[Clinical differential indication : Wearables vs implantables]

In order to document arrhythmias, indicated due to symptoms or for prognostic purposes, both invasive and noninvasive possibilities for ECG monitoring are available. The choice of the device for monitoring depends mainly on the frequency of arrhythmias. If they occur less than once a month, long-term monitoring becomes necessary which either continuously monitors the rhythm by an implantable device (implantables) or by wearable systems (wearables) which usually register the ECG discontinuously. Because wearables, e.g. smartphones, are basically ubiquitously available, they may be used for ECG monitoring. This paper comments on the use of implantables and wearables for the detection of atrial fibrillation and the documentation of symptomatic arrhythmias in syncope or palpitations.