Remote Cardiac Rhythm Monitoring in the Era of Smart Wearables: Present Assets and Future Perspectives

Abstract

Remote monitoring and control of heart function are of primary importance for patient evaluation and management, especially in the modern era of precision medicine and personalized approach. Breaking technological developments have brought to the frontline a variety of smart wearable devices, such as smartwatches, chest patches/straps, or sensors integrated into clothing and footwear, which allow continuous and real-time recording of heart rate, facilitating the detection of cardiac arrhythmias. However, there is great diversity and significant differences in the type and quality of the information they provide, thus impairing their integration into daily clinical practice and the relevant familiarization of practicing physicians. This review will summarize the different types and dominant functions of cardiac smart wearables available in the market. Furthermore, we report the devices certified by official American and/or European authorities and the respective sources of evidence. Finally, we comment pertinent limitations and caveats as well as the potential answers that flow from the latest technological achievements and future perspectives.

Keywords: arrhythmia detection; cardiac function; heart rate; remote monitoring; sensors; smart wearable devices.

Figure 1

Cardiac rhythm recordings derived from a smartwatch (Apple Watch) and a patch (S-Patch), (A) From left to right, the images show the process of data collection from an Apple Watch, the ECG presentation in the respective smartphone application and the final report, featuring a possible diagnosis, (B) From left to right, the images show the same process captured by the wearable S-Patch.

Figure 2

Main limitations and future perspectives of wearable devices for heart rhythm monitoring are presented. Specific information for each category of wearable devices is presented separately.