Consultant Cardiologist, Dr Iqbal Malik, explains why a quarter of the population are now wearing heart rate wearables.
The current craze is to monitor ourselves more and more. Most screening tests in medicine have to be tested thoroughly before they are applied to a whole population. Eg breast screening, bowel screening, using PSA blood test to test for prostrate cancer - they all had to be tested for sensitivity- the ability to detect disease when present, AND specificity -the ability to rule out disease when absent. Almost any screening test carries a downside - if it create anxiety, and leads to more tests to confirm all is well.
Smart Wearables have somehow got into the mainstream with less robust evidence
They could act as a guide - if it keeps alarming on the same things and you need advice, you could get it checked out by a cardiologist. In most cases, I will dismiss it as noise and not a real abnormality. It is more important to get checked if you have symptoms of chest pain, breathlessness or palpitations, or if you are blacking out.
There is a vast choice, and it is hard to put into categories that you might agree with. A chest strap could be more accurate than a wrist strap or ring, for example, but harder to wear. The additional functions you want may also help- Heart rate recovery (HRR) and heart rate variability (HRV) are functions I have been recently asked about recently. A worry about your health or to diagnose palpitations will need a different device to one that needs to track your fitness levels or your sleep quality.
Here is my personal way to do group them. I am not taking about medical grade devices that could be used in a clinic or emergency setting.
1. Smart watches eg Apple, Samsung, Withings, which can take a single lead ECG with a touch of the watch, but track Heart Rate, oxygen level, activity continuously.
Pro: Sensitive
Con: expensive , less specificity , and battery life is a limitation - you will need to charge them every day
2. Heart Rate and rhythm without ECG eg Whoop, Fitbit , Polar
Pro: good for fitness and trends- could we warn constantly, battery life is good
Con: not an ECG, variable HR accuracy and AF detection
3. On the chest wearables eg
- onto your smart phone eg Garmin, Polar
Pro: good for fitness and trends- more accurate for heart rate
Con: not an ECG
4. Monitoring of ECG when you use it- eg Kardia, Wellue . These can take single lead ECGs or more!
Pro: it is an ECG
Con: only when you are touching it- it is not the same as a continuous monitor.
5. Rings that can track heart rates eg Gloring , Oura, ArcX, circular.
Pro: on 24/7, small , constantly wearables and unobtrusive. some can do BP also!
Con: not an ECG- except one company
For more information:
A review of stand alone heart rate monitors:uk.pcmag.com
For information on smart rings:
For information on smart watches:
Dr Iqbal Malik is a consultant cardiologist, specialising in coronary artery disease and structural heart disease including PFO, ASD and the TAVI procedure.
