Continuous AFib Monitoring Coming to Fitbit Watches Following FDA Approval

[MacRumors]

Fitbit owner Google this week came a step closer to rivaling the health features of Apple Watch after the FDA approved its new algorithm for continuously monitoring users' heart rate rhythms.

Like Apple Watch, Fitbit devices with a heart-rate monitoring capability include an ECG app that must be manually run by the user to check for irregular rhythms, which can be a sign of atrial fibrillation (AFib), a potentially serious heart arrhythmia condition. AFib affects nearly 33.5 million people globally, and individuals with AFib have five times higher risk of stroke.

For several years, the Apple Watch has had one up on rival smartwatches by including an irregular rhythm notifications feature, which occasionally checks heart rhythm in the background and sends a notification if an irregular heart rhythm is identified that could potentially be atrial fibrillation (AFib). Upon receiving a notification, users can then launch the ECG app and perform a more comprehensive 30-second test by placing their finger on the Digital Crown to generate an ECG waveform.

Google's new PPG (photoplethysmography) algorithm works similarly by passively monitoring heart rhythm in the background overnight and whenever the user is resting, making for a potentially more capable life saver.

The clinical validation for Fitbit's PPG algorithm is supported by data from the landmark Fitbit Heart Study, which launched in 2020 and enrolled 455,699 participants over five months. The study was conducted entirely virtually during the pandemic, making it one of the largest remote studies of PPG-based software to date. Data presented at the 2021 American Heart Association Scientific Sessions found that the Fitbit PPG detections correctly identified AFib episodes 98% of the time, as confirmed by ECG patch monitors.

Google says the new PPG-based algorithm and Irregular Heart Rhythm Notifications feature will soon be available to consumers in the U.S. across a range of heart-rate enabled Fitbit devices.

Apple plans to further bolster the health smarts offered by Apple Watch this year, with a new body temperature monitoring sensor expected to feature in the Apple Watch Series 8. As part of watchOS 9, Apple is also planning to improve its existing atrial fibrillation detection feature with a new capability to measure how long a person is in a state of atrial fibrillation across a certain period.

Article Link: Continuous AFib Monitoring Coming to Fitbit Watches Following FDA Approval

 

[icanhazmac]

Fitbit owner Google this week

Thanks but that is all I need to know to issue a hard pass.

While "competition" is good, I cannot believe that people let Google anywhere near their health related data.

 

[I7guy]

Thanks but that is all I need to know to issue a hard pass.

While "competition" is good, I cannot believe that people let Google anywhere near their health related data.

It didn't start out that way.

I've been using Fitbits for years. When google bought Fitbit, I was debating to "throw it away" and get an apple watch. I didn't and know google has my fitness data.

 

[therunningman]

I made the jump from FitBit to an Apple Watch over a year ago. The one thing that I REALLY miss is 24-7 heart rate monitoring. Constant heart rate monitoring potentially makes afib detection more accurate simply because there's more data there. I'm just not sure how useful the Apple Watch's alerts might be taking heart rate readings once every five to eight minutes.

 

[FloatingBones]

Two words, Apple: ketone bodies. Beta-hydroxybutyrare levels (or Bob to its friends). Thanks!

When google bought Fitbit, I was debating to "throw it away" and get an apple watch. I didn't and know google has my fitness data.

Yep. Some people will be complacent about what Google will do with your data, just like some people will be complacent about what Facebook/Meta will do monitoring you in their meta-world. That monitoring has an impact on our health. ?

 

[bsbeamer]

Apple could start moving in the right direction by offering the "TOP MIDDLE" complication on more watch faces, or even add a "BOTTOM MIDDLE" to some. At least that can show heart rate at a glance, even if it's infrequently updated.

I'll likely hold off on updating Apple Watch until there are more medically-based monitors or sensors built-in. Probably 2-3 years away from a significant update.

 

[Umacga]

It didn't start out that way.

