Remote Monitoring of Cardiac Arrhythmias Using Wearable Digital Technology: Paradigm Shift or Pipe Dream?

Cardiac arrhythmias – the most common of which is atrial fibrillation – are a leading cause of cardiovascular morbidity and mortality. Mobile health (mHealth) and wearable devices are a fast-evolving and disruptive area of innovation in assessing both asymptomatic and symptomatic patients for cardiac rhythm abnormalities. Remote monitoring has been used in cardiovascular health monitoring since the invention of the Holter monitor; however, mHealth devices, ranging from smartphones and watches to rings and textiles, have rapidly evolved in their potential uses. These devices are in the early stages of investigation in prospective clinical trials designed to validate their accuracy and, more recently, assess the potential benefits of their use on cardiovascular outcomes. We explored the potential societal and health benefits of using wearable technologies to improve the early diagnosis of arrhythmias by evaluating the current evidence for their use in clinical practice and proposing a framework for integrating them into diagnostic pathways.