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A Deep look at the Apple Watch ECG

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  • A Deep look at the Apple Watch ECG

    First impressions about heart rate tracking, recently appeared in the Apple Watch


    When Apple introduced the fourth version of its "smart" watches, the main marketing advantage was that we usually do not associate with watches or any other "smart" devices. Instead, the company added the opportunity that only recently became available to the consumer through special devices: an electrocardiograph (ECG), a device designed to track the electrical activity of the heart.

    However, the release of hours ahead of the release of software, so we could not describe this technology in our detailed review of the Apple Watch Series 4. But in early December, Apple finally included the missing features, and we checked them for several days.

    Main features

    People who have not used the Apple Watch may not understand how strongly they are attached to the iPhone. This also applies to software that tracks heart activity, which requires updating the operating system both on the clock and on the phone in order for it to start working. (We are a bit confused - the program did not start when we updated only the operating system of the clock). After the update, the Health application on the phone will track all ECG data created by the clock. On the clock update will install a new application.

    After that, ECG tracking becomes very easy: start the application, touch the clock head with your finger, and wait. Within 30 seconds, the electrical activity of the heart will draw a red trace on the clock screen. It is very convenient - no more difficult to measure the pulse. And if you wear a watch today, this opportunity is available to you.

    Upon completion, the application will let you know whether the heartbeat that tracked the device is normal - this heartbeat is known as sinus rhythm. However, the result of the ECG on the clock will not be visible - the application allows you to only record it. To study the results yourself, and do not trust the application, you have to switch to the phone.

    This is a bit annoying. The whole point of the watch, in theory, is that you can interact with them, and not with the phone. And there is something wrong with the fact that you have to get the phone and mess with the screen, instead of quickly looking at the clock.

    But if we discard this inconvenience, the graphics look great. Depending on the distance of your fingers from the heart, extraneous noise may interfere in the ECG, and the software of the clock needs to be filtered out. Apple's software does an excellent job with this. The watch track looks like a thick red line and is easy to interpret. On the phone, the schedule also looks good, and you can share the usual methods. When sending by email or Air Drop you will receive a PDF that can be stored for archive or shown to the doctor.

    ECG Evolution

    Those who read my previous reviews know that I have my own interest in ensuring that this system works correctly. Genetics rewarded me with sensitivity to atrial fibrillation , cardiac arrhythmia with bad health consequences. At the moment, I have an unpredictable mix of atrial fibrillation and harmless premature atrial contractions, and I can feel them. From a medical point of view, I have to make sure that the frequency of atrial contractions remains small and does not appear asymptomatic. It does not require detailed information that can be obtained from doctors with special medical equipment - a simple general description of the activity is enough (but, obviously, this will not be enough for everyone !).

    Over the years, activity tracking has changed. It all began with a weekly wearing a Holter monitor , a compact and portable ECG device that is worn around the clock for a week. The idea is that a week should be enough to collect detailed information about the behavior of the heart before the end of the year - but in my case this is usually not the case. Over time, I still developed an allergy to glue, which held the electrodes.

    Around that time, technology evolved enough to satisfy my needs. One company has created a small and inexpensive device.Kardia Mobile, which reads the work of the heart with the fingers, and sends this data to the phone. And assuming that I can continue to feel an irregular heartbeat, it will allow me to track what kind of arrhythmia I am experiencing, and send information to a cardiologist. Over time, I learned to interpret the readings of the device.


    A graph showing premature atrial contractions obtained with a Kardia device.


    The same abbreviations read by Apple Watch.

    It was better, but not perfect. The device from Kardia transmits the data to the phone via ultrasound, as a result of which the device and the phone must be positioned very carefully - small changes in the device during recording strangely affect the graph. And although the device was portable, I didn't always have it with me, and I didn't always have enough space to properly position the device and the phone for data transfer. Finally, it could not answer the critical question: did I have an arrhythmia that I could not keep track of since it did not have symptoms?

    In many ways, Apple Watch heart activity tracking is the next step in the evolution of my procedure. They are on my wrist for a long time during the day, and if an asymptomatic arrhythmia begins, then there is a chance that they will catch it. I set the clock so that they report a high pulse when I am resting, and I also gave incorrect information about my diagnosis of auricular contraction, so that they also track it. They, apparently, provide quite good results, allowing me to track premature reductions. At the same time, no fuss is required for this - in principle, I can qualitatively monitor the work of the heart at dinner, for example. Yes, they are more expensive than a special device, but, obviously, they are capable of more than just tracking the heart.

    Before I get the same confidence in the reliability of the new tracking method that I have about the proven method, several months have to elapse before I follow the work of my heart, and survive several incidents of its strange behavior. But if the first results are representative, then we can say that Apple has done an excellent job on this new program
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