Hak Seung Lee replied to a Key Question
Key Question · WATCH-LV · AHA Scientific Sessions 2026
How should clinicians act on mixed or negative smartwatch AI-ECG results?
Consumer smartwatch artificial intelligence-enabled electrocardiogram for left ventricular systolic dysfunction: cross-manufacturer validation and serial home monitoring (WATCH-LV)
Jong-Hwan Jang et al.
Hak Seung Lee
Cross-Cutting Cardiology · Seoul National University
Mixed results should be treated as indeterminate. In our cohort they occurred in about half of participants, and their LVSD prevalence (40.3%) was close to baseline (33.6%), so pretest probability should guide what happens next. In referred patients, echocardiography is reasonable. In lower-risk screening, repeat recordings come first, with referral if positivity recurs (for example, ≥2 of 3 days). A consistently negative week (5.7% LVSD) should not override a clinical reason for echocardiography.