Clinical consequences of smartwatch implementation in a cardiology outpatient clinic

INTRODUCTION: Long-term cardiac monitoring has become more accessible with the advent of consumer-oriented wearable devices. Smartwatches (SWs) hold promise for extended rhythm monitoring owing to their availability and direct electronic health record (EHR) integration. We studied the clinical consequences of SW implementation in patients with palpitations.

METHODS: Patients referred for palpitations or with inconclusive diagnostics were issued a SW for up to three months. They were instructed to take an SW-electrocardiogram (ECG) during symptoms and transfer it to the EHR. A cardiologist interpreted the ECGs, diagnosed the patient and initiated relevant clinical actions.

RESULTS: We included 50 patients with a median age of 57 years (IQR: 45-64), 56% women. The following ECG diagnoses were made: 20 (40%) had sinus rhythm, six (12%) had extrasystoles and 24 (48%) had clinically relevant arrhythmias. Consequently, 25 (50%) completed their arrhythmia evaluation, whereas clinical actions were taken in 25 (50%). Notably, more than 20% underwent an electrophysiology study and ablation. Patients found the SW to be user-friendly with minimal impact on their daily life.

CONCLUSIONS: SW use for symptom-based diagnosis had a high yield for both arrhythmia detection and completion of arrhythmia evaluation. Additional studies are needed to determine if SWs may replace traditional ECG monitoring.

FUNDING: The project was funded by internal funds at the Department of Cardiology, Herlev and Gentofte University Hospital (HGH), Denmark.

TRIAL REGISTRATION: As a quality assurance project, no ethical board approval was needed under Danish law. The study was approved by the HGH directors.