Fitness
Why fitness trackers, smartwatches pose serious risks for some heart patients
![Why fitness trackers, smartwatches pose serious risks for some heart patients Why fitness trackers, smartwatches pose serious risks for some heart patients](https://studyfinds.org/wp-content/uploads/2024/07/Woman-jogging-with-fitness-tracker-scaled.jpg)
(Photo by Prostock-studio on Shutterstock)
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.
![Person checking heart rate on smartwatch](https://studyfinds.org/wp-content/uploads/2023/03/Person-checking-heart-rate-on-smartwatch-1200x800.jpg)
![Person checking heart rate on smartwatch](https://studyfinds.org/wp-content/uploads/2023/03/Person-checking-heart-rate-on-smartwatch-1200x800.jpg)
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.
![Young woman jogging and looking at smart wristwatch](https://studyfinds.org/wp-content/uploads/2024/05/fitness-tracker-1200x800.jpg)
![Young woman jogging and looking at smart wristwatch](https://studyfinds.org/wp-content/uploads/2024/05/fitness-tracker-1200x800.jpg)
“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.
Paper Summary
Methodology
The researchers conducted a retrospective study involving 172 AF patients from UNC Health. Participants completed detailed surveys about their use of wearable devices, psychological well-being, and quality of life. This self-reported data was then combined with information from electronic health records to examine healthcare utilization patterns. The study compared various outcomes between wearable users and non-users over a 9-month period, using statistical techniques to account for potential confounding factors.
Results
The study found that AF patients who used wearables reported higher rates of symptom monitoring and preoccupation, as well as more AF treatment concerns compared to non-users. About 20% of wearable users experienced intense fear and anxiety in response to irregular rhythm notifications and frequently contacted their doctors due to device alerts. Wearable users had significantly higher rates of AF-specific healthcare use, including more outpatient visits, diagnostic tests, and procedures. They also used informal healthcare resources more frequently, particularly sending more messages to healthcare providers through patient portals and calling clinics more often.
Limitations
The study has several limitations. As an observational study from a single healthcare system, it cannot establish causal relationships. The sample may not be representative of all AF patients. The reliance on self-reported data for some measures could introduce recall bias. Additionally, the study couldn’t determine whether wearable data directly triggered healthcare contacts or the appropriateness of the increased healthcare utilization observed among wearable users. It’s also unclear if the reported anxiety contributed to the worsening of AF symptoms, although anxiety has been well-documented as a contributing factor to various conditions, including AF.
Discussion and Takeaways
This study highlights the complex impact of wearable devices on AF patients. While many users report feeling safer with their devices, a significant portion experience increased anxiety and healthcare utilization. The findings suggest a need for more personalized approaches to wearable use in AF management. Future research should focus on identifying which patients benefit most from wearables and developing strategies to mitigate potential negative effects. The study also underscores the need for healthcare systems to prepare for the influx of patient-generated health data and its impact on clinical workflows.
Funding and Disclosures
The study was supported by a grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Some of the researchers reported relationships with various medical device and pharmaceutical companies, but these were not deemed to significantly influence the study’s findings.