Smartphones have become an integral part of our daily
life now, so much so that a world without smartphones now seems inconceivable.
As
technology has evolved, the use of phones has undergone a revolution. Each new
version of the smartphone is equipped with better and often some mind-boggling
features. Physical keypads have made way for touch screen. You can video chat
with someone anywhere in the world. All you need is an internet connection on
your smartphone. Apps like Google Assistant make it possible to interact with
the phone through natural voice. Phones today, therefore, can perform many more
functions beyond just making calls.
Apple has now taken a step ahead leaving a trail for the
future with two new features in Apple Watch Series 4.
An ECG app on Apple Watch Series 4 is now
available. As the first direct-to-consumer product, it helps people to take an
ECG right from their wrist, whenever they experience symptoms such as rapid or
missed heart beat and also share the data with their doctors.
The irregular rhythm notification feature on Apple
Watch can now also monitor heart rhythms in the background and send a
notification if an irregular heart rhythm is detected on five rhythm checks
over a minimum of 65 minutes
According to a news release from Apple, “New
electrodes built into the back crystal and Digital Crown on Apple Watch Series
4 work together with the ECG app to enable customers to take an ECG similar
to a single-lead reading. To take an ECG recording at any time or following
an irregular rhythm notification, users launch the new ECG app on Apple Watch
Series 4 and hold their finger on the Digital Crown. As the user touches the
Digital Crown, the circuit is completed and electrical signals across their
heart are measured. After 30 seconds, the heart rhythm is classified as either
AFib, sinus rhythm or inconclusive. All recordings, their associated
classifications and any noted symptoms are stored securely in the Health app on
iPhone. Users can share a PDF of the results with physicians”.
Rhythm classification from a 12-lead ECG by a
cardiologist was compared to the rhythm classification of a simultaneously
collected ECG from the ECG app in around 600 participants. The ECG app on Apple
Watch showed 98.3% sensitivity in classifying AFib and 99.6% specificity in
classifying sinus rhythm in classifiable recordings; 87.8% of recordings could
be classified by the ECG app.
In a sub-study of the Apple Heart Study, which included
participants that received an irregular rhythm notification on their Apple
Watch while simultaneously wearing an ECG patch, 80% showed AF on the ECG patch
and 98% showed AF or other clinically relevant arrhythmias. With over 400,000 participants, the
Apple Heart Study was the largest screening study on atrial fibrillation ever
conducted, also making it one of the largest cardiovascular trials to date.
The ECG App and the irregular heart rhythm notification
have been provided De Novo classification by the US FDA. They are available as
part of a free update to watch OS 5.1.2.
Health care today has shifted from being ‘paternalistic’
to ‘patient-centric’. The patient now wants to be a part of decision making. He
has literally all information related to his illness at his fingertips because
he has a smartphone.
Technology has again empowered patients, who can use the
App to monitor themselves for signs of AF and be alerted about the event right
at the time it is occurring.
It’s a promising tool indeed, yet it needs to be used
cautiously.
(Source: Medscape, Apple News)
Dr KK Aggarwal
Padma
Shri Awardee
President Elect Confederation of Medical Associations in Asia and
Oceania (CMAAO)
Group
Editor-in-Chief IJCP Publications
President
Heart Care Foundation of India
Past National President IMA
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