If someone’s heart skips a beat, the tech companies want to let them know.
Gadget companies – starting with Apple and now Fitbit, which is owned by Google – are selling wearable devices that test heartbeat rhythms and warn users when something doesn’t sync.
This product technology involves some feats. Many use sophisticated optical sensors that peer under the skin to monitor how the blood volume changes – almost like tracking the tide – and as a result the heart rate is counted. Other devices have a miniature electrocardiogram – which records the electrical activity of the heart – embedded. Either method can detect irregular heartbeats – and potential atrial fibrillation, a condition that affects an estimated 2.7 million Americans and increases the risk of stroke and heart failure. When a person has it, the pulse in the upper chambers of the heart becomes irregular and blood does not flow in the lower chambers of the heart.
Yet, although gadgets are a technological achievement, some cardiologists say that the information that devices produce is not always effective. Notifications from devices are not specific diagnoses
This is a puzzle for the healthcare system, and a consequence. Millions of people are armed with these devices, and if even a small fraction of them get a ping, it can mean a lot more care and cost for the system.
“Technology has overtaken us,” said Rod Pasman, a cardiologist at Northwestern University who is assisting in a study to test the ability of the Apple Watch to screen for the rhythmic state of the heart. “The industry came up with these things because they could. Now we are playing catch-up and trying to figure out what to do with this information. ”
Heart rhythm sensors are among the many devices packed in these wearables. Users can count their steps, track their sleep, and analyze their movements. Some products will call 911 if the wearer has been in a car accident or has fallen badly.
These traits make patients the main characters in maintaining their health. During an event about Fitbit’s atrial fibrillation function, company co-founder James Park said it was one of several features of the brand’s fitness-tracking bands that were “creating effortlessly controlling users’ health and wellness.”
Wearable atrial fibrillation ping – a “test [doctors] Didn’t order, “says Pasman – Patients are told there are potential irregularities. In the end, though, any treatment is left to the doctor.
Initial visits do not always provide quick answers. To confirm a notice, a cardiologist equips patients with medical-grade diagnostics – a patch or heavy monitor – that is more accurate than wearables. (Apple Watch, for example, has been cleared by the FDA for “informational use only”). That wait means more time and money, more visits to the doctor.
“It can be very difficult to diagnose a disease,” said Ethan Weiss, a cardiologist at the University of California, San Francisco. Patients may be anxious along the way. Social media forums like Reddit show that many users are wondering if their watches or their doctors are more reliable. One user wrote, “It’s still confusing me,” even after a doctor told him he was probably fine.
“It’s going to be a time of uncertainty,” admits Tony Farranesh, a research scientist at Fitbit. He said the company provides educational material to warn users about potential arrhythmias.
It is difficult to study the spread of anxiety as a result of atrial fibrillation pings. Fitbit collected such information, Farnesh told KHN, as part of a survey submitted to the FDA for clearance of his device. But the full results of the study – which collected data from 455,000 patients – are not yet available.
The diagnosis is not the same as knowing what the best treatment should be. For example, treating otherwise healthy patients with anticoagulants – the ideal treatment for atrial fibrillation – may cause them to experience unnecessary side effects.
According to doctors interviewed by KHN, atrial fibrillation is a widespread condition. Some patients take multiple shots in a given year and have symptoms such as fatigue or shortness of breath. Some patients do not notice a thing.
In the past, transient fibrillation could not be detected, let alone treated. And users of wearable technology are healthier and richer than ordinary atrial fibrillation patients. A new Apple Watch costs about $ 400; The cheapest Fitbit is 50. (Company officials could not say which Fitbit device will have atrial fibrillation detection function, although they said they are committed to making the technology widely available.)
Less understanding of health conditions and the combination of healthy patients means cardiologists are not entirely sure what patients will do with this group.
Among the concerns and unknowns, technology companies have yet to launch a massive science experiment health system.
A large number of people have adopted wearable gadgets. Analysts at Counterpoint Research say the Apple Watch – which has included atrial fibrillation-scanning features since 2018 – surpassed 100 million users worldwide last summer. Fitbit probably has millions more users. It is unknown at this time what he will do after leaving the post.
More companies are coming. “Everyone wants to add high- and high-caliber medical-grade sensors to their consumer gadgets,” said Dr. Justin Klein, managing partner of Vensana Capital, a venture capital firm. It is “taking patients to the clinic to confirm the diagnosis,” Klein said.
Companies are expanding the capabilities of wearables. Klein said big technology and startups are similarly looking at more conditions for gadgets to passively warn users about everything from blood oxygen levels to high blood pressure.
It is up to the patients and doctors to decide what to do with these new dudads.
Northwestern Pasman considers himself optimistic about the potential of the devices. In an interview – playing an Apple Watch on his wrist – he said the devices could help doctors and patients handle situations and respond quickly to funny flats. And cardiologists like Pasman say doctors can use the devices to make sure their treatment is working for atrial fibrillation.
Nevertheless, the feature can cause headaches for cardiologists. “It’s created some extra burden, managing phone calls, going to the office,” Weiss says – and all for a still-unclear benefit.
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