Early smartwatch detection: getting to the heart of the issue of Atrial Fibrillation


Atrial fibrillation, a common heart rhythm disorder, is growing in prevalence and can pose significant health risks if left untreated.

ATRIAL Fibrillation (AF) is a common type of sustained arrhythmia presenting as irregular heart rhythm.

Subang Jaya Medical Centre (SJMC) consultant cardiologist Dr Choy Chun Ngok describes it as a degenerative rhythm disorder.

It is often linked to various underlying conditions such as age, hypertension, diabetes, heart disease or habits like excessive alcohol consumption and smoking.

Dr Choy Chun Ngok shares his thoughts on using smartwatch’s early detection functions for managing AF to safeguard heart health.Dr Choy Chun Ngok shares his thoughts on using smartwatch’s early detection functions for managing AF to safeguard heart health.

AF can manifest symptoms such as palpitations and, if left untreated, potentially serious complications, such as stroke, heart failure and other cardiovascular diseases.

The Global Burden of Diseases, Injuries, and Risk Factors Study is the largest and most comprehensive scientific effort to quantify health trends worldwide.

Its 29-year study on the impact of AF on the global population revealed that global prevalence rose to almost 40 million from 19.1 million in 1990.

Symptoms and complications

There are two common presentations of AF: palpitations and stroke.

Dr Choy compared the heart's condition in AF to a disrupted circuitry system, drawing parallels to a car engine.

In this analogy, AF causes the heart's rhythm to act unpredictably, like a car engine revving up and down even when idle, which can persistently disrupt normal activities, often presenting as a fast heart rate (100 beats per minute).

In younger patients, the rapid heartbeat associated with AF may be mistaken for heart flutters, sometimes described as the heart racing.

This can lead to symptoms such as difficulty in breathing, chest pain and dizziness. Dr Choy cautions that: “Not everything that flutters in the chest is first love.”

However, AF does not always manifest as a fast heartbeat, particularly in older patients, whose conduction systems may fail to transmit the rapid rhythm conspicuously.

As a result, they may perceive their heart rate as relatively slower, despite underlying AF.

Complications associated with untreated AF include increased risk of stroke due to clot formation in the heart's left atrial appendage (LAA) and the potential for heart failure due to sustained high heart rates over time.

Treatment options for AF involve addressing both stroke prevention and heart rate control, including blood thinners to reduce stroke risk and ablation procedure to restore normal heart rhythm.

Dr Choy compares the treatment (may it be pharmacological treatment or invasive procedure

called radiofrequency ablation) to build a fence around a lake to restore normal heart rhythm.

In his analogy, he likens the normal heart rhythm to a peaceful lake disturbed by unwanted “intruders" throwing stones, representing irregular heartbeats.

To restore calm, and if intervention is the treatment of choice, it will be like building a fence around the lake, symbolising the isolation of specific areas of the heart, called pulmonary veins.

This procedure is called pulmonary vein isolation. This fence prevents "intruders" from disrupting the heart's rhythm, restoring it to normalcy.

Smartwatches and early detection

Dr Choy highlights consumer technology's role in detecting AF, particularly smartwatches.

Smartwatches can monitor heart rate variability and can detect irregular rhythms indicative of AF.

While not medical-grade devices, he warns, some smartwatches can provide reliable AF notifications, prompting users to seek medical evaluation.

However, not all irregular heart rhythms detected by smartwatches indicate AF, so caution and further medical assessment are advised.

Dr Choy comments that smartwatch users have to ensure their device’s reliability and pay attention to heart rate notifications that seem disproportionate to activity levels or occur frequently.

While smartwatches can provide valuable insights, they should not replace medical consultation.

Users should seek medical evaluation if they receive multiple AF notifications to confirm the diagnosis and determine appropriate management.

Dr Choy also warns against developing an overly worried mindset when using this smartwatch function for early detection, as not all AF episodes are clinically important and some may not need any treatment at all.

Overall, it is important to raise awareness about AF and modern technology in smartwatches are at a stage where they can be leveraged for early detection.

Smartwatches represent a promising tool in this effort, but they should complement rather than substitute for medical advice and evaluation.

By understanding the symptoms, complications and treatment options for AF, individuals can take proactive steps to manage their heart health effectively.

Keywords: Digital Advertorial, StarPicks, Atrial fibrillation, heart rhythm disorder, smartwatch detection, heart health, Arrhythmia, stroke, palpitation, ablation, pulmonary veins

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