A magazine for friends of the Warren Alpert Medical School of Brown University.

Ask the Expert: Elizabeth Goldberg


Can the Apple Watch accurately diagnose atrial fibrillation?

When Apple released the latest iteration of its smartwatch, the company announced the single-lead EKG built into the device could identify more than 98 percent of wearers who had atrial fibrillation (AFib), an arrhythmia that affects as many as 6 million Americans. But results of a large study at Stanford, presented in March, fell short of that claim. Elizabeth Goldberg RES’13 ScM’17, MD, an assistant professor of emergency medicine and of health services, policy, and practice, who is studying the fall detection capabilities of the Apple Watch 4, talks about the pros and cons of an “anytime, anywhere” EKG.

I think there is great promise here. We see many patients in the emergency department every day who complain of palpitations. We need to do a lot of different investigations to figure out why they’re feeling this way. From that standpoint, it would be really helpful if someone said, “My watch is showing that I have atrial fibrillation, and here’s the EKG.” People with AFib often don’t have any symptoms. They might not present for months or years after they have this condition, and be at risk for strokes that entire time.

Individuals 65 years and older who have hypertension or other risk factors for stroke would benefit most from this technology. In a population where the prevalence of a disease is low, such as 25-year-old healthy adults, you’re going to get more false positives.

That might bring people to the ED who don’t have AFib, and it could encourage additional health care costs. You need to weigh the cost and distress caused by false positives with the potential benefit of early detection of a health problem. Most young people should buy the watch if they’re interested in its other features rather than as a strategy to detect chronic diseases sooner.”


Comments are closed.