Apple Watch, With Some Maneuvering, Can Deliver 12-Lead ECG

From today’s news.  I have actually done this when I was feeling unusual after water aerobics.


A “quasi-standard” multilead ECG can be recorded using just the Apple Watch, a report showed.

The ECG function on the Watch is designed to monitor electrical activity of the heart in the direction of lead I only, ignoring the superoinferior axis captured by the standard leads (II and III) and the horizontal plane captured by the precordial leads (V1 to V6).

Yet certain workarounds can give the Apple Watch the “quasi-standard” 12-lead information of a proper ECG recording, according to Miguel Ángel Cobos Gil, MD, PhD, of Hospital Clínico San Carlos in Madrid, Spain, reporting online in the Annals of Internal Medicine.

Users can generate lead II by touching the digital crown with a finger on the right hand and lead III by touching with the left hand after moving the smartwatch to the ankle or somewhere on the leg, he said.

And although it’s not possible to generate the conventional precordial leads (V1 to V6), bipolar chest leads (CR1 to CR6) may be sufficient: those can be obtained by placing the back of the watch on the chest and touching the digital crown with a right-hand finger, according to the author.

Cobos Gil showed the similarity in ECG recordings between a standard 12-lead device and the Apple Watch in three test subjects: a healthy person (the author himself), someone with ST-segment-elevation MI, and another with non-ST-segment-elevation MI.

“Standard limb leads (I, II, and III) obtained using both methods are identical, and the precordial leads (V1 to V6 vs. CR1 to CR6) bear a strong resemblance,” he reported.

“Considering the sales figures of Apple devices, the watches likely outnumber conventional ECG machines worldwide. The availability of a method to record an ECG with diagnostic potential anytime and anywhere could potentially revolutionize our approach to cardiac emergencies,” the author suggested.

This report presents a “new twist” on how the Apple Watch can be used and shows that getting the 12-lead information from this device is “definitely something that can be done,” commented Jeffrey Goldberger, MD, of the University of Miami.

But when and why it would be done are unclear, he told MedPage Today in an interview.

Perhaps it could be useful in an urgent scenario where a 12-lead ECG machine is not available, somewhere where medical resources are very limited and there are no hospitals or doctor’s offices around that can do the standard test, he suggested.

Yet the Apple Watch ECG recording would need to be transmitted somewhere to someone who can give advice over the phone — and that would require Internet access. “If it’s a remote area, where do you call for medical care and attention?” Goldberger said.

The smartwatch ECG could be a niche strategy in theory and is certainly not going to replace the conventional machines, he said.

“You need a fair amount of cooperation from the patient to do the various maneuvers to make the various recordings,” he added. “It’s probably more time-consuming to do than just a standard 12-lead where you make the recording and you’re done. Here you do everything in sequence.”

More clinical studies are needed to determine the role of smartwatch ECG recordings, Cobos Gil acknowledged.

Another consumer-oriented device, the AliveCor KardiaMobile 6L, provides 6-lead ECG recordings when paired with a smartphone app.


Cardiac Rehabilitation Starts Today!


DH finally starts his cardiac rehab today, just over 8 weeks after his triple bypass.

Cardiac rehabilitation (rehab) teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. Cardiac rehab can help you feel better and reduce your risk of future heart problems.

In cardiac rehab, you work with a team of health professionals. Often the team includes a doctor, a nurse specialist, a dietitian, an exercise therapist, and a physical therapist. The team designs a program just for you, based on your health and goals. Then they give you support to help you succeed.

If you have had a heart attack, you may be afraid to exercise. Or if you have never exercised, you may not know how to get started. Your cardiac rehab team will help you start slowly and work up to a level that is good for your heart.

Many hospitals and rehab centers offer cardiac rehab programs. You may be part of a cardiac rehab group, but each person will follow his or her own plan.

Who should take part in cardiac rehab?

Doctors often prescribe cardiac rehab for people who have had a heart attack or bypass surgery. But people with many types of heart or blood vessel disease can benefit from cardiac rehab. Rehab might help you if you have:

  • Heart failure.
  • Peripheral artery disease (PAD).
  • Had or plan to have a heart transplant.
  • Had angioplasty to open a coronary artery.
  • Had another type of heart surgery, such as valve replacement.

Often people are not given the chance to try cardiac rehab. Or they may start a program but drop out. This is especially true of women and older adults. And that’s not good news, because they can get the same benefits as younger people. If your doctor suggests cardiac rehab, stay with it so you can get the best results.

Medicare will pay for cardiac rehab for people with certain heart problems. Many insurance companies also provide coverage. Check with your insurance company or your hospital to see if you will be covered.

What happens in cardiac rehab?

In cardiac rehab, you will learn how to:

  • Manage your heart disease and problems such as high blood pressure and high cholesterol.
  • Exercise safely.
  • Eat a heart-healthy diet.
  • Quit smoking.
  • Reduce stress and depression.
  • Get back to work sooner and safely.

Exercise is a big part of cardiac rehab. So before you get started, you will have a full checkup, which may include tests such as an electrocardiogram (EKG or ECG) and a “stress test” (exercise electrocardiogram). These tests show how well your heart is working. They will help your team design an exercise program that is safe for you.

At first your rehab team will keep a close watch on how exercise affects your heart. As you get stronger, you will learn how to check your own heart rate when you exercise. By the end of rehab, you will be ready to continue an exercise program on your own.

What are the benefits of cardiac rehab?

Starting cardiac rehab after a heart attack can lower your chance of dying from heart disease and can help you stay out of the hospital. It may reduce your need for medicine.

Cardiac rehab may also help you to:

  • Have better overall health.
  • Lose weight or keep weight off.
  • Feel less depressed and more hopeful.
  • Have more energy and feel better about yourself.

Changing old habits is hard. But in cardiac rehab, you get the support of experts who can help you make new healthy habits. And meeting other people who are in cardiac rehab can help you know that you’re not alone.

Adapted from