Overview
Atrial fibrillation (AF) is a major predictor of heart failure, stroke, and mortality. Traditional Holter monitors and event recorders are limited by short recording times. Wearable electrocardiographic (ECG) and photoplethysmographic (PPG) devices enable continuous monitoring and large-scale AF screening. This review assesses their diagnostic performance, clinical usefulness, and implementation challenges. Following PRISMA guidelines, PubMed, Embase, and Web of Science were searched for studies from 2010-2025. Included studies had ≥30 participants and reported AF detection accuracy or clinical outcomes. Studies evaluating PPG devices required ECG verification as the reference standard. Wearable ECG patches showed high sensitivity (92-98%) and specificity (85-97%) and detected more AF episodes than short-duration Holter monitoring. PPG-based smartwatches demonstrated moderate-to-high accuracy in irregular pulse detection, further improved by AI-assisted algorithms. Limitations included motion artifacts, false positives, adherence issues, clinician data burden, and limited evidence for stroke prevention. Wearable ECG devices are reliable for clinical AF detection. PPG-based devices are best used for screening, with subsequent ECG confirmation according to international AF management guidelines. Atrial fibrillation (AF) is a common heart rhythm disorder that can increase the risk of heart failure and stroke. Conventional heart monitoring methods, such as short-term hospital ECG tests or Holter monitors, are accurate but may fail to detect AF episodes that occur intermittently or without symptoms.Recent wearable devices can now monitor heart rhythm over longer periods while individuals continue their normal daily activities. This review considered two broad categories of wearable devices: ● ECG devices: small patches or portable devices that directly record the electrical activity of the heart. ● Smartwatches and wrist-worn devices: sensors that detect pulse irregularities and estimate heart rhythm. Studies have shown that wearable ECG adhesive patches worn on the chest for up to 12–14 days are highly accurate in detecting AF. Smartwatches and portable ECG devices with ECG capability also perform well. However, abnormal findings from screening devices should always be confirmed with a standard ECG before diagnosis. Smart rings and sensor-enabled clothing show promise in this area but require further research. Wearable technology cannot replace conventional tests, but it can supplement them by enabling easier heart rhythm monitoring, earlier identification of abnormalities, and more timely medical review. These devices also generate large amounts of data, which must be managed carefully by healthcare systems while ensuring that final clinical decisions are made by qualified healthcare professionals. Further studies are needed to determine whether wearable-detected AF improves clinical outcomes, such as stroke prevention, and how patient-generated data can be safely integrated into mainstream healthcare.
Why This Matters for Body-Mind Practice
This review consolidates current evidence on wearables and health monitoring — helping practitioners and individuals make informed decisions based on the latest science.
Source
- Future cardiologyRead Source →
