Your smartwatch knows a lot about you—how you slept, how many steps you’ve taken today and whether you’ve been exposed to ear-damaging noise. Your watch may even alert authorities if you’ve fallen and need medical assistance.
“Wearables like smartwatches and fitness bands are great tools to help patients understand and improve their health,” says UNC Health cardiac psychologist Lindsey Rosman, PhD, who helps heart patients strengthen their mental and emotional health.
But once you have a diagnosed cardiac condition, some of those heart rate alerts may become less useful. In fact, they may cause you unnecessary stress and worry, according to a paper Dr. Rosman and her colleagues published in the Journal of the American Heart Association.
How should people with a cardiac condition use their smartwatch? Dr. Rosman provides some guidance based on the research.
Wearables Create More Anxiety in People with Atrial Fibrillation
Atrial fibrillation is a type of arrhythmia in which your heart beats irregularly or very rapidly. It can cause symptoms such as heart palpitations, chest pain, dizziness and shortness of breath, and it has been linked to an increased risk of stroke and heart failure.
Your doctor may treat A-fib with medications, implantable devices, ablation or surgery. It’s also important to make heart-healthy lifestyle changes, including managing your stress. That may not be so easy if your device is often telling you that you’re experiencing an irregular heart rate.
“When your watch draws attention to those symptoms, it can create anxiety, even when you know you have a diagnosis,” Dr. Rosman says. “People with atrial fibrillation are already more likely to experience stress and anxiety than those who don’t.”
In Dr. Rosman’s research, 20 percent of people with A-fib who wore a wearable experienced intense fear and anxiety and contacted their doctor because of an alert they received. Compared to people who didn’t use a wearable, they were more likely to report preoccupation with their symptoms and concerns about treatment.
Becoming overly preoccupied with heart symptoms has been linked to unnecessary medical care, social withdrawal, avoiding activities and worse health outcomes. In a previous paper, Dr. Rosman and colleagues reported on a person with atrial fibrillation who used their smartwatch to perform more than 900 electrocardiograms in one year. That constant worry has a negative impact on mental health, relationships and quality of life.
And while it’s important to be aware of symptoms, current wearables may not provide accurate enough information to raise such concerns.
“It’s important to keep in mind that these devices were originally tested on healthy young people, not people with these heart conditions,” Dr. Rosman says. “Devices can also vary in their accuracy in terms of measuring heart rate and rhythm. Some devices are more accurate than others.”
Some who wore wearables said that the alerts from their device helped them feel safer and more confident in managing their symptoms, so it may be a matter of learning what kinds of alerts you’ll be able to receive without experiencing unnecessary distress.
You Can Adjust Your Wearable Based on Your Needs
If you have an established heart condition, Dr. Rosman says it’s fine to use a smartwatch or fitness tracker to encourage activities such as getting more exercise or prioritizing sleep, but you should remember that these devices have limits when it comes to chronic conditions.
“If you’re on appropriate medications for your heart condition, you may not need to always be aware of your heart rate,” she says. “If you take a medication that you know lowers your heart rate at night, then wearing your watch while you sleep and getting an alert that your heart rate was low all night may not be helpful.”
Instead, Dr. Rosman recommends talking to your doctor about what sort of monitoring they want you to do—which may not involve your smartwatch—and then disabling some of the notifications that your device sends you.
“The sensors and settings can be adjusted on most devices,” Dr. Rosman says. “If you have a known underlying condition, you can change the alerts you get for heart rate and rhythm.”
Understanding how to change the settings on these devices isn’t always easy, and Dr. Rosman hopes that changes.
“People and their doctors need more information on what these devices can and can’t do,” she says. “There needs to be a way to better explain what info is going to be displayed when these are purchased, especially if someone has an underlying condition.”
Understanding Remote Monitoring vs. Smartphone Data
Remember that if you have an implantable cardiac device such as a pacemaker or defibrillator, your doctor already knows how your heart is performing.
“Implantable cardiac devices are medical-grade devices that are FDA-approved, and they perform remote monitoring,” Dr. Rosman says. “There are device clinics with dedicated staff whose full-time job is to manage that information.”
That means your doctor doesn’t need you to keep track of heart rate or rhythm on your smartwatch or other wearable, as the job’s already being done with a reliable and professionally monitored device. And even if you don’t have an implantable cardiac device, there can be such a thing as too much data.
“If you have a heart condition, talk to your health care provider about how you’re going to use your personal device,” Dr. Rosman says. “It can be an important tool for how active you are, but for the information about heart rate and rhythm, ask about when you should check that and when the provider wants that information.”
Does your smartwatch have you asking questions about your health? Talk to your doctor. If you need a doctor, find one near you.