Apple Watch Can Detect Irregular Heartbeats in Children

The Apple Watch can record arrhythmias in children, including arrhythmias that were not identified by traditional ambulatory monitors, according to recently published research.

Arrhythmia, or irregular heartbeat, can cause chest pain, dizziness, fatigue, and heart palpitations in children. Cardiomyopathy, congenital health disease, certain medications, and inherited conditions like long QT syndrome are some of the causes of arrhythmias in children.

“These irregular heartbeats are not life-threatening, but they make kids feel terrible,” said senior study author Scott Ceresnak, MD, professor of pediatrics at the Lucile Packard Children’s Hospital Stanford, in a press release. “They can be a problem and they’re scary, and if wearable devices can help us get to the bottom of what this arrhythmia is, that’s super helpful.”

The study, published in the journal Communications Medicine, aims to examine the efficacy of wearable devices like smartwatches in heart monitoring among children. Prior research shows that the Apple Watch can detect a variety of arrhythmias in adults, the study states. But, whether wearables could effectively monitor heart issues in children is less clear, as children have higher heart rates and activity levels than adults.

Thus, researchers from Stanford University, Lucile Packard Children’s Hospital Stanford, and the Stanford Byers Center for Biodesign set out to investigate whether the Apple Watch can detect and characterize arrhythmias in children.

The research team used data for all patients 18 or younger whose arrhythmia was documented by an Apple Watch between 2018 and 2022 and who received a formal arrhythmia diagnosis at Lucille Packard Children’s Hospital Stanford. They collected various data, including patient demographics, the type of arrhythmia identified, and the Apple Watch's role in arrhythmia diagnosis.

Of 145 EHR documentations of Apple Watch use, researchers identified 41 patients with confirmed arrhythmia.

The pediatric patients used their Apple Watch for arrhythmia characterization either through a patient-initiated ECG using the Apple Watch ECG App (44 percent) or the high heart rate notification feature of the Apple Watch ECG App (56 percent).

Thirty-six patients had an arrhythmia diagnosis of supraventricular tachycardia (88 percent), three had ventricular tachycardia (7 percent), one had a heart block (2.5 percent), and one a wide complex tachycardia (2.5 percent).

Invasive electrophysiology studies confirmed arrhythmia diagnosis in 34 of 36 patients with supraventricular tachycardia (94 percent). However, 35 patients (85 percent) also underwent a workup involving a traditional ambulatory cardiac rhythm monitor, and the traditional monitor did not detect an arrhythmia in 10 (29 percent) patients.

The Apple Watch led to a workup resulting in a new arrhythmia diagnosis for 29 patients (71 percent). Seventy-three patients used the Apple Watch for recreational or self-directed heart rate monitoring, of which 18 (25 percent) sought care after receiving abnormal heart rate or rhythm notifications.

“This data demonstrates that consumer wearables such as the Apple Watch may play an important role in arrhythmia diagnosis and surveillance in children,” the researchers concluded.

While research on using the Apple Watch in cardiac care is ongoing, a patent dispute has halted the sale of the latest version of the device.

The company has confirmed to several news outlets that it will stop selling its Apple Watch Series 9 and Apple Watch Ultra 2. The new version of the device includes a feature that enables blood oxygen readings, as well as atrial fibrillation (AFib) history recording and medication tracking capabilities.

However, medical technology company Masimo has alleged that Apple infringed on its blood oxygen sensor patent, NPR reports. The U.S. International Trade Commission ruled in favor of Masimo in October, stating that some Apple Watches violated Masimo's patents. It also issued an import ban on the watches that include the blood oxygen reading capability. Though the ban will take effect on Dec. 26, Apple has acted early.