Why You Need an Apple Watch to Monitor for Atrial Fibrillation

At the KAHN CENTER, we work with many patients with Atrial fibrillation (AF), the most common cardiac arrhythmia, and a major cause of stroke

 

AF often remains undiagnosed due to its paroxysmal and frequently asymptomatic nature. Wearables provide a scalable, noninvasive screening tool. We recommend ot patients with suspected or known AF to acquire and wear an Apple watch as it has an accurate detection system. But is it actually helpful and worth the cost?

An new trial evaluated new onset AF detection in patients at elevated stroke risk using remote smartwatch-based screening.

 

This prospective multicenter randomized controlled trial included patients ≥65 years with elevated stroke risk (CHA₂DS₂-VASc ≥2 men, ≥3 women) from 2 secondary care centers in the Netherlands.

 

Patients were randomized to 6-month (180-day) monitoring with a smartwatch with photoplethysmography and single-lead electrocardiogram (ECG) functions, or standard care. ECGs were reviewed remotely by an independent eHealth team within 24 hours. The primary outcome was new onset AF, defined as a confirmed episode lasting ≥30 seconds on single-lead ECG or standard ECG methods.

Between November 2022 and December 2023, 437 patients were randomized (219 intervention, 218 control); the median age was 75 years, 47% were female and the median CHA₂DS₂-VASc score was 3.0.

 

 

Several asymptomatic AF episodes were detected only in the intervention group, while paroxysmal AF occurred in both groups.

This randomized controlled trial provides evidence that 6-month smartwatch-based AF screening enhances the detection rate of new onset AF compared with standard care in patients at elevated stroke risk.