A number of doctors are raising concerns that the ECG feature on the new Apple Watch Series 4 could lead to a “whole new level of anxiety for hypochondriacs, unnecessary testing and panicked visits to emergency,” according to a new report by Canada’s National Post. While both Apple and the American Heart Association touted the new feature as leading to a quicker diagnoses of atrial fibrillation (AF) — a condition that affects approximately 34 million people worldwide, often with no obvious symptoms — studies have found that systemically screening large groups of people for AF “isn’t terribly productive” according to Montreal cardiologist Dr. Christopher Labos in an article published by McGill University’s Office for Science and Society. Dr. Labos went on to add that “The danger with any new medical technology is that in the enthusiasm to be an early adopter, for what is an admittedly cool gadget, we risk engaging in a population-wide screening strategy that is decidedly flawed.”
Doctors are particularly concerned about false positives, with Labos noting that they’ll be especially common when testing healthy people, who are more likely to be the target market for the Apple Watch. As Dr. Samuel Vaillancourt of Toronto’s St. Michael’s Hospital added, “The fear is we could end up with a lot of over treatment, over call and people waiting in emergency departments for no good reason,” while Dr. Ethan Weiss, an associate professor at the University of California at San Francisco, went even further, telling The Atlantic, “This is going to create such a massive headache” for doctors, with “Every worried [healthy] Tom, Dick, and Harry […] freaking out about every blip thing that shows up on their Apple Watch.” Weiss adds that he’s not “an alarmist” about unnecessary tests, but that he had dealt with a “number of patients who were found to have certain conditions because of inappropriate screening” causing them unnecessary stress.
The National Post article also makes the interesting point that American Heart Association does not actually endorse the Apple Watch, despite the presentation by the association’s president at the product’s unveiling. Several doctors also noted that the ECG feature isn’t necessarily the panacea that many are making it out to be, with Dr. Vaillancourt adding that a single-lead ECG can’t diagnose a heart attack, and it’s important that users understand that in situation where they suddenly start experiencing chest pain, despite the lack of any unusual readings from the ECG app. On the flip side, even for its intended purpose of diagnosing atrial fibrillation, Dr. Labos notes that it’s not something that will kill a person by itself, but merely increase the risk of stroke, combined with other risk factors. The intent of course is to ensure users seek medical attention, but the concern from physicians is that many will simply pour into emergency rooms fearing a life-threatening condition, rather than simply consulting with their family doctor.
Dr. Andrew Ha, a cardiac electrophysiologist at the Peter Munk Cardiac Centre at Toronto’s University Health Network, notes that “it’s a tricky scenario” as users who detect something in the app should definitely share it with a doctor and have further testing done “to figure out if it’s atrial fibrillation, or if it’s nothing,” but adds that the likelihood of AF in people even in their 30s or 40s is “probably less than one per cent,” and that there’s a need to educate the public to what atrial fibrillation is, and that “if you have Afib, it’s not the end of the world,” but rather something that needs to be weighed by a doctor along with other risk factors and conditions.