I've been using Fitbits for years. When google bought Fitbit, I was debating to "throw it away" and get an apple watch. I didn't and know google has my fitness data.

I’m an Apple guy through and through but despite having an Apple Watch 6, I find my older Fitbit far superior and use it most of the time instead. Much better heart monitoring, sleep monitoring, and battery life. Text/phone features are better on the Apple Watch but it’s way behind on everything else. AW was a big disappointment.

 

[DeepIn2U]

I made the jump from FitBit to an Apple Watch over a year ago. The one thing that I REALLY miss is 24-7 heart rate monitoring. Constant heart rate monitoring potentially makes afib detection more accurate simply because there's more data there. I'm just not sure how useful the Apple Watch's alerts might be taking heart rate readings once every five to eight minutes.

It’s VERY useful even if non constant Afib or constant heart monitoring, Apple Watch silently does so.

2 alerts occurred while watching a horror movie that for decades causes me nightmares and insomnia. Actually I was watching the continuation of it on Netflix “The Thing”. The original back in ‘81 bell no not watching that - even though I’m older certain memories are ingrained.

Still the Watch does have some detection.

 

[jz0309]

competition is great, time for Apple to up its game on health sensors

 

[JosephAW]

My friend and I just went to the Apple store to ask about this and they cannot provide this yet with the Apple Watch.

 

[Robert.Walter]

It didn't start out that way.

I've been using Fitbits for years. When google bought Fitbit, I was debating to "throw it away" and get an apple watch. I didn't and know google has my fitness data.

Confirmation bias never allows much of a debate.

 

[Robert.Walter]

Apple could start moving in the right direction by offering the "TOP MIDDLE" complication on more watch faces, or even add a "BOTTOM MIDDLE" to some. At least that can show heart rate at a glance, even if it's infrequently updated.

I'll likely hold off on updating Apple Watch until there are more medically-based monitors or sensors built-in. Probably 2-3 years away from a significant update.

I went from a 0 to a 6 (basically to get the blood ox measurement) and have been pleased with both. I will wait for blood pressure or sugar before I make my next upgrade.

 

[WWPD]

It’s VERY useful even if non constant Afib or constant heart monitoring, Apple Watch silently does so.

2 alerts occurred while watching a horror movie that for decades causes me nightmares and insomnia. Actually I was watching the continuation of it on Netflix “The Thing”. The original back in ‘81 bell no not watching that - even though I’m older certain memories are ingrained.

Still the Watch does have some detection.

Interesting, I have the same reaction when I watch Battlefield Earth.

 

[DaveN]

I made the jump from FitBit to an Apple Watch over a year ago. The one thing that I REALLY miss is 24-7 heart rate monitoring. Constant heart rate monitoring potentially makes afib detection more accurate simply because there's more data there. I'm just not sure how useful the Apple Watch's alerts might be taking heart rate readings once every five to eight minutes.

Likely that it isn't as big of a difference as one may think. Think of it this way, if something happens once a day, and you monitor every five minutes, you will catch it in day one of continuous monitoring. If monitored every five minutes, you have a one in five chance catching it in day one, two in five by day two, etc. to near certainty by day five. That is on a crude analysis. The reality is that you are still more likely to catch it one in five, two in five, etc.

A neighbor of mine was gifted an Apple watch. He is elderly and was getting upset with the watch giving hime AFIB warnings. The first couple of times he thought there was something wrong with the watch and said he was about to throw it away but then he had his heart checked. He now has a pacemaker and is very tankful of the gift.

All that said, it would be interesting to see a study to see how effective the Apple Watch is at finding such issues.

 

[Hessian]

I’m an Apple guy through and through but despite having an Apple Watch 6, I find my older Fitbit far superior and use it most of the time instead. Much better heart monitoring, sleep monitoring, and battery life. Text/phone features are better on the Apple Watch but it’s way behind on everything else. AW was a big disappointment.

