The Use of Digital Devices in the Management of Athletes with Paroxysmal Arrhythmias During Exercise—A Case Series

Background: Athletes may experience paroxysmal arrhythmias that occur during exercise and are difficult to document using standard diagnostic modalities. Such arrhythmias are often unpredictable, transient, and cannot be reproduced during routine exercise testing or ambulatory electrocardiographic monitoring, leading to prolonged diagnostic pathways and uncertainty regarding management. Methods: This case series presents ten athletes in whom clinically relevant paroxysmal arrhythmias were initially detected using commercially available wearable digital devices, primarily chest-strap heart rate monitors and smartwatches. Results: In most cases, arrhythmias could not be documented using conventional diagnostic methods despite repeated investigations. Most presented athletes were referred for invasive electrophysiological study, which confirmed supraventricular arrhythmias and enabled curative catheter ablation based solely on data obtained from wearable devices. The use of digital devices substantially shortened the time to diagnosis and treatment, reduced diagnostic burden, and allowed definitive therapy in symptomatic athletes. Conclusions: Wearable technology, particularly chest-strap heart rate monitors, may play an important role in the diagnostic evaluation of exercise-induced paroxysmal arrhythmias when standard methods fail.