Key result
Apple Watch abnormal pulse alerts yield actionable cardiovascular diagnoses in only ~11% of patients.
Why the study?
The study sought to characterize the clinical evaluation of patients presenting after detection of an abnormal pulse using an Apple Watch.
Does medical evaluation following an abnormal pulse detected by an Apple Watch yield clinically actionable cardiovascular diagnoses in real-world practice?
Cohort (n=264)
Yes
Does medical evaluation following an abnormal pulse detected by an Apple Watch yield clinically actionable cardiovascular diagnoses in real-world practice?
Real-world medical evaluation prompted by Apple Watch abnormal pulse alerts yields a low rate of new actionable diagnoses, highlighting a high false-positive rate and potential for healthcare overutilization.
Low yield after Apple Watch alerts suggests selective evaluation to limit overutilization; leaves open optimal thresholds for prospective validation.
OBJECTIVE: The study sought to characterize the evaluation of patients who present following detection of an abnormal pulse using Apple Watch. MATERIALS AND METHODS: We conducted a retrospective review of patients evaluated for abnormal pulse detected using Apple Watch over a 4-month period. RESULTS: Among 264 included patients, clinical documentation for 41 (15.5%) explicitly noted an abnormal pulse alert. Preexisting atrial fibrillation was noted in 58 (22.0%). Most commonly performed testing included 12-lead echocardiography (n = 158; 59.8%), Holter monitor (n = 77; 29.2%), and chest x-ray (n = 64; 24.2%). A clinically actionable cardiovascular diagnosis of interest was established in only 30 (11.4%) patients, including 6 of 41 (15%) patients who received an explicit alert. DISCUSSION: False positive screening results may lead to overutilization of healthcare resources. CONCLUSIONS: The Food and Drug Administration and Apple should consider the unintended consequences of widespread screening for asymptomatic ("silent") atrial fibrillation and use of the Apple Watch abnormal pulse detection functionality by populations in whom the device has not been adequately studied.
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Wyatt et al. (2020) conducted a cohort in Abnormal pulse detected using Apple Watch (n=264). Apple Watch abnormal pulse detection was evaluated on Establishment of a clinically actionable cardiovascular diagnosis of interest. Evaluation of patients presenting with an Apple Watch abnormal pulse detection established a clinically actionable cardiovascular diagnosis in only 11.4% of cases.