The irregular heartbeat condition known as atrial fibrillation, a leading cause of stroke, afflicts as many as 6 million Americans, but an estimated 700,000 don’t know they are at risk. I was one of them. For decades, I was unaware that I was living with this potentially deadly condition.
Strokes, resulting from a blockage in the flow of blood to the brain, are a leading cause of disability, striking someone in the U.S. every 40 seconds. They cost the nation an estimated $34 billion each year in treatment, rehabilitation, medicines and lost work.
That number could drop substantially thanks to the latest innovation in wearable technology — a smartwatch that detects irregular heartbeats. Apple’s newly released software is now delivering this advance to its watches, and competing consumer technology companies are following with their own versions. French electronics company Withings has just unveiled its analog watch that can record electrocardiograms, and, the company says, detect A-fib. This innovation could prevent many people from suffering strokes; it certainly could have saved me a lot of trouble.
Because my father and grandfather both died young of heart-related issues, I was concerned when I began feeling tired and occasionally light-headed during the day, so I visited my primary care physician. After a stress test and a weekend wearing a Holter monitor to track my heartbeat, I got the all-clear and chalked up the changes I had experienced to normal aging.
Had there been a smartwatch with the capacity to detect A-fib back then, I would have had a more complete data set — and known differently.
Apple’s watch has an optical sensor that analyzes pulse rate data to identify A-fib. A preliminary study submitted to the U.S. Food and Drug Administration showed the watch correctly identified the condition in 99 percent of cases, and the FDA has already given the watch its blessing, with commissioner Scott Gottlieb saying it “may help millions of users identify health concerns more quickly.”
In the two years following my stress test, the sensations of fatigue and light-headedness became more frequent. Eventually, I returned to the doctor who ordered that the tests be repeated. This time, the nurse who administered the stress test identified a problem and said, “You need to get this fixed!” The electrical signals that controlled the beating of my heart’s upper chambers — the atria — had lost their rhythm. Instead of beating with the precision of a drum major, my heart appeared to be taking the odd break for a cup of coffee. It was as if it was stopping and then, when the caffeine kicked in, erupting into the kind of drum roll a novice percussionist would deliver.
I was fortunate. After detection of my atrial fibrillation, a surgeon at Boston’s Massachusetts General Hospital restored my heart to its regular rhythm through a procedure called a catheter ablation. A year later, I ran the Boston Marathon to raise money for the hospital.
Through no fault of my physician, it took more than two years to correctly detect my condition. A-fib is notoriously difficult to diagnose because it is inherently irregular; it can easily be missed, as there’s no assurance an episode will occur during a stress test or even when wearing a Holter monitor for several days. Because a smartwatch can be worn daily, it has the potential to dramatically reduce the number of unidentified cases of atrial fibrillation before they take a toll — in health, lives and money.
Apple’s primary motivation, of course, is to make its products indispensable to consumers. But by integrating a health feature that can detect A-fib into its watch, Apple and its competitors, including Fitbit and Samsung, can play a significant role in reigning in the ever-growing cost of healthcare, which the federal government forecasts will rise at an annual rate of 5.5 percent through 2026. The potential cost savings of billions of dollars are so compelling that health insurers may eventually be willing to subsidize customer purchases of personal health trackers of this sort. United Healthcare already offers free devices to clients who participate in an exercise rewards program.
Wearable health trackers and smartwatches can be game changers that could improve health and reduce medical expenses for hundreds of thousands of people just like me and their employers. Had my father or grandfather been able to benefit from technology of this sort, it might have significantly prolonged their lives.
Chris Steel is the global healthcare lead at PA Consulting
Our new value-based care research shows why putting patients at the centre of healthcare is important and how to do it