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Medicine Biotech Apple Science

Can Researchers Detect Irregular Heart Rhythms with the Apple Watch? (usatoday.com) 42

An anonymous reader quotes USA Today: Might wearing an Apple Watch save you from a stroke or cardio problem? Apple is careful not to make that direct claim. But the company, in collaboration with Stanford University School of Medicine, launched the Apple Heart Study app on Thursday that uses the heart rate sensor inside the Apple Watch to collect data on irregular heart rhythms... If an irregular heart rhythm is detected, participants in the study will be notified through the Apple Watch and on their iPhones. Should that occur, you'll be offered a free consultation with a study doctor, and possibly an electrocardiogram patch for additional monitoring...

A participant in the study merely has to download the app and wear the watch... The way Apple explains it, a sensor inside the watch uses green LED lights flashing hundreds of times per second and light-sensitive photodiodes to detect the amount of blood flowing through the wrist. The sensor has an optical design that gathers signals from four distinct points on the wrist. Using software algorithms, the Apple Watch can isolate heart rhythms from other noise, and identify an irregular heart rhythm.

The FDA has also approved the first personal electrocardiogram accessory for the Apple Watch, according to TechNewsWorld. "The KardiaBand" also detects and records atrial fibrillation that can lead to strokes or other heart problems. "The user simply touches an integrated sensor, and the results are then displayed on the face of the Apple Watch."

An irregular, bloodflow-disrupting heartbeat is the top cause of strokes, which kill 130,000 people every year just in the U.S. -- in many case before they've experienced any symptoms.
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Can Researchers Detect Irregular Heart Rhythms with the Apple Watch?

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  • The user should have the choice for the data to stay local. No "caring and sharing" with cloud providers (including Apple) without consent. Imagine if insurance companies got access to this kind of data and used it to deny coverage, or price customers out of the market. ACA and community rating may not last forever, sadly.
    • Re: (Score:2, Informative)

      by Anonymous Coward

      That... is exactly what Apple does. Your health data remains local to your device, full stop.

      • by Anonymous Coward

        Look at your iCloud settings - there is a toggle for Health. It used to only stay on your device and backups, but now it syncs to iCloud by default.

      • by TheRaven64 ( 641858 ) on Monday December 04, 2017 @06:04AM (#55671209) Journal

        It's actually a shame that there isn't some anonymised collection of this data. Talking to a cardiologist friend a few months ago, one of the biggest problems that they have is that they don't actually know what a regular heartbeat looks like. Lost of people are diagnosed with heart problems and then wear a monitor, but no one sticks heart monitors on healthy people for a few months to get a good baseline. What the discipline really needs is a few thousand healthy people to wear a heart monitor for a year. They suspect that various forms of arrhythmia are actually quite common and not life threatening, but they have to assume that they are because the only times that they see them are when people have been specifically referred to a cardiologist.

    • by shmlco ( 594907 )

      Ah... which part about "it's a study" is unclear?

  • Not the cause. (Score:4, Informative)

    by Anonymous Coward on Sunday December 03, 2017 @12:27PM (#55668117)

    No EditorDavid, 'An irregular, bloodflow-disrupting heartbeat' is not 'the top cause of strokes'.

    Why did you add that nonsense?

    • Afib CAN cause strokes due to blood not flowing correctly and forming small clots, though.
      • by Anonymous Coward

        Afib CAN cause strokes due to blood not flowing correctly and forming small clots, though.

        Indeed, but it is most definitely NOT the leading cause.

        • Re: (Score:2, Offtopic)

          No. The leading cause of death in most western countries is shock brought on by reading telecoms bills.
  • Kardia (Score:4, Insightful)

    by mspohr ( 589790 ) on Sunday December 03, 2017 @12:41PM (#55668187)

    https://www.alivecor.com/ [alivecor.com]
    Apple should be able to detect A-fib but if not, Kardia can do it.

    • by AmiMoJo ( 196126 )

      Unless these optical sensors have improved a lot in the last few months I think this is going to need some heavy qualification.

      Other optical sensors have proven wildly inaccurate when people use them for exercising or just wearing them all day. Maybe if the watch waits until you are stationary and not moving much it could get a better reading, but realistically trying to measure blood flow accurately using through-the-skin optics is never going to be very good.

      Maybe they don't need to accurately measure amp

      • Other optical sensors have proven wildly inaccurate when people use them for exercising or just wearing them all day. Maybe if the watch waits until you are stationary and not moving much it could get a better reading, but realistically trying to measure blood flow accurately using through-the-skin optics is never going to be very good.

        On the upside it could probably detect if you'd had a heart attack or stroke and fallen down dead.

    • It is not written anywhere in the article, but the video attached to it makes it clear that Apple is talking about the Kardia, not some internal product they're developing.

