Hands-On With the ECG Feature for Apple Watch Series 4

[redman042]

Here’s a juicy scenario for you malpractice attorneys and clinicians out there...Let’s say a person is signaled by the Apple Watch that they are in atrial fibrillation. The person goes to his doctor, and the physician orders an EKG, which shows the patient is in sinus rhythm. Does the physician A) trust the reading on the watch, and start the patient on a blood thinner or B) Not accept the data from the watch and not initiate a blood thinner? I would think most physicians not accepting/trusting new technology might go with scenario B. Should the patient actually have paroxysmal atrial fibrillation, develops a mural thrombus that embolizes and leads to stroke, the patient in scenario B would have some substantial evidence against the physician should litigation be attempted.

I know, it’s not going to be a frequent scenario, but makes for some interesting malpractice commentary.

No doctor is going to base his diagnosis on the watch. The doc may do additional tests because of readings from the watch and comments from the patient. If the hospital equipment doesn't pick it up, then the doc will have the patient wear a medical monitor for a day or two.

The watch is only meant to inform the wearer that they should consider seeing a doctor and getting further testing. That's it.

 

[nexusrule]

Why? A normal resting heart rate is between 60-100 and he was even in that range while not resting. While a lower resting heart rate may indicate better cardiovascular shape, he also wasn't exactly resting while filming the video. Moving around, talking, maybe the stress of doing a video demo all would elevate his resting heart rate.

Well, because, at 98 is borderline, and moving around and talking doesn't usually increase the hearth rate. Also, while 98 is still in the limit, we all get old, and arriving at 60 with a 100 or a 75. heart rate can make a difference.

 

[lanegandy]

Same issue, open health app and nuttin!

Well this sounds like a completely different issue you should talk to your doctor about

 

[nexusrule]

I just went out and bought an Apple watch for this very purpose. (plus I was about due, anyway.) I have occasional (2-3 times a year) heart palpitations and over the years the docs have never been able to capture it to see what was going on. Or to even know how often it happens (I only notice it when I'm in a sedentary posture.) It's difficult to describe the heartbeat pattern to a human, too.

At the very least this will likely let me know how often this occurs, I may not notice it sometimes. Plus if I'm able to capture it in-watch a few times perhaps the admittedly not entirely clinical tape could give a clue on where to look for problems with my ticker.

I'm not under any delusions that this qualifies as a medical device, but broadly it could give me an idea of how prevalent the problem really is, and perhaps the intensity of it at the time it occurs.

Yours doctors never told you that if it keeps happening but they can't catch anything it may be psychological (you don't necessarily have to "feel" anxiety or stress when you suffer from stress and other psychological issues)? Often growing up people stops having anxiety because they learn to control, and the body could start signalling the same psychological issues with accelerated heart rate, or occasional stoma aches etc.

 

[Surfer13134]

Yep... not necessary for people to play doctor for the OP.

Apple’s info regarding the sinus rhythm says:

Sinus rhythm
A sinus rhythm result means the heart is beating in a uniform pattern between 50 and 100 BPM.

https://support.apple.com/en-us/HT208955

Not playing doctor, been a medic for 6 years now. Just stating that the heart rate is completely normal.

 

[OverSpun]

Here’s a juicy scenario for you malpractice attorneys and clinicians out there...Let’s say a person is signaled by the Apple Watch that they are in atrial fibrillation. The person goes to his doctor, and the physician orders an EKG, which shows the patient is in sinus rhythm. Does the physician A) trust the reading on the watch, and start the patient on a blood thinner or B) Not accept the data from the watch and not initiate a blood thinner? I would think most physicians not accepting/trusting new technology might go with scenario B. Should the patient actually have paroxysmal atrial fibrillation, develops a mural thrombus that embolizes and leads to stroke, the patient in scenario B would have some substantial evidence against the physician should litigation be attempted.

I know, it’s not going to be a frequent scenario, but makes for some interesting malpractice commentary.

Likely not, if you read the details that came with the EKG app-

https://support.apple.com/en-us/HT208955
[doublepost=1544139288][/doublepost]

Not playing doctor, been a medic for 8 years now. Just stating that the heart rate is complexity normal.

I was agreeing with you.

