Wearable Arrhythmia Detection: Moving from your Watch to your Shirt?

Digital devices play an increasingly important role in the detection and screening of cardiac arrhythmias. Atrial fibrillation (AF), the most common arrhythmia, is associated with an increased risk of stroke, heart failure, and mortality. This review summarises the current evidence on wearable devices for screening and diagnosing atrial fibrillation.

Numerous studies have demonstrated the value of wearables for AF detection and diagnosis. In addition, artificial intelligence enhances automated rhythm analysis and signal processing, supporting the increasing clinical implementation of digital technologies in outpatient care. Single-lead ECG devices provide the strongest evidence for AF detection, with smartwatches representing one of the most extensively investigated wearable technology. Limitations include motion artefacts and predominantly semi-continuous monitoring. Future research should focus on integrating artificial intelligence to improve signal analysis and artefact reduction, and on evaluating the impact of wearable-based strategies on clinically relevant outcomes, including stroke and heart failure.