The Emerging Role of Wearable Technologies in Detection of Arrhythmia

Over the past decade, there has been an explosion of consumer devices for the purposes of health and fitness tracking. The wearable technology market, composed of devices that monitor physiological parameters, such as heart rate and sleep pattern, is anticipated to grow to 929 million connected devices in 2021. These devices encompass wristbands, glasses, in-ear monitors, or electronic shirts, with varying capacity to monitor heart rate, heart rhythm, blood pressure, physical activity, respiratory rate, blood glucose, and sleep patterns. For heart-rate monitoring, most wearable devices use photoplethysmography (PPG) technology, meaning they are inherently less accurate than conventional electrocardiography monitoring techniques (reference standard). However, a growing body of evidence suggests that these technologies can be harnessed to facilitate arrhythmia detection in the appropriate context. Studies evaluating PPG-based wearables in conjunction with machine-learning algorithms have shown promise in detection of such arrhythmias, as atrial fibrillation. Limitations of wearable technologies include their accuracy and accessibility and the clinical implications of wearable-detected arrhythmias. Despite this, wearable technologies represent an important frontier in health evaluation. Future wearables will benefit from improved reliability and accuracy, collect additional health and fitness parameters, support management of chronic disease, and provide real-time connectivity and feedback that may supplant conventional medical monitoring. Wearables have the potential to become truly disruptive in our health care sector, with large segments of the population soon to have readily available health data that the physician must interpret.