 

[Surfer13134]

Likely not, if you read the details that came with the EKG app-

https://support.apple.com/en-us/HT208955
[doublepost=1544139288][/doublepost]

I was agreeing with you.

Ah sorry about that. Read it the wrong way

 

[JTalbertPhoto]

For those that don't get setup in the Health app. If you are on the beta. Remove the profile. Then check again for SW update. I just did and even though with the beta profile, it showed I had the latest build. Once I removed the beta profile, I had 12.1.1 again to install, I am installing it now. And then hopefully it will work.

 

[WinterWolf90]

Here’s a juicy scenario for you malpractice attorneys and clinicians out there...Let’s say a person is signaled by the Apple Watch that they are in atrial fibrillation. The person goes to his doctor, and the physician orders an EKG, which shows the patient is in sinus rhythm. Does the physician A) trust the reading on the watch, and start the patient on a blood thinner or B) Not accept the data from the watch and not initiate a blood thinner? I would think most physicians not accepting/trusting new technology might go with scenario B. Should the patient actually have paroxysmal atrial fibrillation, develops a mural thrombus that embolizes and leads to stroke, the patient in scenario B would have some substantial evidence against the physician should litigation be attempted.

I know, it’s not going to be a frequent scenario, but makes for some interesting malpractice commentary.

No medical provider is going to make a decision off of one watch reading. As a nurse practitioner I would never start someone on thinners for a watch alert saying they are on AFIB if the EKG I do in practice is normal.

 

[DiamonDecoden]

Here’s a juicy scenario for you malpractice attorneys and clinicians out there...Let’s say a person is signaled by the Apple Watch that they are in atrial fibrillation. The person goes to his doctor, and the physician orders an EKG, which shows the patient is in sinus rhythm. Does the physician A) trust the reading on the watch, and start the patient on a blood thinner or B) Not accept the data from the watch and not initiate a blood thinner? I would think most physicians not accepting/trusting new technology might go with scenario B. Should the patient actually have paroxysmal atrial fibrillation, develops a mural thrombus that embolizes and leads to stroke, the patient in scenario B would have some substantial evidence against the physician should litigation be attempted.

I know, it’s not going to be a frequent scenario, but makes for some interesting malpractice commentary.

You guys are acting like if this watch technology is 1000% accurate.. it is still in beta phase....... It is a whole lot of what ifs. honestly, I think if someone do go to the doctor with results from the watch, the doctor will run the test again to confirm and base his or her judgement on their test NOT the watch.

 

[Bin Cook]

Okay, it is only 1 test with a watch that is still in Beta!
Normally, it takes a few takes to get the 'average' heart rate- Just like blood pressure, sometimes the test fails to give accurate results that is why we need to take the average. Secondly, we don't know if that is really his true resting heart rate- not talking, laying down, relaxed state.
A heart rate is not exactly an exact science, I done a LOT of research into it because I used to have anxiety over the heart rate numbers. However! a lower heart rate can be achieved via regular exercise, which me and many others lack.

Just wanted to add this is a single point measurement. To get an idea of someone's heart rate 'health' you'd need to have the data from the Health app. My BPM often spikes on the Apple Watch for no discernible reason and it doesn't bother me one bit because over the course of 5-10 minutes I feel like the much lower value is the stable measurement. Lots of hospital-grade measuring devices spike during usage - it's simply the device continuing to calibrate itself as per the manufacturer's design.

 

[Tech198]

It's always god to know you take take a ECG just by the touch of a finger.

 

[redman042]

Seems the new ECG feature is already generating a lot of controversy. That didn't take long.

Well I can report that I've used the ECG twice now and it works great. Watching my heart rate dance across the display of my watch, and then generating a PDF that I can send to my doctor, is a next-level experience. This is really cool, and I can't wait to see what they're working on next.

 

[simidene]

Folks-AliveCor has been doing the same thing that apple just did, Apple just has it all in one package, its watch! Many cardiologists have been using Alivecor (band for Apple Watch /or Kardia Mobile device) to keep an eye on their patients!! Is has been Shown and approved by the FDA to be accepted as a device for practitioners as well to use for this specific issue; being Afib!! If the watch picks it up multiple times Dr.'s can and have been treating pt's on this data?
[doublepost=1544143118][/doublepost]If I am correct Apple had and continues to be teamed up with Harvard to initially show its results, that the watch can do what they claim and that this ECG on the watch was just as accurate as Holter monitor at picking up Afib. There was a study conducted by Harvard and Apple, they gathered data etc...and they are continuing to gather more data, I believe on another large study based on the watch. This is why the FDA game them a thumbs up for this use!!!!

