Connected health: Ventricular tachycardia detection with Apple Watch-A case report

Traditional screening methods, such as 12-lead electrocardiograms (ECGs) and Holter monitors, often fall short in detecting transient arrhythmias. However, advancements in wearable technology, like the Apple Watch®, enable real-time rhythm monitoring and specific arrhythmia detection through dedicated algorithms.

A 60-year-old man with a history of arrhythmogenic cardiomyopathy and an implanted cardioverter-defibrillator (ICD), during a walk, experienced palpitations and dizziness; the Apple Watch® alerted him of an elevated heart rate. He recorded a single-lead ECG with the watch, recognizing an abnormal electrocardiogram, then he sought for immediate medical assistance. After few minutes ICD delivered a shock. The patient underwent further evaluation and radiofrequency ablation to successfully treat the ventricular tachycardia.

Wearable technologies, like the Apple Watch®, hold a promise in detecting arrhythmias, as demonstrated by the Apple Heart Study's high sensitivity and specificity for atrial fibrillation detection. This case emphasizes the importance of correlating symptoms with smartwatch-recorded ECGs, especially when receiving a elevated heart rate alert. Limitations include reliance on user activation and potential challenges in recognizing artifacts in single-lead ECGs. However, in high-risk patients, smartwatches may complement existing devices, potentially reducing mortality by aiding in early intervention and optimizing ICD programming.

The presented case emphasizes the potential of smartwatches in identifying ventricular arrhythmias, especially in high-risk individuals. Despite the existence of many challenges, the integration of wearable technologies into clinical care could enhance arrhythmia detection, reduce unnecessary shocks, and therefore improve patient outcomes. Future research could explore the role of smartwatches as a non-invasive alternative to implantable rhythm monitoring devices.