He was discharged on an oral anticoagulant as well as an oral anti-arrhythmic medication. Attempted chemical cardioversion initially dropped the heart rate but the patient subsequently required electrical cardioversion, which restored sinus rhythm (Bottom pane of Fig. A trans-oesophageal echocardiogram showed that there was no thrombus in the left atrial appendage.
The patient was admitted to the coronary care unit and anticoagulated. The bottom panes show the drop in heart rate to 113-bpm post-chemical cardioversion (left) and then to normal post-electrical cardioversion (right). The top panes show the patient’s pre-symptom heart rate (left) and subsequent post-symptom heart rates (right) averaging 150 bpm. Ĭomposite screenshots from the Apple Health app over a 1-week period. These features, however, are only available in some regions and languages-not currently in South Africa.
Apple Watches that are series 4 or later have the capability to record an ECG as well as the ability to notify the user of irregular heart rhythms. The diagnosis of atrial flutter was confirmed on a formal 12-lead electrocardiogram (ECG). This created a suspicion of atrial flutter with 2:1 AV nodal block by the emergency physician. When the ‘Health app’ data on his iPhone was reviewed, it could be seen that his Apple watch had recorded a consistent rate of 150 bpm for the previous 4 days (Top pane of Fig. He had no symptoms of chest pain, nausea, vomiting, diaphoresis or dizziness. Since he became symptomatic with the palpitations 4 days previously, he had noticed that his heart rate on his Apple watch had remained essentially unchanged at ~150 bpm at all times of the day including during training at the gym and even before bed.
He attributed the symptoms to the dietary ‘fat burners’ that he had recently started. CASE REPORTĪ 56-year-old hypertensive, diabetic male patient presented with a 4-day history of new-onset palpitations. We present a case of atrial flutter which was suspected based on the Apple watch and iPhone Health app findings. Their value in the long-term monitoring of patients is being investigated with a focus on atrial fibrillation (AF). The use of smart watches like the Apple watch and other health monitoring devices (so-called wearables) by the general public has been dramatically increasing. Atrial flutter, wearable electronic device, digital health, heart rate determination INTRODUCTION