      At first I thought Apple was nefariously trying to drown out news about the Kardia, but no, this is just exceptionally bad reporting.

    • No it cannot unless the person has symptoms in which case they probably have been diagnosed. The purpose of the study is to detect a fib in those who do not know that they have it. These are going to be almost exclusively intermittent a fib and asymptomatic. The watch will be constantly monitoring for an irregularly irregular pulse,
  • by Ronin Developer ( 67677 ) on Sunday December 03, 2017 @12:47PM (#55668199)

    As someone who suffers from the occasional AFIB and bigemeni heartbeat, I was dismayed that a condition of joining the study is NOT knowing if you have AFIB.

    You discover this AFTER downloading the app and applying.

    As for keeping the data local ... it is send to a machine learning algorithm to help it learn to detect arrhythmia. Keeping that data simply wonâ(TM)t work.

    All this being said, I have found my AppleWatch invaluable as an aid to getting healthier. I received mine in late October. By concentrating on closing the rings every day, I have lost seven pounds and have had all my glucose readings in range for the past 3 weeks. Yes, exercise and diet alone probably would have done it. But, having the little taskmaster pushing me and giving a slight incentive worked for me and made the exercise regime and weight loss effort fun. Yes, I now weigh 223 pounds ( and 73 inches). I am not short and stout (there, either).

    • You should definitely listen to the speeches on youtube of Dr. Eric Westman en Dr. Jason Fung.
    • by nine-times ( 778537 ) <nine.times@gmail.com> on Sunday December 03, 2017 @02:19PM (#55668497) Homepage

      I was dismayed that a condition of joining the study is NOT knowing if you have AFIB.

      My understanding is that they're hoping to be able to detect the condition that causes irregular heartbeats, and not necessarily detecting the actually instances of irregular heartbeat.

      That is, the benefit would be for someone going through their lives unaware that they have a heart condition, and it could provide warning to them that they should talk to their doctor for an in-depth examination. It's not to alert you that you're having an irregular heartbeat while you're having an irregular heartbeat. I might imagine that the kind of measurements they're trying aren't reliable enough to warrant an emergency response in the event that a single event is detected. For example, it might be that scratching your wrist is enough to disrupt the contact between your skin and the watch, causing a reading that looks like an irregular heartbeat. But even if it's not reliable in detecting an individual incident, it might still be good enough to detect a condition when the data is taken in aggregate.

      On the other hand, it does seem a little strange that they'd exclude people who know they have a condition. I would think they'd want to know whether people did or didn't have a condition, so that after taking the data and predicting who had a heart condition, they could compare their predictions of whether people had the condition with actual diagnoses. Otherwise, how would they be able to tell whether their predictions were correct?

      • If you have a fib, even intermittent a fib, then presumably you are being treated or at least was given the option for treatment. I would presume they did a study comparing the watch to implantable rhythm monitors to determine its accuracy. It would be nice if they published this info.
  • by SummitCO ( 1043824 ) on Sunday December 03, 2017 @01:10PM (#55668279)

    Can it detect irregular heart rhythms? YES... but probably with terrible specificity (false positive).

    This device is a single lead EKG. It has potential to save lives... but it also potential to scare the bejezus out of a ton of folks and get them in for unneeded ER visits.

    Anyone who has been in an ICU or telemetry unit can tell you the frequency that machines beep (often dozens of alarm initiations per patient PER HOUR). Nearly all the hospital alarms from vital monitoring systems (multi-lead EKG rates/rythmns/segmental DSP, oximetry, CO2, impedence, gas flow, etc) are either false or non-actionable even when properly configured to minimize alarms by using dozens of inputs, advanced multi-sensor fusion alarm suppression, noise filters, signal averaging, and DSP all on patients who are holding relatively still. Sometimes it feels like an ICU nurse's primary job is to instantly analyze 6+ continuous waveforms of multiple types and determine if there is yet another false positive alert.

    • by mspohr ( 589790 )

      I've used the Kardia EKG for several years now and never had a false positive from their data analysis algorithm. Fortunately, I have a healthy heart. It gives me nice, clear EKG rhythm strip which accurately shows P QRS and T waves.
      (I'm an MD and I do have experience reading EKGs)

      Most ICU telemetry is very primitive and gives frequent alerts and drives the nurses crazy. They would be better served building some better analysis into their equipment rather than harassing the nurses.

      • by Tugrik ( 158279 )

        I've used the Kardia since they first were available and I'm an afib patient. It has indeed been able to detect pre-afib conditions and confirm early afib when it occurs, which has gotten me to go into the ER far earlier than I would have if I was instead guessing 'do I just feel funky or is my heart being weird again'. Which means that I got electrocardioverted sooner, and as such have a much lower risk for stroke and other complications. I am incredibly grateful to be able to have this bit of tech on

    • Can it detect irregular heart rhythms? YES... but probably with terrible specificity (false positive).

