Smartwatch a new tool in the assesment of ischaemic heart disease

Abstract

Abstract Introduction Outpatient ECG tracing is getting more important. Therefore, an everyday tool such as the watch has become "smart" (127.5 M units sold in 2021), and its key application is the heart rate measurement through ECG tracing. Some devices are already approved for atrial fibrillation detection. However, their role in ischemic heart disease (IHD), leading cause of cardiovascular death, has not been appropriately tested. Objetcive The aim of this study was to evaluate the usefulness of smartwatch ECG registry in IHD. Methods We present an observational study of 25 consecutive patients with acute IHD. Conventional ECG and smartwatch tracing were obtained simultaneously at admission. Waves of conventional and smartwatch ECGs were objectively compared. A survey on medical attitude was conducted among 12 physicians (3 cardiologists, 3 intensivists, 3 emergency physicians, and 3 general practitioners) and a score (1–5) of concordance between the records was requested. Figure 1. Results There were no differences in Q-wave, Rwave, ST segment, or T-wave. There was a very strong correlation between ST segments, a strong correlation in Q-waves and R-waves, and a moderate correlation in T-wave measurements. All specialists obtained a high level of agreement (4.45 ± 0.45). Smartwatch tracings would lead to similar management compared to conventional ECG. There were only 6 (2%) discrepant cases due to differences in inferior repolarization, showing an almost perfect agreement (kappa = 0.96). Conclusions In most patients with acute IHD, smartwatch ECG tracing is a reliable tool to make the diagnosis and guide appropriate medical care. However, due to their intrinsic limitations, inferior myocardial infarctions may be missed and require a conventional 12-lead ECG to rule them out.