Guarnieri Gianluca, Mapelli Massimo, Moltrasio Massimo, Agostoni Piergiuseppe, Tondo Claudio
Centro Cardiologico Monzino IRCCS, 20138, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy.
Heliyon. 2024 Nov 21;10(23):e40595. doi: 10.1016/j.heliyon.2024.e40595. eCollection 2024 Dec 15.
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.
传统的筛查方法，如12导联心电图（ECG）和动态心电图监测仪，在检测短暂性心律失常方面往往存在不足。然而，可穿戴技术的进步，如苹果手表（Apple Watch®），通过专用算法能够实现实时心律监测和特定心律失常检测。
一名60岁男性，有致心律失常性心肌病病史且植入了心脏复律除颤器（ICD），在散步时出现心悸和头晕；苹果手表（Apple Watch®）提醒他心率升高。他用手表记录了单导联心电图，发现心电图异常，随后立即寻求医疗帮助。几分钟后ICD进行了一次电击。患者接受了进一步评估并进行了射频消融术，成功治疗了室性心动过速。
如苹果手表（Apple Watch®）这类可穿戴技术在检测心律失常方面具有潜力，苹果心脏研究对房颤检测的高敏感性和特异性就证明了这一点。该病例强调了将症状与智能手表记录的心电图相关联的重要性，尤其是在收到心率升高警报时。局限性包括依赖用户激活以及在识别单导联心电图中的伪差时可能面临的挑战。然而，在高危患者中，智能手表可能会补充现有设备，通过协助早期干预和优化ICD编程，有可能降低死亡率。
本病例强调了智能手表在识别室性心律失常方面的潜力，尤其是在高危个体中。尽管存在诸多挑战，但将可穿戴技术整合到临床护理中可以增强心律失常检测，减少不必要的电击，从而改善患者预后。未来的研究可以探索智能手表作为植入式心律监测设备的非侵入性替代方案的作用。
