Initial findings from an online diagnostic service for smart device ECGs: insights from an online wearable clinic

A large amount of ECG data is now being generated by smart devices. The use of such devices by patients and healthy individuals is growing exponentially. There is an unmet need for well-organized programs to handle the large amount of data and to identify patients in need for medical contact.

To report initial findings from a dedicated platform for single-lead ECG (SL-ECG) interpretation – an online wearable clinic.

We included SL-ECGs sent to an online wearable clinic from wearable device users in Switzerland,

Austria and Germany over a period from June 2023 to October 2024. Besides the SL-ECG, demographic characteristics were collected.

Overall, 341 SL-ECGs were submitted, resulting in an average 1.7 of SL-ECGs per participant. 22% were female, median age was 53.1 years and median CHA2DS2-VA score was 1. Reasons for contacting the wearable clinic were in 59% palpitations, 4% chest pain, 4% dizziness, 5% exercise intolerance, 2% fatigue and in 1% presyncope. 18% submitted SL-ECGs for a check-up (no symptoms). AF was found in 16% and paroxysmal supraventricular tachycardia in 5% of cases. Premature atrial and ventricular contractions were found in 12% and 17%, respectively (Figure). 78% of SL-ECGs were uploaded during the daytime (6:00 to 20:00). The most frequent used smart device was the Apple Watch (66%).

In this initial analysis, predominantly male patients uploaded SL-ECGs, most frequently for palpitations. Abnormal findings were detected in 50% of submitted-SL-ECGs, with AF present in 16%. The most frequent used smart device was the Apple Watch. Our initial experience demonstrates the unmet need for an online diagnostic service and proves the feasibility of a wearable clinic.

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