The Apple Watch Heart Monitoring Features May Be Worrying People

Although the Apple Watch has become legendary for its life-saving features, a new study suggests that it may also be contributing to an excessive amount of worry among health-conscious users, needlessly increasing visits to the doctor and hospital emergency rooms.

While it’s not news that the Apple Watch heart monitoring features aren’t foolproof, most studies have looked at that problem simply in terms of too few heart-related notifications. In short, there’s no guarantee that the Apple Watch will notify you of a heart condition or other health problem — and Apple very specifically says it will not notify you of things like a heart attack — and the number of life-saving stories we heard about from Apple watch users can actually create a dangerously false sense of security.

In short, if you think you might be experiencing a health problem, you shouldn’t shrug it off just because your Apple Watch isn’t telling you anything is wrong.

On the flip side, however, a new study has revealed that the Apple Watch and other personal health-monitoring devices can also create the opposite problem, causing “over-utilization of the health care system” as many folks visit hospital emergency rooms as a result of even the slightest blips from their Apple Watch health features.

Too Many False Positives

According to a recently published study that monitored patients visiting all of the various Mayo Clinic sites around the U.S. over the course of several months, only 10% of people who saw a doctor as a result of an abnormal pulse reading on their watch were diagnosed with an actual cardiac condition.

Specifically, the study, which was led by Heather Heaton, assistant professor of emergency medicine at the Mayo Clinic College of Medicine, analyzed the patient health records across every Mayo Clinic site from states such as Arizona, Florida, Wisconsin, and Iowa, looking for references to the term “Apple Watch” within the reports, beginning in December 2018 through to April 2019 — the time period just after Apple released the Apple Watch Series 4 in the U.S. with the ECG and irregular heart rhythm notification features.

In total, out of 534 patients whose records included the term “Apple Watch” during that time period, 264 indicated that they had come into the hospital as a result of their Apple Watch identifying a “concerning heart rhythm.” 41 of those patients specifically mentioned receiving an actual “abnormal pulse alert” from their Apple Watch, while the 223 others didn’t explicitly mention whether their visit resulted from an alert, the ECG feature, or some other health monitoring aspect of their Apple Watch.

Of the 264 patients who visited the Mayo Clinic, 58 were previously diagnosed with atrial fibrillation already. However, only two-thirds of patients presented with symptoms of any kind, such as lightheadedness or chest pain.

In other words, 87 of the patients who visited the Mayo Clinic due to abnormal pulse detection on their Apple Watch had no actual symptoms at all. Notably, 23 patients were also under 22 years old — an age below which the ECG features are not designed for.

According to The Verge, which first reported on the study, the finding shows that the Apple Watch and other at-home health monitoring devices can lead to a burden on the healthcare system.

It is hard for a user to ignore an alert that they could have a serious medical condition.

Kirk Wyatt, assistant professor of pediatrics at Mayo Clinic

However, it’s not really a new problem — merely one that’s been exacerbated by having so many users with wearable health monitoring devices. As professor Heaton notes, doctors have already been watching patients come needlessly into their offices for years after researching medical conditions online, with many automatically coming to the worst possible interpretation of what even minor symptoms can represent. So the situation with the Apple Watch isn’t really all that different.

For example, while a notification of actual atrial fibrillation shouldn’t be ignored — it’s a serious condition, and studies have confirmed that the Apple Watch is highly accurate in this area — the Apple Watch also often simply provides alerts of other abnormal heart rates, such as high and low pulse. While these can certainly represent a problem sometimes, that’s not always the case.

Of course, this doesn’t mean that you shouldn’t see a doctor if you’re receiving multiple high or low heart rate notifications, or if other symptoms accompany these. Still, as study co-author professor Kirk Wyatt notes, products like the Apple Watch “blur the line between rigorously-student medical devices and wellness tools.” Many users don’t even fully understand how well they work and how they should be used.

For example, patients who have already been diagnosed with atrial fibrillation aren’t supposed to use the Apple Watch feature, since it’s only designed to alert those who may have the condition and might not otherwise know about it. Yet over 20% of the people in the Mayo Clinic study visited the hospital because their Apple Watch had informed them of an irregular heart rhythm notification pointing to Afib, despite already having been diagnosed with the condition. In other words, their Apple Watch wasn’t telling them anything that they — and their doctors — didn’t already know.

Understanding context and the nuances of illness is important and at this point cannot be fully understood purely by a wearable medical device.

Heather Heaton, assistant professor of emergency medicine at the Mayo Clinic College of Medicine

Although many studies confirm the accuracy of the Apple Watch when it comes to detecting things like Afib and abnormal heart rates, there’s been far less research into how useful it is as a screening tool in the health care system. In other words, while the Apple Watch is pretty accurate at notifying you about what is going on, it’s relatively useless as to why; interpreting what that data means and, therefore, how concerned users should be when seeing notifications of things like abnormally high or low heart rates.

Of course, none of this should be construed as a suggestion that you shouldn’t seek medical attention if you’re experiencing symptoms that you’re concerned about; however, the Apple Watch shouldn’t be seen as an authoritative heart monitoring device, but rather merely a tool to help increase your awareness of what’s happening in combination with all of the other things that your body is already telling you.