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Related Concept Videos

Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

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Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
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Electrocardiogram01:29

Electrocardiogram

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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Holter Monitor: 24-Hour Monitoring01:23

Holter Monitor: 24-Hour Monitoring

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Holter monitoring is a continuous electrocardiography (ECG) recording that tracks the heart's electrical activity over an extended period, generally 24 to 48 hours. This noninvasive diagnostic tool detects irregular heart rhythms that may not be captured during a standard ECG performed in a clinical setting.DeviceThe Holter monitor is a portable, small device connected to several electrodes on the patient's chest. These electrodes detect the heart's electrical signals and transmit them to the...
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Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Related Experiment Video

Updated: Jan 16, 2026

Patient Directed Recording of a Bipolar Three-Lead Electrocardiogram using a Smartwatch with ECG Function
05:03

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From Wrist to Precision: Enhanced Atrial Flutter Detection with Modified Smartwatch Single-Lead Electrocardiogram

Yuval Avidan1, Amir Aker1,2, Razi Khoury1

  • 1Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.

CJC Open
|September 26, 2025
PubMed
Summary

Smartwatch atrial flutter detection is inaccurate with standard lead-I ECG. Modifying lead-II positioning significantly improves atrial flutter diagnosis accuracy, aiding clinical decisions.

Keywords:
Smartwatchatrial fibrillationatrial fluttermodified configuration

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrocardiography

Background:

  • Smartwatches like the Apple Watch (AW) are used for detecting atrial fibrillation (AF).
  • Traditional single-lead ECG configurations may misdiagnose atrial flutter (AFL).
  • Modified smartwatch lead positioning may enhance AFL diagnostic accuracy.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of standard lead-I (AW-I) versus modified lead-II (AW-II) smartwatch ECG configurations for atrial flutter (AFL).
  • To assess the impact of device positioning on AFL detection by physicians across different specialties.

Main Methods:

  • Obtained standard AW-I and modified AW-II ECG recordings from 75 patients (25 AFL, 25 AF, 25 SR).
  • 20 physicians from 4 specialties independently analyzed 100 tracings (75 AW-I, 25 AW-II).
  • Assessed diagnostic accuracy for AFL detection using both configurations.

Main Results:

  • Physicians had poor AFL detection rates with AW-I (11.6%), frequently misdiagnosing it as AF.
  • Diagnostic accuracy for AFL significantly improved with AW-II, exceeding 80% across specialties (P=0.001).
  • Variable atrioventricular conduction was linked to correct AFL diagnosis solely via AW-II (OR 1.85, P=0.012).

Conclusions:

  • Standard smartwatch lead-I ECG configurations are unreliable for AFL detection and prone to misdiagnosis as AF.
  • A simple modification to lead-II positioning substantially enhances smartwatch-based AFL diagnostic accuracy.
  • This AW-II modification is valuable for rhythm identification in clinical decision-making, including post-ablation surveillance.