A new study suggests that the Apple Watch could make a meaningful difference in the aftermath of atrial fibrillation ablation, not by changing the procedure itself, but by changing how patients and doctors view it afterwards.
Researchers found that a simple routine of patient-directed ECG check-ins surfaced more recurrences and was associated with fewer unplanned hospitalizations during follow-up.
The study was conducted by researchers at St. Bartholomew’s Hospital in London, and the results were published in the Journal of the American College of Cardiology.
The paper focused on how patients who underwent atrial fibrillation ablation, a procedure that uses heat or cold to destroy heart tissue and cause irregular rhythms, were treated and monitored after the procedure. There were two groups in the study, the first being the Apple Watch group.
- Patients were given an Apple Watch and instructed to record their ECG on the watch daily.
- If you felt symptoms or received a notification from your Apple Watch, you were required to record an ECG at that time as well.
- The clinical team checked their electrocardiograms remotely.
The standard treatment group would then be:
- Standard clinic-based follow-up at 3, 6, and 12 months with ECG monitoring and Holter monitoring at symptom-based intervals.
After a 90-day “gap period,” atrial fibrillation recurrence was detected sooner in the Apple Watch group than in the standard-of-care group, with a median time to first confirmed recurrence of 116 days versus 132 days.
By the end of follow-up, relapses were also detected more frequently using the watch. 52.9% of patients in the Apple Watch group vs. 34.9% of patients in the control group.
This difference was primarily caused by the watch capturing more paroxysmal (intermittent) episodes. This is the kind of thing that is easy to miss on the occasional clinic ECG or short Holter ECG.
Of note, although more abnormalities were identified, there were fewer unplanned hospitalizations in the Apple Watch group, and repeat ablation rates were similar between the two groups.
This study suggests that by moving on-demand ECG monitoring into patients’ daily lives, a structured Apple Watch workflow may improve post-ablation monitoring and reduce unnecessary escalation in treatment.
This is a great example of how Apple Watch can help with early detection of atrial fibrillation as well as long-term monitoring after a procedure.
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