      This device is a single lead EKG. It has potential to save lives... but it also potential to scare the bejezus out of a ton of folks and get them in for unneeded ER visits...

      I'm sorry, but you appear to be mistaking this as a unintended design feature. A ton of folks generate a ton of revenue.

  • by boudie2 ( 1134233 ) on Sunday December 03, 2017 @01:17PM (#55668295)
    Reminds me of the internet meme where the guy forgets to take off his apple watch while watching porn and masturbates for 3 miles.
  • No they cannot.

  • There is a dataset of recorded heartbeats at Kaggle [kaggle.com] free for everyone to download. Not that many results there, though. I wonder how much better the algorithms have gotten and if Apple can actually do something useful with their device.
  • That is if you give them a hundred bucks per year to save your data.

  • I bought the gen-1 version of Kardia's little sensor because I thought it was a nifty gadget. Get an affordable 2-lead ECG to play with? Neat!

    When I got it I started taking readings, and your first few 'get a review by a real cardiologist' instances were free. I got mine back with something worrying: sinus bradycardia; an unnaturally slow heartbeat. They recommended I go see a real cardiologist, so I did. After a number of tests they were sure something was wrong, but weren't sure what. I was therefore lucky enough to be under a cardiologist's care when I had my first major afib attack shortly thereafter while upgrading a router at work. This got me better-informed care quicker.

    After the attack I had to wear one of those 24-hour monitors for three weeks, and it was seriously limiting. It's like wearing a walkman you can never take off with wires hooked up to stickypads on your chest. After all the monitoring and other tests it turns out I had a "multiple heartbeat source" genetic defect shared with the males in my family line, and it's the most likely cause of what ended up killing my granddad, great granddad, and has my father on a pacemaker these days.

    Not long after that first attack I had a surgery called an ablation ( https://www.mayoclinic.org/tes... [mayoclinic.org] ) to try and repair it. In the three years since I've had four more instances of afib attacks that required electro-cardioversion, each one lesser in strength than the one before. These days my electrocardiologist says I'm past the worst of it and life should be getting better and better, and shouldn't require a 2nd ablation. The worst part, though, was having a mild panic attack at every single flutter or uneasy feeling in the chest; I never knew if it was just gas or if it was the start of another attack that'd get me zapped/burned in a hospital along with a 24 hour stay and a few thousand dollars (even after insurance coverage) of medical bills.

    Since then I've carried the Kardia tool in my pocket. It has helped me identify when each of those four additional attacks were going on, getting me to get it dealt with earlier, and thus have less risk of stroke or other complications (every hour you spend in afib your risk of stroke or other permanent damage keeps going up). The kardia unit can be a pain in the ass, though; you have to clip it to the back of your phone, sit _very_ still, and take a 60 second reading. Often times the flutter that would cause me to take a measurement would pass before I'd even get the unit set up and started.

    With the release of Apple Watch 3 and their latest software the built-in heart monitoring has been able to ping me when it sees something 'out of normal' before I even feel it, which I then follow up with a Kardia measurement to make sure, and it has given me much better peace of mind. But it still doesn't do as much as the Kardia system would.

    As of this week I've gotten one of the new Kardia Band monitors, since they were finally approved by the FDA after a stupidly long wait. I've only had it for a few days but it's already proven to be a much better tool than the keep-in-pocket/hold-to-back-of-phone version. Any time my heart skips a little or feels odd it takes mere seconds to get a sample recording and predictive analysis to prove if something is going on or not, which serves to calm me down much quicker. I can indeed catch the odd rhythms before they fade, recording them for the cardiologist to look at without having to wear one of those terribly limiting 24-hr monitor systems. It makes me feel more in control of my condition.

    Currently the Kardia band software is a little blunt; it has to abuse the Apple Watch's 'exercise mode' to be at its most predictive and accurate. Hopefully this will change with time and Apple will open up some API changes to let tools like the Kardia band work more transparently. Even so, I find it a liberating piece of technology; it lets me get out with friends and live a more active life without being as in-fear of my condition as I would be otherwise.

  • Doing this with an Applewatch and an iPhone ? - that's gotta be at least $500, likely much more. So that will never be a an affordable option outside of the 1st world.

    Have a look at Heartypatch, orderable now for $95. "HeartyPatch is a completely open source, single-lead, ECG-HR wearable patch with HRV (Heart Rate Variability) analysis. "
    https://hackaday.io/project/21... [hackaday.io]
    https://www.crowdsupply.com/pr... [crowdsupply.com]

    Pleasant side effect, you have 100% control over the data.

Never test for an error condition you don't know how to handle. -- Steinbach

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