Smartwatches can Detect Irregular Cardiac Rhythms in kids

According to a recent Stanford School of Medicine study, smartwatches can help clinicians detect and diagnose abnormal cardiac rhythms in youngsters. The research was based on a review of electronic medical data for pediatric cardiology patients at Stanford Medicine Children’s Health. The work will be published online in Communications Medicine on December 13th.

Patients’ medical records mentioned “Apple Watch” 145 times during a four-year span. Among patients whose medical records indicated the smartwatch, 41 had irregular heart rhythms confirmed by traditional diagnostic procedures; 29 of these youngsters were diagnosed with arrhythmias for the first time.

“I was surprised by how often our standard monitoring didn’t pick up arrythmias and the watch did,” said senior study author and pediatrics professor Scott Ceresnak, MD. Ceresnak works as a pediatric cardiologist at Stanford Medicine. “It’s awesome to see that newer technology can really make a difference in how we’re able to care for patients.”

Aydin Zahedivash, MD, a clinical lecturer in pediatrics, is the study’s lead author.

Ceresnak stated that the majority of the aberrant rhythms discovered were not life-threatening. However, he said that the arrhythmias discovered can result in uncomfortable symptoms such as a racing heart, dizziness, and fainting.

Doctors encounter two obstacles when diagnosing children’s cardiac arrythmias, or heart rhythm disorders.

The first is that, while cardiac diagnostic equipment have improved in recent years, they are still not suitable for children. Ten to twenty years ago, a youngster had to wear a Holter monitor for 24 to 48 hours, which consisted of a gadget approximately the size of a smartphone connected by wires to five electrodes glued to the child’s chest. Patients can now wear event monitors for a few weeks, which take the shape of a single sticker placed on the breast. Although event monitors are more comfortable and can be worn for longer periods of time than Holter monitors, they can fall off prematurely or cause skin irritation due to adhesives.

The second problem is that even a few weeks of continuous monitoring may not catch the heart’s unpredictable behavior, as arrythmias occur unpredictably in children. Children may go months without bouts, making it difficult for doctors to figure out what’s wrong.

Connor Heinz and his family confronted both obstacles when he began experiencing racing heartbeats at the age of 12: An adhesive monitor was too bothersome for him, and he only had aberrant cardiac beats every several months. Ceresnak had a theory about what was producing the racing beats, but he needed evidence. He advised that Connor and his mother, Amy Heinz, try recording the beat on Amy’s smartwatch the next time Connor’s heart started racing.

The use of smartwatches to measure children’s heart rhythms is limited since present smartwatch algorithms for detecting cardiac issues have not been tuned for children. Children have faster heartbeats than adults, and they also have distinct forms of aberrant rhythms than adults with cardiac arrhythmias.

The article demonstrated that smartwatches appear to aid in the detection of arrhythmias in children, implying that it would be beneficial to create versions of the smartwatch algorithms based on real-world cardiac rhythm data from children.

Medical record evaluation
From 2018 to 2022, the researchers searched patients’ electronic medical records for the word “Apple Watch,” then looked to see which patients had submitted smartwatch data and obtained a diagnosis of cardiac arrhythmia.

Data from watches included heart rate alerts and patient-initiated electrocardiograms, or ECGs, from an app that uses the watch’s electrical sensors. When patients launch the app, the ECG function records the electrical impulses of the heart; clinicians can utilize this pattern of electrical pulses to identify many types of cardiac disorders.

41 individuals had arrhythmias confirmed from 145 mentions of the wristwatch in healthcare records. 18 of these patients had obtained an ECG with their watches, and 23 had received a high heart rate notification from the watch.

The data from the smartwatches encouraged the children’s doctors to undergo medical workups, which resulted in 29 new arrythmia diagnoses. The smartwatch detected arrythmias that standard monitoring methods had missed in ten patients.

Connor Heinz was one of those patients

“At a basketball tryout, he had another episode,” Amy Heinz remembered. “I put the watch on him and emailed a bunch of captures [of his heartbeat] to Dr. Ceresnak.” Ceresnak’s hunch that Connor had supraventricular tachycardia was verified by the information from the watch.

Most children with arrythmias had the same condition as Connor, a pattern of racing heartbeats originating in the heart’s upper chambers.

“These irregular heartbeats are not life-threatening, but they make kids feel terrible,” she said. “They can be a problem and they’re scary, and if wearable devices can help us get to the bottom of what this arrythmia is, that’s super helpful.”

In many cases of supraventricular tachycardia, the abnormal heart rhythm is caused by a small short-circuit in the heart’s electrical circuitry. The problem can often be cured by a medical procedure called catheter ablation that destroys a small, precisely targeted region of heart cells causing the short circuit.

Now 15, Connor has been successfully treated with catheter ablation and is playing basketball for his high school team in Menlo Park, California.

The study also found smartwatch use noted in the medical records of 73 patients who did not ultimately receive diagnoses of arrythmias.

“A lot of kids have palpitations, a feeling of funny heartbeats, but the vast majority don’t have medically significant arrythmias,” he said. “In the future, I think this technology may help us rule out anything serious.”

A new study

The Stanford Medicine research team plans to conduct a study to further assess the utility of the Apple Watch for detecting children’s heart problems. The study will measure whether, in kids, heart rate and heart rhythm measurements from the watches match measurements from standard diagnostic devices.

The study is open only to children who are already cardiology patients at Stanford Medicine Children’s Health.

“The wearable market is exploding, and our kids are going to use them,” Ceresnak said. “We want to make sure the data we get from these devices is reliable and accurate for children. Down the road, we’d love to help develop pediatric-specific algorithms for monitoring heart rhythm.”

The study was conducted without external funding. Apple was not involved in the work. Apple’s Investigator Support Program has agreed to donate watches for the next phase of the research.

Apple’s Irregular Rhythm Notification and ECG app are cleared by the Food and Drug Administration for use by people 22 years of age or older. The high heart rate notification is available only to users 13 years of age or older.

Source Link