically there is more of a chance of having a procedure on your heart? Is that because of the popularity of the Apple Watch that the statistics are skewed?

Yeah, it could be that people that know they have a heart issue buy an Apple Watch to help monitor it.

It is a fine start for a study, but not worth a whole lot more than a start.
 
  • Like
Reactions: I7guy

jasonsewell

macrumors newbie
Apr 27, 2010
25
9
23226
What do you mean the Watch "caught an episode of V-tach?" The Watch doesn't identify V-tach, only A-fib or general high heart rate.

And as many have already said, either we aren't getting the whole story or you need to get new doctors. No competent EP would order a heart study based solely on a single-lead EKG from a $400 watch.
It would have been more accurate to say I caught an episode of v-tach on my Apple Watch. You can see the ECG in my post.
 

Ungibbed

macrumors 6502a
Dec 13, 2010
754
195
USA
I found it odd that at my last cardiologist appointment, the nurse asked me to check my watch so she could record my pulse.

My doctor doesn’t use any of the heart features at all on his.
 
  • Like
Reactions: matrix07

incoherent_1

macrumors 6502a
Oct 19, 2016
794
1,318
It's saying that people who have an Apple Watch are more likely to get this type of heart procedure than those who don't in the control group. This could be due to a number of reason such as easier detection or demographics/health status of people who are buying an Apple Watch. There is nothing to indicate wearing an Apple Watch by itself causes you to be more likely to get an heart procedure.
Exactly. More than likely, the data is simply showing that people who have the resources to own an Apple Watch are more likely to get heart surgery because of those same resources (money, access to medical care, a support network, a personal investment in your own health, etc). All of which we probably could’ve guessed anyway.
 
  • Like
Reactions: Tricericops

Tricericops

macrumors newbie
May 22, 2009
2
0
Perhaps consider what studies have shown time and time again, that people with greater income not only have access to better healthcare but are treated better by doctors. Not everyone can afford an Apple Watch.
 

laz232

macrumors 6502a
Feb 4, 2016
642
1,225
At a café near you
People who can afford a relatively expensive economic-want device that monitors their heart, can also afford the repeated doctor, specialist, and surgeon procedures that lead to surgery on their heart.

The study is showing the improved medical outcomes of affluence in a user-pays-healthcare society.
Except that it doesn't, it is not showing any improved medical outcomes, only more surgery in the medical – industrial complex.

I know that you want to view this as a class struggle, but it is only showing that rich people can afford more things, not that they live longer due to those procedures.
 

Makosuke

macrumors 603
Aug 15, 2001
6,363
628
The Cool Part of CA, USA
This is more musing on epidemiology than an educated opinion about the risks and benefits of this particular condition, but:

Atrial fibrillation does somewhat increase your risk of stroke and a number of other potentially severe problems. My mother, in fact, died of such a stroke.

And it's certainly possible that, indeed, wearing an Apple Watch makes people more aware of their atrial fibrillation, which in turn makes them more likely to seek a procedure to treat it, rather than just monitoring it.

Based on which, it's possible that, on average, the risk of the procedure is greater than the risk of the atrial fibrillation, so this is a net negative. Or it could be a wash, in which case it's just causing people to spend money unnecessarily. But if in fact the procedure is safe and does save lives or avoid serious complications of atrial fibrillation on average, it is possible that even though the Apple Watch isn't actually doing anything useful, the simple fact that it's making people more aware of their condition causes them to be more likely to treat it and therefore less likely to die.

So it could basically be a statistical positive even if it's not very useful.

It's a little bit like those speed signs on the highway. Every single person who drives by one has a gauge giving the same number right in front of their face, but seeing it on a sign psychologically does encourage at least some people to slow down. Or like the non-pro exercise features on the Apple Watch--you already know whether you're being lazy or not, but having something reminding you to be aware of it makes some people exercise more, and therefore be healthy, even if the Watch isn't technically doing anything productive.
 

mattspace

macrumors 68000
Jun 5, 2013
1,712
1,347
Australia
Except that it doesn't, it is not showing any improved medical outcomes, only more surgery in the medical – industrial complex.

I know that you want to view this as a class struggle, but it is only showing that rich people can afford more things, not that they live longer due to those procedures.

True, I wasn't looking so deeply at it as to draw a conclusion that the entire premise was effectively fraudulent research (the surgery itself not having any benefit), more that it was a potentially well-meaning experiment, where unconscious researcher bias failed to understand what the results actually showed - akin to the Stanford Marshmallow Experiment.
 

rxp

macrumors member
Apr 15, 2018
34
19
The health benefits of a ton of this tech is interesting, but it's massively over-stated as it stands. It's more of a marketing ploy to justify the use of purchasing a device. Eating an actual apple a day, rather than buying a smart watch, would reduce heart disease as much as statins (
)

Also a general good video on why more medical data isn't necessarly useful in asymptomatic cases:

I suspect the best use of any of these devices is the pedometer - it encourages you to get to a goal. But of course you can have that for fractions of the cost.
 

soheilk

macrumors member
Feb 19, 2014
72
67
What us even the point of this study? What is it trying to prove? It’s like saying 99% of people with cancer have driver license!!!
 
Register on MacRumors! This sidebar will go away, and you'll see fewer ads.