Photo by Pixabay[/caption]
The Apple Watch ECG feature is a game changer in heart health screening and gives users an easy way to take a single lead ECG from their wrist. The ECG app on the Apple Watch uses an electrical heart sensor to detect the heart's electrical activity and identifies atrial fibrillation (AFib) early on – a condition that, if not treated, can lead to serious consequences including stroke. This is done through a simple process of launching the app and placing the finger on the digital crown for about 30 seconds and the users will have their heart rhythm categorized as normal, AFib, or inconclusive. The results can then be easily sent to healthcare providers through the Health app thus increasing the accessibility of health information.
Accuracy and Reliability
It has been established that the Apple Watch ECG is quite effective in its operation. Clinical studies have shown that the sensitivity of AFib detection using the Apple Watch is more than 98% and specificity is more than 99% compared to the traditional 12 lead ECGs. This high level of accuracy makes the device a good screening tool for the early detection of heart arrhythmias. It is crucial to identify AFib early as this gives patients a chance seek medical attention before complications occur. In this way, the Apple Watch not only provides convenience but also possible life-saving services.
Dr. Singer[/caption]
Daniel E. Singer, MD
Professor of Medicine, Harvard Medical School
Professor in the Department of Epidemiology
Harvard T.H. Chan School of Public Health
Division of General Internal Medicine
Massachusetts General Hospital
Boston, MA, 02114
MedicalResearch.com: What is the background for this study?
Response: Atrial fibrillation (AF) raises the risk of ischemic stroke 4-5-fold and this risk is largely reversible by oral anticoagulants (OAC). These facts are part of the core knowledge of internal medicine and the basis of multiple guidelines. They are based on studies of patients with persistent or predominantly “heavy burden” paroxysmal AF completed in the 1990s.
More recent studies using cardiac implantable devices (CIEDs: implantable defibrillators, pacemakers, etc) which have the capacity to monitor heart rhythm continuously have found that many older patients have brief, often undiagnosed, episodes of AF. Several of these studies have found that strokes occur during periods of sinus rhythm temporally distant from a preceding episode of AF. This has led to a widespread suspicion that AF is not a direct causal risk factor but a risk “marker” indicating the presence of other truly causal features like a diseased left atrium (atrial myopathy). If the risk marker hypothesis is correct, then long-term anticoagulation is needed even for brief and rare episodes of AF (assuming the patient’ s CHA2DS2-VASc score is high enough). The key problem with prior prospective studies using CIEDs was that only a small number of strokes were observed leading to inadequate statistical power.
Our study addressed this power problem by linking the very large Optum electronic health record database which could identify ischemic strokes with the Medtronic CareLink database of long-term, continuous heart rhythm records of patients with CIEDs. We ended up studying 891 individuals who had an ischemic stroke and had 120 days of continuous heart monitoring prior to the stroke.
Dr. Fornwalt[/caption]
Brandon K Fornwalt, MD, PhD
Associate Professor, Director Department of Imaging Science and Innovation
Geisinger
MedicalResearch.com: What is the background for this study?
Response: Atrial fibrillation (AF) is an abnormal heart rhythm that is associated with outcomes such as stroke, heart failure and death. If we know a patient has atrial fibrillation, we can treat them to reduce the risk of stroke by nearly two-thirds. Unfortunately, patients often don’t know they have AF. They present initially with a stroke, and we have no chance to treat them before this happens. If we could predict who is at high risk of either currently having AF or developing it in the near future, we could intervene earlier and hopefully reduce bad outcomes like stroke. Artificial intelligence approaches may be able to help with this task.
Dr. Phelan[/caption]
Dermot Phelan, MD, PhD
Director of the Sports Cardiology Center
Cleveland Clinic in Cleveland, Ohio
MedicalResearch.com: What is the background for this study?
Response: It is well recognized that long-term elite endurance athletes are at higher risk of atrial fibrillation. We wished to evaluate whether this held true for primarily strength-type athletes. We had the opportunity to screen almost 500 former NFL athletes. It became clear that we were seeing more atrial fibrillation than one would expect during the screenings.
Dr. Elgendy[/caption]
Akram Elgendy MD
Division of Cardiovascular Medicine
University of Florida
MedicalResearch.com: What is the background for this study?
Response: Recent clinical trials have demonstrated that percutaneous patent foramen ovale closure is associated with lower risk of stroke recurrence in cryptogenic stroke patients. However, new-onset atrial fibrillation (AF) has been reported as a safety concern. To better understand the risk of new-onset AF, we performed a meta-analysis of PFO closure trials in patients with cryptogenic stroke and migraine.
