There's two features: the irregular heart rhythm notification (available on Series 1 and later) which uses the heart rate sensor and is passively monitoring you, and the ECG app (only available on Series 4) which is an actual ECG (lead 1).
>If the PPG-based arrhythmia detection is enabled, each tachogram is classified using a proprietary algorithm to determine if an irregular rhythm may be present. An irregular tachogram initiates a cascade of more frequent tachogram collection (as frequently as possible, subject to a minimum spacing of 15 minutes) and analysis. Tachograms are collected and analyzed only if the user remains still enough to obtain a reading; because of this, the algorithm is not always monitoring the user, but rather is doing so opportunistically when adequate signal is available for collection/analysis. If five out of six sequential tachograms (including the initial one) are classified as irregular within a 48-hour period, the user is notified of the potential arrhythmia. In addition to the notification, the user can access more information related to these irregular tachograms within the Health app (Figure 1). If two tachograms are classified as not irregular before the threshold is reached, the cycle is reset and tachogram collection returns to the baseline rate (every two hours).
Apple published a white paper and a mini site for medical professionals about it [1][2].
I’ve got the Kardia and had the opposite experience. I was having heart palpitations and was convinced I was dying even though every time I went to the cardiologist they said it was just premature contractions and nothing to worry about.
Since it was intermittent, I was convinced they just weren’t capturing the afib while it was happening. The doctor recommended I get the kardia.
After a few weeks of compulsively checking the kardia every time I had a palpitations it kept saying over and over again ‘normal’. I even captured a few that had visible skipped beats and sent them in to their technicians and they said ‘pvcs’, the same thing the cardiologist told me.
After a month or so, I finally convinced myself I wasn’t dying and the pvcs slowed down to the point where I barely noticed them.
Turns out that anxiety about heart palpitations causes heart palpitations which is sort of fucked if you think about it.
I basically quit caffeine, started exercising more and now I just get pvcs for a few minutes every few weeks or so instead of for hours every few days.
So yeah, if you have any anxiety about heart stuff at all, I recommend getting the new watch.
That's happened to me, too. Worst episode I ever had was in India earlier this year, while dealing with jet lag and a significant case of gastrointestinal poisoning, my PVCs stepped up to once every two-three beats. For a short time, they spiraled into some form of SVT (not formally diagnosed as this was before I started carrying an EKG on me) that resulted in visible chest movement (as in you could stand in front of me and watch my chest shaking) and a 240 bpm reading on my Apple Watch. Good times. Between being absolutely run-over-by-train tired and having (likely) electrolyte imbalances due to the impossibly large amount of liquid going in one end and out the other, my heart was not at all pleased.
Now that I'm back on my routine schedule, I find that everything is mostly okay if I get a full night's sleep and take my meds. Even with the meds, though, if I get woken up by the kids or something and get a half-night of sleep, the PVCs ramp up quite a bit. As does the temptation to find some caffeine, which would be completely counterproductive.
It's not worth speculating if Watches and other gizmos make men go to the doctor more often or whatever. This is not the first nor the last gizmo. Blah blah blah, some benefit, but not a huge one. Otherwise some other gizmo would have long ago radically improved men's health, but the difference in mortality between men and women and men's fewer encounters with medicine persists since decades ago.
If every otherwise healthy man went to their doctor for a checkup today, how many would have their Afib detected? EKGs are not routinely given during checkups, and Afib is not necessarily constant enough that a doctor will catch it during those few moments he has the stethoscope on your chest. And even if it is happening he may not pick up on it.
Afib is relatively common (2% to 9% depending on age), and so is outwardly healthy people dropping dead with no prior warning. The premise that a 24x7 Afib detector on your wrist will save lives is quite plausible.
Now, what you may get from this post is that you should get an EKG once in a while, and not buy an Apple Watch or other gizmo for that purpose, but to suggest that merely visiting the doctor will achieve a similar result is obviously incorrect.
Just because two things are "common" does not mean they are related. Afib is way, way down on the list of things causing outwardly healthy people to drop dead.
Apple as the world's leading health tech company is currently underrated and not widely thought about.
Despite a confused and unfocused introduction, the genesis of the Apple Watch came about when Steve Jobs was ill and had to experience the issues with the healthcare system first hand. It's been documented that the watch project came about as a result of this experience and the true goal for it is to contribute significantly to improvements across health and the broader healthcare system.
The biggest issue with introducing a new wearable product is having users happily wear it. In recent times, only Apple has been successful in doing so. This shouldn't be dismissed as it will give them a market advantage for decades to come.
Meanwhile, the Android OEMs that tried to get in front of the Apple Watch by rushing their own products to market seem forever condemned to third-class marketshare. What happened?
Apple managed to get people happy to wear a computer on their body for most of their waking hours. Even 10 years ago such a thing would have been considered far fetched.
They called this computer a watch so that people had a shortcut to think about its utility and placement on the body.
They then introduced it as a high-end fashion item (e.g. in gold) to ensure that style makers can't dismiss it as simply a geek low end piece of technology. It didn't need to continue to be a high end item but by introducing it as this, it managed to allay any potential initial low end connotations.
They managed to make it a high-end fashion item by hiring some of the most experienced people in luxury goods. People such as the former CEO of Burberry, the former CEO of Yves Saint Laurent and world class designers such as Marc Newson.
What did Android OEMs do? They slapped some technology together, grabbing an OS from Google and a processor from Qualcomm. Lately they've tried partnering. None of it will work and they should just give-up trying to compete with such a multi-faceted approach that Apple is taking with wearables.
Good to see they got FDA approval for ECG. Anyway, I wish they could measure glucose levels without going under skin which is still far from happening.
I went on a weird diet of pure fat once and my wife could feel my heart was skipping a beat.
Went to a cardiologist and he told me to stop, though he said it might be a virus. I wore a machine for a day and it was showing loads of missed beats.
No symptoms since.
Worth doing if you ever suspect anything with your heart.
I've had afib and it's not as scary as "heart problem" and "cardiologist" makes it sound like. Where I live at least, you don't even go to a cardiologist but an electrophysiologist and if you get the operation, it's a same-day in and out or maybe one night procedure with 85% success rate.
That seems very anecdotal. For some people the first symptom of their Afib will be sudden death. That it doesn't present for everyone that way does not make it trivial.
Also, an electrophysiologist IS a cardiologist, with an additional couple years of specialization. Ablations are still considered invasive surgery and they do carry some risks.
Now if you told me PVCs are not scary, I'd probably agree. I get 5K-30K of them every day, depending on some factors. Definitely not up there with Afib.
"first symptom of their Afib will be sudden death" - citation?
It's clearly possible, as is the risk of death from pulmonary embolism after flying on a plane - but that doesn't mean that we should screen all flyers for pulmonary embolism.
I had an ablation, don’t know enough to know if it was “radio-frequency”. Home that night once they concluded that I wasn’t going to bleed out from the leg vein punctures.
That said, I would not have the same casual attitude of parent. Poking holes in your heart, no matter how small, is not without risk. And it is my understanding that most people stay overnight after an ablation.
Anyone know - can I stop in an Apple Store and try this on a demo watch which is out for display, or do you have to be logged-in to iCloud and paired to a phone for it to work?
Don't know about demo at Apple Store but setup of ECG required Health app on my iPhone. So if you already have an iPhone, you can just 'buy' the watch, use it for couple of weeks and return it if it doesn't interest you using Apple 14 day return policy.
I don't understand something from the the reddit thread. He said his heart rate was finally down from 120-140. If that's your non-exertion heart rate, isn't that a pretty good sign that you should see a doctor? Apart from any more sophisticated diagnosis?
Yeah, if your heart is beating that fast, you should go see a doctor... If a fast heart rate is accompanied by other symptoms (feeling light-headed, short of breath, etc), call an ambulance.
I’ve had a handful of those episodes over the summer but only after heavy exertion. Running stairs for 4 hours at an indoor water park, TKD sparring, and once or twice after very stressful events. I wrote it all off to a stressful year with unique occurrences. That morning I just happened to be paying attention and the Watch was the final straw that made it click.
Pardon for asking, but if you’re doing TKD sparring, my hunch is that you’re otherwise pretty fit? I do a lot of aikido as my primary source of cardio exercise, and my resting heart (Apple Watch 3, now thinking about the 4) is quite low (low/mid 50s). I have no idea what my heartrate is when I’m at peak exertion, because I can’t practically wear the watch on the mat, but I suspect it’s probably up pretty high.
So, if I understand things correctly, your doctor would otherwise probably look at you and be like, “nah, don’t need to worry about this guy’s heart.” Is that fair to say?
So, if I understand things correctly, your doctor would otherwise probably look at you and be like, “nah, don’t need to worry about this guy’s heart.” Is that fair to say?
Not OP, and I’m sure as hell not a cardiologist, but I would have fit that description. Wolfes-Parkinson, and would only rarely raise its head under narrow circumstances involving exertion. If you looked at my heart (which they did) and it didn’t repro the problem, you’d never know the difference. Former Cat 1 bike racer, and pretty damned good distance runner, I was for sure fit. But you can’t outrun genetics.
HR of 145bpm an hour after exercise told me, “something ain’t right”, abalation fixed it. I’m not diagnosing, and odds are darned good that OP doesn’t have my problem, but if it were me I’d pay a visit to doctor. Being fit doesn’t exclude one from heart problems. Wolfes-Parkinson killed a college ball player many years ago, and I personally witnessed a 35 year old Cat2 bike racer drop dead mid-race from what I suspect was Wolfes-Parkinson or a similar heart-related anomaly (again, IANACardiologist).
And as a side note, I wish the Apple Watch were around fifteen years ago. In an attempt to get a repro, I wore this inconvenient contraption for a few weeks (no repro). I know it’s only single lead, but at least I would have had something to record data when the problem repro’ed. And were the watch to have picked up something, I would have gone to the doctor a lot sooner because at least I had a tool that’s probably better than Dr. Google. As it was, “I should make a doctor appointment. Meh, probably nothing.” Men...amirite?
> pressure still elevated around 125/80
Elevated? 120/80 is perfect. 135/x seems only a bit worrying for everyone around me. I recently had around 150/x for whole week.
I know something is going on, keeping on doing the checks, but saying 125/80 is elevated sounds so silly to me. I've never seen such nice pressure on myself.
I have a lousy family history with heart issues, stokes, on and on. After a lousy year mine hit pre-hyper and I worked on stress reduction and more exercise. I was monitoring BP regularly. That was high for me compared to the past few years.
The reddit post was interesting but not helpful (actionable) for other patients.
In the USA, if you experience the symptoms of a heart attack, you just take a taxi to the emergency ward, walk up to the receptionist and say, "I think I'm having a heart attack."
You will get priority over everybody else, minimal forms, and you don't need insurance to get initial treatment.
If you can think of other reasons for the symptoms, like you went to the gym for the first time the day before and have chest muscle soreness, then you can just sit in the lobby while you sort things out. (Walking up a flight of stairs at the hospital is a good DIY stress test. Some on-call doctors actually ask what entrance you arrived at, and if there's a ramp, they know you're prolly ok if you walked in.)
45 comments
[ 2.4 ms ] story [ 87.9 ms ] thread>If the PPG-based arrhythmia detection is enabled, each tachogram is classified using a proprietary algorithm to determine if an irregular rhythm may be present. An irregular tachogram initiates a cascade of more frequent tachogram collection (as frequently as possible, subject to a minimum spacing of 15 minutes) and analysis. Tachograms are collected and analyzed only if the user remains still enough to obtain a reading; because of this, the algorithm is not always monitoring the user, but rather is doing so opportunistically when adequate signal is available for collection/analysis. If five out of six sequential tachograms (including the initial one) are classified as irregular within a 48-hour period, the user is notified of the potential arrhythmia. In addition to the notification, the user can access more information related to these irregular tachograms within the Health app (Figure 1). If two tachograms are classified as not irregular before the threshold is reached, the cycle is reset and tachogram collection returns to the baseline rate (every two hours).
Apple published a white paper and a mini site for medical professionals about it [1][2].
[1] https://www.apple.com/healthcare/site/docs/Apple_Watch_Arrhy...
[2] https://www.apple.com/healthcare/apple-watch/
Since it was intermittent, I was convinced they just weren’t capturing the afib while it was happening. The doctor recommended I get the kardia.
After a few weeks of compulsively checking the kardia every time I had a palpitations it kept saying over and over again ‘normal’. I even captured a few that had visible skipped beats and sent them in to their technicians and they said ‘pvcs’, the same thing the cardiologist told me.
After a month or so, I finally convinced myself I wasn’t dying and the pvcs slowed down to the point where I barely noticed them.
Turns out that anxiety about heart palpitations causes heart palpitations which is sort of fucked if you think about it.
I basically quit caffeine, started exercising more and now I just get pvcs for a few minutes every few weeks or so instead of for hours every few days.
So yeah, if you have any anxiety about heart stuff at all, I recommend getting the new watch.
Now that I'm back on my routine schedule, I find that everything is mostly okay if I get a full night's sleep and take my meds. Even with the meds, though, if I get woken up by the kids or something and get a half-night of sleep, the PVCs ramp up quite a bit. As does the temptation to find some caffeine, which would be completely counterproductive.
Sorry for the wall of text.
(2) That if you don't see that's the premise, you're being naive. Why would otherwise anyone care about some Redditor's doctor visit?
(3) That the underlying public health issue isn't the lack of Apple Watches.
The overwhelming consensus is that men don't see out health help as much as women do. Peruse through this (https://scholar.google.com/scholar?q=related:y2_y94H6XCwJ:sc...) if you're not persuaded.
It's not worth speculating if Watches and other gizmos make men go to the doctor more often or whatever. This is not the first nor the last gizmo. Blah blah blah, some benefit, but not a huge one. Otherwise some other gizmo would have long ago radically improved men's health, but the difference in mortality between men and women and men's fewer encounters with medicine persists since decades ago.
Afib is relatively common (2% to 9% depending on age), and so is outwardly healthy people dropping dead with no prior warning. The premise that a 24x7 Afib detector on your wrist will save lives is quite plausible.
Now, what you may get from this post is that you should get an EKG once in a while, and not buy an Apple Watch or other gizmo for that purpose, but to suggest that merely visiting the doctor will achieve a similar result is obviously incorrect.
I asked the doctor if I should be getting checked like this regularly.
“Do you feel okay?”, he asked. I said yep. “Then no”, he said.
Despite a confused and unfocused introduction, the genesis of the Apple Watch came about when Steve Jobs was ill and had to experience the issues with the healthcare system first hand. It's been documented that the watch project came about as a result of this experience and the true goal for it is to contribute significantly to improvements across health and the broader healthcare system.
The biggest issue with introducing a new wearable product is having users happily wear it. In recent times, only Apple has been successful in doing so. This shouldn't be dismissed as it will give them a market advantage for decades to come.
They called this computer a watch so that people had a shortcut to think about its utility and placement on the body.
They then introduced it as a high-end fashion item (e.g. in gold) to ensure that style makers can't dismiss it as simply a geek low end piece of technology. It didn't need to continue to be a high end item but by introducing it as this, it managed to allay any potential initial low end connotations.
They managed to make it a high-end fashion item by hiring some of the most experienced people in luxury goods. People such as the former CEO of Burberry, the former CEO of Yves Saint Laurent and world class designers such as Marc Newson.
What did Android OEMs do? They slapped some technology together, grabbing an OS from Google and a processor from Qualcomm. Lately they've tried partnering. None of it will work and they should just give-up trying to compete with such a multi-faceted approach that Apple is taking with wearables.
Went to a cardiologist and he told me to stop, though he said it might be a virus. I wore a machine for a day and it was showing loads of missed beats.
No symptoms since.
Worth doing if you ever suspect anything with your heart.
Why? Was this in attempt to get to ketosis?
Also, an electrophysiologist IS a cardiologist, with an additional couple years of specialization. Ablations are still considered invasive surgery and they do carry some risks.
Now if you told me PVCs are not scary, I'd probably agree. I get 5K-30K of them every day, depending on some factors. Definitely not up there with Afib.
It's clearly possible, as is the risk of death from pulmonary embolism after flying on a plane - but that doesn't mean that we should screen all flyers for pulmonary embolism.
This site has a useful risk calculator for risk of complications of a-fib: http://www.zunis.org/FHS%20Afib%20Risk%20Calculator.htm
Could you expand on that? Radio-frequency ablation is not something that is done the same day.
That said, I would not have the same casual attitude of parent. Poking holes in your heart, no matter how small, is not without risk. And it is my understanding that most people stay overnight after an ablation.
So, if I understand things correctly, your doctor would otherwise probably look at you and be like, “nah, don’t need to worry about this guy’s heart.” Is that fair to say?
Not OP, and I’m sure as hell not a cardiologist, but I would have fit that description. Wolfes-Parkinson, and would only rarely raise its head under narrow circumstances involving exertion. If you looked at my heart (which they did) and it didn’t repro the problem, you’d never know the difference. Former Cat 1 bike racer, and pretty damned good distance runner, I was for sure fit. But you can’t outrun genetics.
HR of 145bpm an hour after exercise told me, “something ain’t right”, abalation fixed it. I’m not diagnosing, and odds are darned good that OP doesn’t have my problem, but if it were me I’d pay a visit to doctor. Being fit doesn’t exclude one from heart problems. Wolfes-Parkinson killed a college ball player many years ago, and I personally witnessed a 35 year old Cat2 bike racer drop dead mid-race from what I suspect was Wolfes-Parkinson or a similar heart-related anomaly (again, IANACardiologist).
And as a side note, I wish the Apple Watch were around fifteen years ago. In an attempt to get a repro, I wore this inconvenient contraption for a few weeks (no repro). I know it’s only single lead, but at least I would have had something to record data when the problem repro’ed. And were the watch to have picked up something, I would have gone to the doctor a lot sooner because at least I had a tool that’s probably better than Dr. Google. As it was, “I should make a doctor appointment. Meh, probably nothing.” Men...amirite?
I know something is going on, keeping on doing the checks, but saying 125/80 is elevated sounds so silly to me. I've never seen such nice pressure on myself.
In the USA, if you experience the symptoms of a heart attack, you just take a taxi to the emergency ward, walk up to the receptionist and say, "I think I'm having a heart attack."
You will get priority over everybody else, minimal forms, and you don't need insurance to get initial treatment.
If you can think of other reasons for the symptoms, like you went to the gym for the first time the day before and have chest muscle soreness, then you can just sit in the lobby while you sort things out. (Walking up a flight of stairs at the hospital is a good DIY stress test. Some on-call doctors actually ask what entrance you arrived at, and if there's a ramp, they know you're prolly ok if you walked in.)