AI-Driven Real-Time Monitoring of Cardiovascular Conditions With Wearable Devices: Scoping Review

BACKGROUND: Cardiovascular diseases remain the leading cause of mortality worldwide, accounting for 18 million deaths annually. Detection and prediction of cardiovascular conditions are essential for timely intervention and improved patient outcomes. Wearable devices offer a promising, noninvasive solution for continuous monitoring of cardiovascular signals, vital signs, and physical activity. However, the large data volumes generated by these devices and the rapid fluctuations in cardiovascular signals necessitate advanced artificial intelligence (AI) techniques for real-time analysis and effective clinical decision-making. OBJECTIVE: The objective of this scoping review was to identify the main challenges of AI-driven platforms for real-time cardiovascular condition monitoring with wearable devices and explore potential solutions. In addition, this review aimed to examine how AI algorithms are developed for robust monitoring and how deployment pipelines are optimized to enable real-time cardiovascular condition monitoring. METHODS: A comprehensive search was conducted in the following electronic databases: MEDLINE(R) ALL (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Ovid), Web of Science Core Collection (Clarivate), IEEE Xplore, and ACM Digital Library, yielding 2385 unique records. Inclusion criteria focused on studies that used wearable devices for participant data collection and applied AI algorithms for real-time analysis to detect or predict cardiovascular events and diseases. After title and abstract screening, 153 papers remained, and following a full-text review, 19 studies met the inclusion criteria. RESULTS: The findings indicate that despite the promise of AI and wearable devices, research on real-time cardiovascular monitoring remains limited and lacks comprehensive validation. Most studies relied on publicly available wearable datasets rather than real-world validation with recruited participants in community settings. Studies that deployed AI algorithms in real time frequently failed to report operational characteristics and challenges. Electrocardiography-based wearable sensors were the most frequently used devices, primarily in hospital settings. A variety of AI techniques, ranging from traditional machine learning to lightweight deep learning algorithms, were deployed either on wearable devices or via cloud-based processing. CONCLUSIONS: Robust, interdisciplinary research is needed to harness the full potential of AI-driven, real-time cardiovascular health management using wearable devices. This includes the development and validation of scalable solutions for continuous community-based deployment. Furthermore, real-world challenges such as participant compliance, hardware and connectivity constraints, and AI model optimization for real-time continuous monitoring must be carefully addressed.