My smartwatch EKG says I have an irregular heartbeat. Now what?

Heart Health

by Praveen K. Rao, MD

Aug 1, 2022

Every day, I’m amazed at how many of my patients own smartwatches or wearable devices. In fact, a recent study by Pew Research found approximately one in five Americans owns and wears a smartwatch. That translates to 66.5 million people.

Young and old alike are wearing them for different reasons. In my practice, I’ve seen a trend in seniors buying smartwatches because of the health apps available on the devices. Older people seem to appreciate being able to monitor their health and well-being in real time via their smartwatch. Younger people seem to enjoy having the ability to track different metrics to fine tune their health and fitness.

While many people recognize the potential value of the health apps available on their smartwatch, they also often ask how they should use or interpret the information, especially EKGs. If you’re reading this, you likely have the same questions. I’ll give you the same answer I give them.

What is an EKG or ECG?

I always start by defining an EKG. An electrocardiogram (ECG or EKG) is a recording of the heart’s electrical activity. It is a simple, yet effective test. A traditional 12-lead EKG can be done in a doctor’s office or in the hospital. Personal devices such as smartwatches produce a simpler EKG.

Small electrodes on the back of a smartwatch or sensor monitor the heart’s electrical activity with every heartbeat. If you experience some abnormal symptoms with your heart, such as fluttering or palpitations, your smart device can record a personal EKG.

The devices provide their own automated interpretation of the heart rhythm recorded by the EKG. However, you should always discuss the EKG results (often referred to as an “EKG strip”) with your physician to provide context within your personal medical history.

How smartwatches detect abnormal heart rhythms

Smartwatches and sensors provide information about heart rate and rhythm. One of the most common abnormal rhythms detected by personal devices is atrial fibrillation (AFib), an irregular rhythm in the upper chambers of the heart.

AFib can cause symptoms of fluttering in the chest, shortness of breath, chest pain or palpitations. It can also be completely asymptomatic. If your smart device records AFib, it is important to discuss this with your physician. AFib increases the chances of having a stroke, but there are lifestyle modifications, medications and other treatments that can help lower that risk.

Smart wearable devices such as smartwatches can serve as a good diagnostic tool for people experiencing intermittent palpitations. These are often difficult to record with a 12-lead EKG because you can’t predict when the palpitations will occur.

If your smart device records such palpitations, your doctor can review the recordings to help determine if it is, in fact, an arrhythmia that requires further treatment.

Using your smartwatch EKG

I caution people that no one piece of information, such as an EKG from a smartwatch, can be used in isolation to draw conclusive decisions about their heart health. You may present with an abnormal reading on your smartwatch, but that doesn’t mean you necessarily have an underlying heart condition.

However, I have had many patients present with their initial diagnosis of an arrhythmia based on the data from their smart device. Having the information allows me to accelerate their treatment by getting to a diagnosis sooner. For some patients, it also serves as reassurance that they are not having recurrent arrhythmias after they have undergone certain treatments for their heart condition.

If you have a smartwatch or sensor and have recorded an arrhythmia, you should discuss the EKG with your doctor so it can be placed into context with your personal medical conditions. Working together, you can use all the tools available to you to get the heart care you need.

Not sure what to make of your EKG readings? Find a cardiologist near you or download our AFib treatment guide today.

About the Author

Praveen K. Rao, MD, is a cardiac electrophysiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas and Baylor University Medical Center. His areas of expertise include ventricular arrhythmias, premature ventricular complexes, atrial fibrillation, supraventricular tachycardia, pacemakers, defibrillators and cardiac resynchronization therapy. After receiving his medical degree from the University of Texas Health Science Center at San Antonio, Dr. Rao subsequently completed a residency in internal medicine and fellowships in cardiovascular disease and cardiac electrophysiology at Washington University in St. Louis, MO. He is also an active member of the Heart Rhythm Society and the American College of Cardiology.

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