A recent study from Stanford School of Medicine suggests that smartwatches, particularly the Apple Watch, can aid physicians in identifying irregular heart rhythms in children. Examining electronic medical records of pediatric cardiology patients at Stanford Medicine Children's Health over four years, the study found that the smartwatch was mentioned 145 times, with 41 cases confirming abnormal heart rhythms through traditional methods. Notably, 29 children received their first arrhythmia diagnosis through the smartwatch, revealing its effectiveness in detecting issues that standard monitoring might miss. Lead author Aydin Zahedivash, MD, highlights the potential of newer technology in enhancing patient care.

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Skipping a beat, sometimes

Doctors diagnosing children's cardiac arrhythmias face two primary challenges. First, current cardiac diagnostic devices, while improved, are still suboptimal for kids. In the past, children had to wear bulky Holter monitors for 24 to 48 hours, but now they can use more comfortable event monitors. However, these may still pose issues like premature detachment or skin irritation. Second, even with weeks of monitoring, capturing erratic heart behavior in children is challenging, as arrhythmias occur unpredictably and with long intervals between episodes. A recent case involving Connor Heinz highlighted these challenges, where adhesive monitors were problematic, and irregular rhythms occurred infrequently. To address this, doctors, like Ceresnak, are exploring the use of smartwatches for recording heart rhythms in children, recognizing the need for optimized algorithms tailored to the unique characteristics of pediatric heart rhythms revealed in real-world data.

Evaluating medical records

Researchers examined electronic medical records from 2018 to 2022, searching for "Apple Watch" mentions. They identified 145 instances and focused on patients with smartwatch data and cardiac arrhythmia diagnoses. The smartwatches collected heart rate alerts and patient-initiated electrocardiograms (ECGs), aiding in diagnosing heart issues. Among 41 confirmed arrhythmia cases, 18 had ECGs, and 23 received high heart rate notifications. Smartwatch data prompted medical workups for 29 children, resulting in new arrhythmia diagnoses. Ten patients were diagnosed solely by smartwatches, including Connor Heinz. His supraventricular tachycardia was confirmed through captured heartbeats sent to Dr. Ceresnak. Smartwatches offer non-life-threatening arrhythmia detection, aiding timely intervention and providing reassurance. The study identified 73 cases with smartwatch use but no arrhythmia diagnoses, suggesting potential for ruling out serious conditions in the future.

A new study

The Stanford Medicine research team aims to investigate the effectiveness of the Apple Watch in detecting heart problems in children. The study will assess whether heart rate and rhythm measurements obtained from the watches align with those from standard diagnostic devices in pediatric patients. Limited to children already receiving cardiology care at Stanford Medicine Children's Health, the research addresses the growing use of wearables among kids. Dr. Ceresnak emphasizes the importance of ensuring data reliability and accuracy for children, expressing the intention to contribute to the development of pediatric-specific algorithms for heart rhythm monitoring. Conducted without external funding, the study received support from Apple's Investigator Support Program, which will provide watches for the next research phase. Notably, Apple's Irregular Rhythm Notification and ECG app are FDA-cleared for individuals aged 22 and above, with the high heart rate notification available to users aged 13 and older.