All of a sudden, we’re hearing about it everywhere – monitoring your heart rate and ECG (electrocardiogram) outside of a medical office.  There’s a business card sized monitor you can carry in your wallet.  FitBit, Galaxy, Apple Watch and many blood pressure monitors have added heart rate and heart rhythm monitoring to the newer versions of their devices.  A quick Amazon search reveals pages of results for consumer heart-monitoring technology, not to mention special cases for carrying the devices around.  All of this new technology has many of us wondering if we should be jumping on the heart monitoring bandwagon. 

We did some research and spoke with the experts to find out who should be using personal ECG monitors and when (and who shouldn’t).  Here’s what you need to know: 

What do personal ECG apps and devices do? 

• Measure heart rate.  By monitoring your heart rate you can detect rate irregularities like tachycardia (abnormally fast heart rate) or bradycardia (abnormally slow heart rate). 

• Monitor heart rhythm.  By monitoring your heart rhythm, you can determine whether or not you are experiencing atrial fibrillation (afib), which is an irregular heart rhythm. 

Why is the detection of those things important? 

All three conditions can be symptoms of underlying health issues that may require treatment.  Knowing that you have bradycardia, tachycardia or afib can help you and your medical provider detect underlying conditions, explain current symptoms and determine next evaluation steps. 

Bradycardia can be a sign of problems with the heart’s electrical system. It may indicate conditions such as “sick sinus (not those sinuses!) syndrome,” heart block, or other cardiac disorders. Early detection allows for timely management.  Severe bradycardia can lead to serious complications, including heart failure, low blood pressure, high blood pressure, and cardiac arrest. Identifying and treating bradycardia can help prevent these outcomes. 

Symptoms of bradycardia can include fatigue, dizziness, weakness, fainting, or shortness of breath. Knowing you have bradycardia is important for managing these symptoms and improving quality of life. 

Tachycardia can strain the heart, increase the risk of stroke, or lead to complications such as heart failure if not managed properly. Tachycardia can be caused by temporary things like fever, medication, and dehydration, or more serious issues like heart disease or thyroid problems.  Identifying tachycardia is the first step towards solving the problem. 

For tachycardia, treatment might involve lifestyle changes, medication, or procedures such as catheter ablation or the implantation of a cardioverter-defibrillator (ICD). In many cases, early detection and treatment can be lifesaving. 

Afib is a common type of irregular heartbeat, that can lead to blood clots, stroke, heart failure, and other heart-related complications. AFib can cause symptoms such as heart palpitations, fatigue, shortness of breath, and dizziness. Knowing if you are in AFib is important for several reasons. 

AFib significantly increases the risk of stroke. The irregular heartbeat can cause blood to pool and form clots in the heart’s atria. A clot can then travel to the brain, causing a stroke. Identifying and managing AFib can lead to the use of anticoagulants (blood thinners) that significantly reduce the risk of stroke. 

Over time, AFib can weaken the heart, leading to heart failure. Recognizing and treating AFib can help to prevent that progression.

The best way to use a personal ECG monitor involves a partner! 

Clearly, ECG monitoring can do a terrific job of detecting signs of a serious underlying condition, but only if the information is reviewed and acted upon by a medical professional.   

Amaze Chief Medical Officer, Dr. Lisa Hile says that information from personal ECG monitoring can be fairly easily interpreted by a non-medical person and can be helpful in some instances. “For example: A patient may say, ‘I felt like I was about to pass out and btw my Apple watch said my heart rate was 35.’ That patient would get an event monitor placed for a week and may need a pacemaker. But those event monitors are monitored by cardiologists!”  In those instances, personal monitoring is only providing a piece of the puzzle. 

Dr. Ed Fisher, a cardiologist at New York’s Mount Sinai Health System, agrees that personal monitoring can extend the reach of a healthcare professional.  He explained that sometimes people come to his office complaining of a too-fast heart rate, but it isn’t picked up on the EKG done in his office.  If the patient picks it up on an Apple Watch or another monitoring device while outside the office, that can add value when determining next steps. 

Dr. Hile says the same is true for patients with afib.  “The devices can also be useful for people who go in and out of atrial fibrillation. Sometimes that can be helpful with deciding whether or not a patient has to go on anti-coagulation medication (blood thinners). They are fairly accurate for detecting stuff like that.”  Both doctors agree that the information is useless if it isn’t in the hands of someone who knows what to do with it. 

What can’t a personal ECG monitor detect? 

Dr. Hile warns, “None of this stuff is useful for the question ‘Am I having a heart attack?’ which is what some people often think they can be used for. That’s scary because it wastes time when they should just be going to an ER.” 

This is probably one of the most important things to understand about these monitors.  They can be part of a non-urgent diagnostic toolkit.  But they will be a dangerous waste of time during an actual cardiac event. 

There are some other limitations as well. Personal ECG monitors do not provide as comprehensive a view as a full-scale ECG in a medical facility. The readings can easily be affected by movement, placement of the device, and other factors, potentially leading to inaccurate results.  

The Bottom Line on Personal ECG Monitoring 

There is a lot of terrific technology built into personal ECG monitors and apps and they can be useful in concert with a medical professional for people with known heart conditions or who are at risk for heart disease.  They also can help with post-surgical and treatment monitoring. 

While they can provide valuable data, they are not a substitute for professional medical advice, diagnosis, or treatment. If you fall into any of the categories listed above and want to take some monitoring responsibility into your own hands, talk to your doctor about which type of device will best support your care.