 

[juanmj93]

I think it's important to clarify that not having a Sinus Rhythm does not inmediately mean that you have atrial fibrilation, and there can also be alterations within a Sinus rhythm such as a grade 1 blockade or repolarization alterations.

Would like to see if the algorithm can detect and categorize those or an EKG interpretation is still needed for those.

 

[simidene]

Seems the new ECG feature is already generating a lot of controversy. That didn't take long.

Well I can report that I've used the ECG twice now and it works great. Watching my heart rate dance across the display of my watch, and then generating a PDF that I can send to my doctor, is a next-level experience. This is really cool, and I can't wait to see what they're working on next.

No controversy, just people who are posting opinions without really thinking about the facts!!

 

[juanmj93]

No one sane would do that, but even with a normal ekg I would consider a 24 hour Holter for someone with AF detected by the watch, Paroxystic AF can be pesky to document and early detection is bliss.

 

[simidene]

No one sane would do that, but even with a normal ekg I would consider a 24 hour Holter for someone with AF detected by the watch, Paroxystic AF can be pesky to document and early detection is bliss.

Well I guess you have not seen Alivecor at work and the many Cardiologists that accept the pdf readings from their patients and look at the tracing to determine what they have? again many pt's have had baseline 12 lead EKGs along with Holters done, no need to repeat unless they suspect something other then Afib?

 

[macdos]

Sorry to be a party pooper, but it is evident that Apple is increasingly becoming a company for the gerontocratic society of old people about to die any minute. It is simply not healthy constanting checking your vital signs, your sleep patterns, your heart rate and so on.

Healthy people don't do that. They run in the park, eat well and enjoy life without worrying about disease all the time.

 

[simidene]

My EP Doc is aware of

No one sane would do that, but even with a normal ekg I would consider a 24 hour Holter for someone with AF detected by the watch, Paroxystic AF can be pesky to document and early detection is bliss.

MY EP Doc is well known and we talked about this device and others and he said that he would be perfectly comfortably with accepting tracings form these devices, as he knows my history!

 

[eliddm1]

I'm in Canada. Is there a place in the settings to let the apple watch 4 think that I'm in the US so that I can use the ECG?

 

[Hoosier317]

The backhanded comment was absolutely unnecessary.

Are you really that fragile?
[doublepost=1544144257][/doublepost]

Seems the new ECG feature is already generating a lot of controversy. That didn't take long.

Well I can report that I've used the ECG twice now and it works great. Watching my heart rate dance across the display of my watch, and then generating a PDF that I can send to my doctor, is a next-level experience. This is really cool, and I can't wait to see what they're working on next.

Umm...based on what exactly? A couple of posts in this thread?

 

[Jervasio]

Read the full article. It clearly states that Apple has to get regulatory approval from other counties before it can be made available. Just like they had to get FDA Clearance here in the US.

I'm happy that I bought mine in the US. Using the ECG feature in Europe

 

[eliddm1]

Sorry to be a party pooper, but it is evident that Apple is increasingly becoming a company for the gerontocratic society of old people about to die any minute. It is simply not healthy constanting checking your vital signs, your sleep patterns, your heart rate and so on.

Healthy people don't do that. They run in the park, eat well and enjoy life without worrying about disease all the time.

You are partialy right, but despite doing everything that you are describing you can still have a serious condition and not be aware of it. This feature can save people lives even if they think that nothing can touch them.

 

[simidene]

No one sane would do that, but even with a normal ekg I would consider a 24 hour Holter for someone with AF detected by the watch, Paroxystic AF can be pesky to document and early detection is bliss.

Your right Paroxysmal Afib is tough to catch, so you would either put someone on a 30day to hopefully catch it or an implantable device? or you can use one of these devices to catch it, and see it hopefully multiple times on tracings to corroborate your suspicions?