I agree with most of what you outline. Fitbit is a good feature bracelet, Apple Watch is more of an extension to the iPhone in its function. I find the Apple Watch to be great. I charge it before bed (20-40 mins) and wear it to track sleep, I wear it all day, track workouts, and find no issues for me on the battery front. I also have cellular data, so I can leave my phone behind and have all alerts, calls, and notifications operate alone. Fitbit has better battery life, but functionality as a tracker bracelet limits why I would even want one to start.

I have had every AW stainless model from the start and love seeing the progression of speed and functionality over time. Really excited for it to have more health data (sugar level, blood pressure, etc.), but I am patient. While the iPhone is certainly more powerful, I oddly feel far more "naked" without my watch than even my phone for most of my day. Can't track workouts, golf, or quickly see alerts as easy or at all compared to the phone stuffed in my pocket most of the day.

 

[DeepIn2U]

Interesting, I have the same reaction when I watch Battlefield Earth.

Because of Travolta or overall poor acting?

 

[Pochi Hanaki]

A neighbor of mine was gifted an Apple watch. He is elderly and was getting upset with the watch giving hime AFIB warnings. The first couple of times he thought there was something wrong with the watch and said he was about to throw it away but then he had his heart checked. He now has a pacemaker and is very tankful of the gift.

you don’t get a pacemaker for Afib. He probably had slow heart rate.

 

[Hessian]

Because of Travolta or overall poor acting?

Seems like the same thing.

 

[Pochi Hanaki]

Likely that it isn't as big of a difference as one may think. Think of it this way, if something happens once a day, and you monitor every five minutes, you will catch it in day one of continuous monitoring. If monitored every five minutes, you have a one in five chance catching it in day one, two in five by day two, etc. to near certainty by day five. That is on a crude analysis. The reality is that you are still more likely to catch it one in five, two in five, etc.

A neighbor of mine was gifted an Apple watch. He is elderly and was getting upset with the watch giving hime AFIB warnings. The first couple of times he thought there was something wrong with the watch and said he was about to throw it away but then he had his heart checked. He now has a pacemaker and is very tankful of the gift.

All that said, it would be interesting to see a study to see how effective the Apple Watch is at finding such issues.

I was in the hospital 15 hours for afib. My Apple Watch only alerted me one time. The sampling is horrible and should not be relied on. The only good thing it auto tracked was heart rate variability and the showed the exact time my afib went away.

 

[ZipZilla]

you don’t get a pacemaker for Afib. He probably had slow heart rate.

Not commonly, but a pacemaker in combination with a cardiac ablation will eliminate afib.

 

[Pochi Hanaki]

Not commonly, but a pacemaker in combination with a cardiac ablation will eliminate afib.

Unfortunately not everyone who gets cardiac ablation have their afib cured. It’s like only 50%

 

[ZipZilla]

Unfortunately not everyone who gets cardiac ablation have their afib cured. It’s like only 50%

You're right, not everyone. My mother's was successful and changed her life. She might need to have it again

 

[Saturn007]

Trying to parse this:

”found that the Fitbit PPG detections correctly identified AFib episodes 98% of the time, as confirmed by ECG patch monitors.”

Do they mean that 98% of the instances it reported AFib that it was — or, that 98% of the times when the person was in AFib, it was flagged? p(y/x) is not the same as p(x/y).

I assume the ECG patch monitors (!) (plural) were constantly operating. If so, then that adds to the confusion. Given that the PPG-AFib is also monitoring 24-7, the use of the phrase “of the time” suggests the PPG literally labeled it as AFib 98% of the *clock time* it was occurring!

Which of these is it?

Often, these studies use a convoluted mathematical formula to arrive at an “accuracy” rate, which averages things in a way that obscures the actual error rates.

That leads to three final basic, but key, questions:

What was the false positive rate? The false negative rate?

How do these compare to the *current* Apple Watch rates?

 

[_Spinn_]

Has Fitbit specified exactly which devices will get this?

 

[DaveN]

you don’t get a pacemaker for Afib. He probably had slow heart rate.

I think you are right now that you mention it.