How people are actually using heart rate monitors on their wearables

We talk to the wearable makers and users to find out
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It was always when he should have been at his most relaxed that Jack Fuller noticed his heart start to race. Sitting on the couch after dinner, the 60-year-old’s heart rate regularly leapt to 120 beats per minute.

“My heart was just shooting up for no reason at all,” he says. “I could feel it inside.”

He was able to track his heart rate because he had taken advantage of an offer from his employer, three years earlier. In 2015, Fuller was a warehouse manager for Accenture in Texas. As part of a healthcare plan the company offered employees money toward a wearable fitness device. Fuller used it to buy a Fitbit Charge 2.

Essential reading: Best heart rate monitor and watches to buy

He took the heart rate data the device logged to his doctor who gave him an electrocardiogram (EKG) to check for signs of heart disease. Fuller was referred to a cardiologist and asked to wear a specialist heart rate monitor for two weeks. He was diagnosed with atrial fibrillation (AFib), a quivering or irregular heartbeat.

How people are actually using heart rate monitors on their wearables

In April 2019, Fuller’s heart rate shot up to 130BPM where it stayed for a week. This time doctors gave him an ablation, an electric treatment designed to shock irregular heartbeats back into rhythm.

It's early days, but Fuller’s pulse appears to have steadied. At a checkup six weeks after the ablation, Fuller was asked if he monitored his heart rate. When he replied that he did, the doctors said that he could stay off the meds. If his heart rate fluctuates his Fitbit will let him know.

Jack Fuller checks his Fitbit multiple times a day. He looks at his heart rate, his sleep patterns, and gets mad if the device doesn’t sync correctly. To help reach his 10,000 daily step goal he takes Lucy, his golden retriever puppy, for a two-mile walk every morning. Fuller is just one of the many people that are now using that heart rate data in truly life-changing ways.

In the doctor's office

How people are actually using heart rate monitors on their wearables

Picture credit: Online Marketing on Unsplash

The rise of fitness trackers like the Charge and smartwatches like the Apple Watch, along with the advent of heart rate monitoring technology, has changed the way people understand their bodies. It has also changed the way patients and doctors interact.

Watches and smartphones can now supply data that would have taken weeks to collect. Devices can illuminate hidden problems and even detect things while users are asleep.

A recent heart rate monitor market research report showed that use of wearable heart rate monitors continues to grow, with sport said to be the biggest application of the technology. Though with more devices introducing ways to harness that HR data for insights outside of the sporting realms, it seems likely that will change.

Read this: A guide to using Apple Watch heart rate monitor

Dr Ralph Brindis is the senior medical officer at the American College of Cardiology’s National Cardiovascular Data Registry. The 70-year-old is an obsessive swimmer and marvels at the data his Apple Watch Series 4 collects.

“It will chart all four strokes that I do,” he says. “I don’t tell it what I'm doing; it knows what I’m doing.”

Brindis has also used his watch to diagnose heart conditions.

He was playing golf with friends when one of them said his heart was thumping. The doctor removed his watch and placed it on his friend’s wrist and performed a 30-second EKG. The heart rate reading was 145.

Brindis massaged his friend’s chest and administered some beta blockers, which slowed the pulse. A few weeks later the friend underwent an ablation. The availability of this technology short-tracked his friend’s evaluation by months, Brindis believes.

Working out

How people are actually using heart rate monitors on their wearables

Garmin has seen an evolution in how its customers use heart rate data. Where historically it was an athletic tool, something to optimise training and workouts, users now want data that goes several steps beyond what a simple fitness tracker could provide.

“Heart rate tells a bigger, more complete story,” says Joe Heikes, lead product manager at Garmin.

Read this: Garmin heart rate monitor guide

Combining heart rate with other data points allows for informed decisions about eating habits, exercise, stress and sleep. “People are just very curious about their data, about their body and heart rate is a big part of that,” Heikes says.

Tech analyst Tim Barajin had a triple heart bypass in 2012 and has been diabetic for nearly 30 years. He wears an Apple Watch Series 4.

Over the last couple of months Barajin noticed the device recording big fluctuations in his heart rate. “Oh crap, I got another thing to deal with,” he thought.

How people are actually using heart rate monitors on their wearables

The jumps came at random moments, when walking, sitting or even sleeping. He took the data to his doctor and was told the palpitations may indicate an irregular heartbeat. They gave him a specialist monitor to wear for three weeks. He is awaiting further diagnosis.

We believe Apple is very interested in helping to streamline the bureaucracy in how health data is managed

Barajin believes Apple’s position at the forefront of consumer wearable heart monitoring is no coincidence.

“It was extremely conscious,” he says. “Steve Job’s illness embedded in all of Apple's top management a complete and sincere desire to try to find solutions for helping people monitor their health.”

The inclusion of EKG in watches could potentially lessen the need for costly medical procedures like heart bypasses.

“We believe Apple is very interested in helping to streamline the bureaucracy in how health data is managed and privately distributed,” Barajin says.

In the future, Barajin expects to see advances in wearable blood pressure and blood sugar monitoring from Apple and other manufacturers.

“The traditional tech companies are all moving towards how they can help their customers stay healthier,” he said.

Is more HR data a good thing?

How people are actually using heart rate monitors on their wearables

The recent Apple Heart Study saw over 400,000 people volunteer their data. Standard clinical trials are expensive. Mass participation clinical research enabled by wearables could save millions of dollars, Brindis says, but there are caveats.

Most Apple Watch wearers tend to be younger than the average heart disease patient. The Apple study revealed a very low percentage of AFib among its population.

The sheer scale of the data collected by wearables is another concern.

Brindis argues there is a risk of “information overload” as doctors are asked to analyse data that may ultimately have little significance. This also carries a financial burden.

Wearable data collection is free, once you remove the price of a device, but analysis carries a cost. In some health systems doctors charge for such services.

Brindis cautions that the cost of devices could also perpetuate “disparities in healthcare,” which are “typically socioeconomic or ethnically focused.” But overall, he is excited by the opportunities wearables afford the medical profession.

“Harnessing digital products is going to be huge,” he says. “Companies like Google and Apple are going to begin to figure out how to harness this technology that will make it very cost effective doing large scale interventions. The opportunities are just going to be magnified over time.”

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