A recent study has found that the Apple Watch is capable of precisely documenting arrhythmia occurrences in children, accurately identifying most prevalent types. Irregular heartbeats, particularly in children, are a common concern requiring pediatric cardiology evaluations. Traditional diagnostic options for children experiencing arrhythmia symptoms, such as patch rhythm monitors and 24–48-h Holter monitors, come with limitations, often failing to capture sporadic symptoms. The rise of wearable technologies, notably smartwatches like the Apple Watch, presents an opportunity for extended cardiac monitoring in children. The study, authored by Aydin Zahedivash, Henry Chubb, and Heather Giacon, sought to explore the clinical utility of the Apple Watch in capturing arrhythmias in children, addressing the need for longer-term noninvasive monitoring in this demographic.
The study analyzed patients aged 18 and below over a 4-year period who reported arrhythmia symptoms captured by an Apple Watch. A total of 145 electronic-medical-record identifications were made, with 41 patients (28%) confirmed to have arrhythmias. The mean age of these patients was 13.8 ± 3.2 years. The identified arrhythmias included 36 cases of supraventricular tachycardia (SVT) constituting 88%, 3 cases of ventricular tachycardia (VT) at 7%, 1 case of heart block at 2.5%, and 1 case of wide complex tachycardia also at 2.5%. The Apple Watch was found to have greatly contributed to prompting diagnostic workups, resulting in new arrhythmia diagnoses for 71% of patients. Invasive electrophysiology (EP) studies confirmed the diagnosis in 94% of SVT cases, highlighting the accuracy of the Apple Watch in capturing clinically relevant arrhythmias. Interestingly, traditional ambulatory cardiac monitors, worn by 85% of patients, failed to detect arrhythmias in 29% of cases. Further analysis revealed that 25% of patients using the Apple Watch for recreational heart rate monitoring sought care based on device findings, despite not having identified arrhythmias. This suggests the potential for false-positive alerts, raising concerns about unnecessary healthcare visits prompted by wearable devices.
The researchers emphasized the value of the Apple Watch in pediatric arrhythmia diagnosis and surveillance, acknowledging its capacity to capture events not identified by traditional monitors. The study highlighted the limitations of current ambulatory monitoring options for children and suggested that wearables like the Apple Watch could fill the gap by providing longer-term, noninvasive monitoring. However, the researchers also acknowledged challenges, such as the limited accuracy of heart rate sensor algorithms with higher heart rates in children.
The researchers highlighted the role of consumer wearables, particularly the Apple Watch, in contributing valuable insights into pediatric arrhythmias. The ability of the Apple Watch to prompt diagnostic workups leading to new arrhythmia diagnoses emphasizes its potential clinical impact. However, concerns about false-positive alerts and the need for further prospective studies comparing the Apple Watch with traditional monitors were noted. Overall, the study advocates for continued exploration of wearable technologies for extended cardiac monitoring in pediatric populations, highlighting a potentially transformative aspect of digital health in pediatrics.
