Wearable devices significantly increased atrial fibrillation detection by 4.4-fold compared to standard care, and reduced heart failure hospitalizations by 41% and mortality by 26%.
Systematic Review
Do wearable devices improve the detection of asymptomatic arrhythmias and clinical outcomes compared to standard care?
Wearable devices significantly improve atrial fibrillation detection and are associated with reduced heart failure hospitalizations and mortality, though clinical integration challenges remain.
Background: The global burden of cardiovascular disease (CVD) necessitates a transition from reactive care to a proactive "5P" medicine paradigm (predictive, preventive, personalized, participatory, and population-based). Wearable devices (WDs), such as smartwatches and biosensors, have emerged as essential socio-technical tools for continuous monitoring in non-clinical settings. However, integrating these data streams into clinical workflows presents a dichotomy between enhanced diagnostic potential and systemic risks. Methods: This systematic–narrative review synthesizes clinical and technical literature published between 2014 and 2026. The analysis evaluates data from landmark trials and examines technical interoperability frameworks, specifically the HL7 FHIR standard for patient-generated health data integration into clinical records. Results: Findings demonstrate that wearables significantly improve the detection of asymptomatic arrhythmias, with trials such as EQUAL showing a 4.4-fold increase in atrial fibrillation detection compared to standard care. Furthermore, wearable-guided care is associated with a 41% reduction in heart failure hospitalizations and a 26% decrease in mortality. Despite clinical gains, integration is hampered by "technostress" from false alerts, "black box" AI algorithms, and unresolved legal liability regarding consumer data privacy. Conclusion: To achieve resilient integration, the paper proposes a framework centered on standardized interoperability and explainable AI. It emphasizes the need for updated regulatory guidelines and interdisciplinary collaboration to ensure that wearable technology promotes health equity while maintaining clinical safety.
Lewicka et al. (Tue,) conducted a systematic review in Cardiovascular disease (CVD). Wearable devices vs. Standard care was evaluated on Detection of asymptomatic arrhythmias, heart failure hospitalizations, and mortality. Wearable devices significantly increased atrial fibrillation detection by 4.4-fold compared to standard care, and reduced heart failure hospitalizations by 41% and mortality by 26%.