Apple Watch EKG
If you own one of the newer Apple Watch EKG, the Series 4, it has this dormant feature that was flipped on last year. This watch can now perform an electrocardiogram test or EKG. It measures the electrical signals that your heart uses to regulate your heartbeat. The point is to detect signs of atrial fibrillation, which is a form of irregular heartbeat that could cause a stroke or heart failure.
This is actually a big step for Apple. You might think of this watch as a notification machine for fitness buffs who want to obsessively track every single step that they take, but with EKG, it’s trying to become something different. Not just a fitness tracker, but now a health monitor, but that change, it opens up a host of new questions. – Do doctors think it’s a good idea? Are people gonna use this the right way?
All this information Apple Watch EKG
Are we just giving people all this information that they don’t even understand? – Oh, we asked our science reporter Angela to tackle those big scary questions for us. – Hey Deeder. – And later, we’re going to fire up a more professional EKG at a medical lab, but before all that, here’s what this new EKG feature actually looks like. (soft music) The EKG process itself is pretty simple. There are two sensors on the watch, one on the back and one on the crown.
When you put your finger on the crown, you’re completing a circuit from your finger to your heart and back to your wrist. That way, the watch can measure your heart’s electrical pulses. After 30 seconds, it’ll tell you if the upper or lower chambers of your heart are out of sync and if they are, it’s time to go see a doctor. In my case, I’m seeing a sinus rhythm and that should mean no AFib. but I’m gonna go see a doctor anyway. (soft music) We’re here at the University of California San Francisco to get an expert opinion.
Here are some of the reasons for their worries:
- Over-detection and “Information Overload”: The Apple Watch EKG is highly sensitive, designed to detect signs of Atrial Fibrillation (AFib). While this is beneficial for early detection in some, it can also lead to an increased number of “false positives” or detections of benign arrhythmias that are not clinically significant. This can result in:
- Unnecessary Anxiety for Patients: Receiving an alert about an “irregular rhythm” can cause significant stress and fear, even if the finding is not dangerous.
- Increased Healthcare Burden: Patients with alerts often seek medical attention, leading to a surge in doctor visits, referrals to cardiologists, and potentially unnecessary follow-up tests (e.g., Holter monitors, stress tests). This strains healthcare resources and increases costs.
- Misinterpretation by Patients: The Apple Watch EKG is a single-lead ECG, which provides limited information compared to a 12-lead ECG performed in a clinic. Patients might misinterpret the readings, assuming a “normal” reading means they have a perfectly healthy heart or dismissing symptoms because their watch shows a normal rhythm. It’s designed to detect AFib, not other serious cardiac conditions like heart attacks or other arrhythmias.
- Lack of Context and Clinical Correlation: Doctors emphasize that an EKG reading is just one piece of a patient’s overall health picture. The watch doesn’t take into account a patient’s medical history, other symptoms, or risk factors. A physician can provide the necessary context to interpret the reading correctly.
- “Watch-Gate” and Data Validity: While Apple’s EKG is FDA-cleared, doctors want to ensure that the data presented by the watch is clinically relevant and accurate enough for diagnostic purposes. There’s a fine line between a screening tool and a diagnostic tool, and the distinction can blur for patients.
- Focus on Screening vs. Diagnosis: The Apple Watch EKG is a screening tool, not a diagnostic tool. It’s meant to alert individuals to potential issues so they can seek professional medical advice. However, many users might view it as a definitive diagnostic device, leading to self-diagnosis or delaying professional consultation.
- Privacy and Data Security Concerns (though less prominent for doctors): While less of a direct medical concern, the sheer volume of health data being collected by personal devices can raise broader questions about data privacy and how this information is stored and used, which might be a background consideration for some practitioners.
New Apple Watch EKG feature
See, there’s already been a little bit of blowback about this new EKG feature. Some critics have argued that it could lead to false positives or become a self-diagnosis machine, so we’re here to do what we expect a lot of Apple Watch owners are gonna do which is to ask a doctor about their results. Dr. Greg Marcus is a specialist in heart arrhythmias at USFS. First, he and medical assistant Vanessa Mallet hooked me up to a lab-grade EKG. It provides 12 different readings of heart activity instead of just the single snapshot that you get on an Apple Watch. – And it’s just already going. You have what’s called a sinus arrhythmia, which is a sign of good health. – [Man] Dr. Marcus walked us through some of the differences between the Apple Watch EKG and this one. Basically, this thing will give you lots more data to help pinpoint issues that you might suspect based on the watch’s readout. It’s meant to be a two-step process. The watch flags a possible problem and the doctor investigates further.
Early beat for Apple Watch EKG
– So if there’s an early beat, for example, the 12 lead apple watch EKG will give us more information as to exactly where that’s coming from. – [Man] How that two-step process will work in practice? It’s not clear yet. The feature is too new. Right now Dr. Marcus isn’t really sure what to make of it. – We still don’t know yet how frequently that Apple Watch by itself will be sufficient versus how often physicians will not be able, not feel confident in that reading, and feel that some additional monitoring needs to be done. As a researcher, it’s fascinating and a great opportunity. As a clinician, it’s worrisome. – The worrisome thing, the precision of the Apple Watch is only part of the story. In theory, the benefit of the Apple Watch is that it’ll catch these lurking heart problems that you would otherwise never know about.
Cardiologists recommend Apple Watch EKG
But in fact, cardiologists don’t recommend apple watch EKG using it to screen for heart problems unless you’re already at risk. – My name’s Seth Landefeld. I’m a professor of medicine and chair of the Department of Medicine at the University of Alabama at Birmingham. – Dr. Landefeld is a member of the US Preventive Services task force. They evaluate various screening tests to see if the benefits outweigh the risks. Recently, they looked at whether EKG screening would help in people who are healthy and otherwise at low risk.
They looked at it for cardiovascular disease, bad stuff like a heart attack, or stroke. – There’s no evidence there that the benefits outweigh the harms and so therefore we recommended against using ECG screening for people at low risk for cardiovascular disease. – And for AFib, the condition Apple Watch screens for, similar situation.
Much evidence that Apple Watch EKG
There’s just not much evidence that Apple Watch EKGs are worth it if you don’t already have these other symptoms but why not just do it anyway to be safe? Because there’s a risk of a false positive. EKG itself is safe, but in an absolute worst-case scenario, there could be a false positive that leads to a treatment that’s unnecessary and unsafe.
Well if it led to further tests that somebody said, jee, it looks like you should undergo bypass surgery and somebody underwent bypass surgery, we know that the average mortality from bypass surgery is one or two percent. – There’s also the issue of the users. AFib studies focus on people 65 and older because they’re the people who are most likely to have heart problems. They’re not the people most likely to have Apple Watches, which makes Dr. Marcus worried that now all the wrong people have their own EKGs.
Tend to purchase Apple Watch EKG
The individuals that tend to purchase these Apple Watches EKG maybe those who are already health-conscious, tend to be fit, tend to probably be quite healthy, whereas the people that really probably have the most to benefit from atrial fibrillation screening will tend to be the older individuals who may be less tech-savvy, those who aren’t as concerned about their health.
– All this means that EKG might be harming all these low-risk people with all this data that might lead them to self diagnose and get freaked out for no good reason. For them, all this might start with an irregular heartbeat alert. – They check their EKG, they don’t actually have atrial fibrillation, they have an irregular rhythm for some other reason that’s totally benign. – In reality, they’re totally okay, but now they’ve gotten the scary notification that something might be wrong and they feel nervous.