Why fitness trackers, smartwatches pose serious risks for some heart patients

From sophisticated smartwatches to simple fitness monitors, digital devices are strapped onto the wrists of millions of people, often with the goal of self-improvement. For many, these devices offer a window into their health, tracking everything from steps taken to hours slept. However, for individuals with atrial fibrillation (AF), a common heart rhythm disorder, these wearable devices might be doing more than just counting steps – they could be fueling anxiety and driving unnecessary medical care.

A startling study published in the Journal of the American Heart Association has shed light on the complex relationship between wearable devices and patients with AF. The research, conducted by a team led by Dr. Lindsey Rosman from the University of North Carolina School of Medicine, reveals that while these gadgets can provide a sense of security for some, they may inadvertently lead to increased anxiety, excessive symptom monitoring, and higher healthcare utilization for others.

Atrial fibrillation, which affects millions worldwide, is characterized by irregular and often rapid heart rhythms. Symptoms can be unpredictable and sometimes severe, ranging from heart palpitations and shortness of breath to fatigue and chest pain. Given the nature of AF, it’s not surprising that patients might turn to wearable devices for constant monitoring and reassurance.

However, the study’s findings paint a nuanced picture of this tech-driven approach to heart health management. Among AF patients who use wearables, researchers found higher rates of symptom preoccupation and more concerns about their AF treatment compared to non-users. Perhaps most strikingly, one in five wearable users reported experiencing intense fear and anxiety in response to irregular rhythm notifications from their devices.

Dr. Rosman’s team found that this anxiety isn’t just a fleeting moment of concern. The study revealed that a similar proportion of wearable users routinely contact their doctors when their devices flag potential AF episodes or when ECG results are abnormal. This behavior translates into real-world healthcare implications, with wearable users showing significantly higher rates of AF-specific medical visits, diagnostic tests, and even surgical procedures.

The impact extends beyond individual patient experiences to healthcare providers and clinics. The study found that wearable users were significantly more likely to use informal healthcare resources, such as calling clinics and sending messages to their healthcare providers through patient portals. This increased communication, while potentially beneficial for patient engagement, could be contributing to an already overburdened healthcare system.

While these findings might seem alarming, it’s important to note that the relationship between wearables and healthcare utilization isn’t entirely negative. Many AF patients who use wearables reported feeling safer with their devices. This sense of security and the potential for early detection of serious heart rhythm issues shouldn’t be discounted.

However, the study raises important questions about the unintended consequences of constant health monitoring. For some patients, the continuous stream of data from their wearables may be transforming normal fluctuations in heart rhythm into sources of constant worry. This heightened awareness, while well-intentioned, could be leading to unnecessary anxiety and medical interventions.

“Given the significant increase in use of wearable devices in this patient group (and the population in general), we believe prospective studies and randomized trials are needed to understand the net effects of wearables – including their alerts – on patients’ healthcare use and psychological well‐being, as well as the downstream effects on providers, hospitals, and health systems,” Rosman says in a statement.

As wearable technology continues to advance and become more integrated into healthcare practices, finding a balance between the benefits of continuous monitoring and the potential for anxiety-inducing over-vigilance will be crucial. This study serves as a reminder that while technology can be a powerful tool in managing chronic conditions like AF, it’s not a one-size-fits-all solution.

Moving forward, healthcare providers may need to consider tailoring their approach to wearable use based on individual patient characteristics. For some, these devices may provide valuable peace of mind and early warning of potential issues. For others, a more measured approach to self-monitoring might be necessary to prevent undue stress and medical overutilization.