In recent years, smart wearable devices have gained immense popularity for health monitoring, particularly in adults. However, the application of health monitoring wearables has been relatively unexplored in pediatrics to date.
On December 13, 2023, research¹ led by Aydin Zahedivash and conducted over a 4-year period at Stanford University in Palo Alto, California was published by Communications Medicine. Their research explored the clinical utility of Apple Watches in capturing and diagnosing arrhythmias in children. The key findings and implications of this research reinforces the broad impact connected wearables offer children across the US and around the globe.
Arrhythmia symptoms in children are not uncommon, affecting as many as 1 in 250 children, requiring a thorough evaluation by pediatric cardiologists. To date, traditional ambulatory monitors have been the go-to for diagnosing these conditions, but limited data on the practical clinical use of wearable devices in children prompted this deeper investigation.
In a detailed review of past medical records at Lucille Packard Children’s Hospital Stanford, the researchers focused on patients aged 18 and below, investigating signs of arrhythmias documented by Apple Watches between 2018 and 2022. Within the medical records queried, they found "Apple Watch" mentioned 145 times.
For 25% of patients who used the smart watch for recreational or self-directed heart rate monitoring, the device prompted them to seek medical care based on abnormal findings. This proactive approach enabled timely clinical evaluations, showcasing the potential of wearable technologies in improving healthcare-seeking behavior among children and their caregivers.
Deeper investigation led to 41 confirmed cases of abnormal heart rhythms, including 29 first-time diagnoses in children. Further, the study revealed the smart watch outperformed traditional ambulatory monitors, prompting 71% of new arrhythmia diagnoses. This signals a potential shift in pediatric monitoring, with wearable devices offering a more accurate alternative.
Until now, smart wearable devices, like Apple Watches, have proven to be effective in monitoring heart health in adults, but their application in children has been largely uncertain. And according to Apple's own documentation and disclosures, "The irregular rhythm notification feature received 510(k) clearance from the FDA for users 22 years and older with no prior history of AFib"² and "These notifications are not intended for use by people under 22 years old."³
This study, however, reveals that smart wearables have the potential to accurately capture and diagnose various heart rhythm disorders in children, and the findings suggest a potential paradigm shift in pediatric arrhythmia monitoring, with wearable devices playing a crucial role in early detection and diagnosis.
Sources:
¹ Zahedivash, A., Chubb, H., Giacone, H. et al. Utility of smart watches for identifying arrhythmias in children. Commun Med 3, 167 (2023). https://doi.org/10.1038/s43856-023-00392-9
² Apple, Healthcare - Apple Watch https://www.apple.com/healthcare/apple-watch/
³ Apple, Heart health notifications on your Apple Watch, Irregular rhythm notifications https://support.apple.com/en-us/HT208931
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