Why is a quarter of the population now wearing heart rate wearables?

Consultant Cardiologist, Dr Iqbal Malik, explains why a quarter of the population are now wearing heart rate wearables.

Why are we wearing heart rate or ECG monitors?

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

These devices are usually NOT as good as those in my clinic

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.

Types of wearables

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: