Apple Watch ECG detects heart condition in German woman
The ECG function of the Apple Watch has been credited with uncovering a heart condition in an 80-year-old woman in Germany, one that was seemingly missed by a hospital's own ECG during a diagnosis.
The Apple Watch has repeatedly appeared in stories where it warned wearers of possible heart problems, and has been praised for being an early warning system for serious cardiovascular issues. In one recently reported case, the Apple wearable actually provided better evidence of a condition than a hospital's own equipment.
In a report published in the European Heart Journal on Wednesday and spotted by 9to5Mac, an 80-year-old woman attended the University Medical Center Mainz of Johannes Gutenberg University, Germany, with what was described as "typical angina symptoms." The patient also advised of two praesyncopy episodes, a situation where a person almost loses consciousness due to reduced flow of oxygenated blood to the brain.
Based on the presented details, and the female engineer's previous diagnosis of arterial hypertension, paroxysmal atrial fibrillation, and having had a pulmonary embolism two years prior, doctors performed an initial 12-channel ECG. The test didn't see any evidence for ischaemia, which is a restriction in blood vessels that can restrict the blood supply.
Despite the hospital's own equipment not showing ischaemia, doctors were then convinced there was a related issue by the patient complaining about earlier ectopic beat episodes, which she recorded by using the ECG function of her Apple Watch. The recordings also included tracings with marked ST-segment depression, evidence that led to the medical team omitting further diagnostic measures in favor of treatment.
![[via European Heart Journal]](https://photos5.appleinsider.com/gallery/35626-65545-ehaa290f1-l.jpg)
[via European Heart Journal]
In effect, the Apple Watch ECG recordings showed evidence of an issue that didn't appear in the hospital's specialized equipment, and successfully convinced doctors to treat the patient.
The woman was transferred to a catheterization laboratory for a "left main stem stenosis and a left anterior descending/diagonal bifurcation lesion," and treatment with coronary artery stenting. The patient left the hospital the next day.
It is suggested by the report that the Apple Watch "may be used not only to detect atrial fibrillation or atrioventricular-conduction disturbances but also to detect myocardial ischaemia."
Current speculation for the Apple Watch Series 6 suggests the next generation of Apple Watch may include a feature for blood oxygen detection, as well as an upgraded ECG capable of working at higher heart rate ranges than the version introduced in the Apple Watch Series 4.
The Apple Watch has repeatedly appeared in stories where it warned wearers of possible heart problems, and has been praised for being an early warning system for serious cardiovascular issues. In one recently reported case, the Apple wearable actually provided better evidence of a condition than a hospital's own equipment.
In a report published in the European Heart Journal on Wednesday and spotted by 9to5Mac, an 80-year-old woman attended the University Medical Center Mainz of Johannes Gutenberg University, Germany, with what was described as "typical angina symptoms." The patient also advised of two praesyncopy episodes, a situation where a person almost loses consciousness due to reduced flow of oxygenated blood to the brain.
Based on the presented details, and the female engineer's previous diagnosis of arterial hypertension, paroxysmal atrial fibrillation, and having had a pulmonary embolism two years prior, doctors performed an initial 12-channel ECG. The test didn't see any evidence for ischaemia, which is a restriction in blood vessels that can restrict the blood supply.
Despite the hospital's own equipment not showing ischaemia, doctors were then convinced there was a related issue by the patient complaining about earlier ectopic beat episodes, which she recorded by using the ECG function of her Apple Watch. The recordings also included tracings with marked ST-segment depression, evidence that led to the medical team omitting further diagnostic measures in favor of treatment.
[via European Heart Journal]
In effect, the Apple Watch ECG recordings showed evidence of an issue that didn't appear in the hospital's specialized equipment, and successfully convinced doctors to treat the patient.
The woman was transferred to a catheterization laboratory for a "left main stem stenosis and a left anterior descending/diagonal bifurcation lesion," and treatment with coronary artery stenting. The patient left the hospital the next day.
It is suggested by the report that the Apple Watch "may be used not only to detect atrial fibrillation or atrioventricular-conduction disturbances but also to detect myocardial ischaemia."
Current speculation for the Apple Watch Series 6 suggests the next generation of Apple Watch may include a feature for blood oxygen detection, as well as an upgraded ECG capable of working at higher heart rate ranges than the version introduced in the Apple Watch Series 4.
Comments
Now, A next-gen AppleWatch or even IR detecting AirPod (alone or linked) could sense coughing, sneezing, temperature, moisture, stats and provide a data diagnosis.
You can clearly see
- The arhythmic QRS complex.
- The missing P wave.
- The overall character of the QRS complex, and how it's the same beat-to-beat (always a qRs).
- The shape of the T wave. Absolute and relative refractory.
- The QT interval
This is diagnostic-quality, without a doubt. I particularly like how you can tell the patient's heart was expecting to have longer for the T at 13.16 seconds, but it was abruptly shortened for the qRs at 13.32 seconds. The Q to T-peak interval on the subsequent beats is noticeably shorter.Exactly. A lot of heart issues only present relatively briefly. The situation above disappeared after about an hour, which is not generally enough time to get into an emergency room (without also being grievously injured, anyway), let alone to a cardiologist. The options are either monitoring over a really long period of time (certainly longer than anyone would want to be hooked up to a 12-lead), or using a personal ECG. A lot of doctors definitely realize this, and realize any hard data showing an issue is better than no data.
That it wasn't caught in hospital but later on the Watch isn't that surprising since, as somebody just mentioned, the episodes are short. But the Watch did catch it, and if she weren't wearing it, she wouldn't have received treatment when she did.
I don't know that it saved her life, but I'm sure she and any friends and family are happy she was wearing it.
Playing around with the watch I've seen all kinds of "irregularities" when I one way or another have felt off; but I haven't got a clue if any of them are signs of a five minutes life expectancy, or not.
And since I'm not about to become that guy that runs to the emergency room every few days I feel like there's a gap here; a gap between the capabilities of my watch to potentially save my life, and me being able to understand the data that I'm given.
I'm retired from a long career designing diagnostic ECG equipment, including ambulatory (worn-at-home) monitors. The Apple Watch is certainly no toy. Both of my parents have had A-Fib for years, and my Apple Watch was able to detect it in both of them. I routinely throw PVCs and I've been able to capture them via the watch.
When it comes to understanding the value of various kinds of medical monitoring, there is real understanding and toy understanding.
The important starting point is the down-UP-down. Each feature of an ECG recording has a letter designation. The quick dip down is the Q, the big spike up is the R, and the small dip down afterwards is the S. Taken together, they make up the QRS complex. When talking about the complex in the abstract, the letters are always uppercase. When talking about the specifics, case can vary. For example, qRs indicates a small Q, big R, small S, which is normal. More Q or S amplitude or less R amplitude can indicate certain problems. Some can be missing entirely. There can even be an extra R (called R prime, written R') in some situations.
Each of these features marks the heart doing something. Together, the QRS is the ventricular beat.
Q is the plane between the ventricles contracting in preparation for a ventricular beat.
R is the ventricles beginning their inward contraction.
S is when the contraction ends.
In a normal ECG, there is a bump up a bit before the QRS called the P wave. This wave is from the atria contracting. It is absent in the recording above, indicating the atria were not contracting. That is almost always caused by atrial fibrillation (kind of a quivering twitch rather than a rhythmic beat).
Then after the ventricular beat, the T wave shows the ventricles relaxing.
ECGs are sensitive to movement. When recording one, you should try to be as still as possible. The R is generally visible, even during movement, but the other features may be overwhelmed entirely.
Everybody with an Apple Watch Series 4 or above should collect a baseline ECG, just to have around in case they need it for comparison later.
To be clear about this next part, I have had medical training, but not in a long time. I haven't practiced any form of medicine in years, and this is NOT MEDICAL ADVICE. It is generic.
It is important to note ECGs can be ambiguous and hard to read, even for professionals. If your ECG looks weird, but you feel fine, maybe schedule a low-priority appointment with your doctor to check it out and learn more. If you feel weird, but your ECG looks fine, it's probably not your heart (most urgent heart problems show up on even single-lead ECGs). If you feel weird, but in a way you have felt before, and your ECG looks weird (missing parts like the one above, different shape from beat-to-beat), call your doctor and see what they recommend.
If you feel weird in a new way and your ECG looks weird, think seriously about going to an ER or urgent care clinic.
Edited to add: Somehow I didn't finish the sentence mentioning R' above. Fixed that.