The following is a summary of “Feasibility and Diagnostic Value of Recording Smartwatch Electrocardiograms in Neonates and Children,” published in the FEBRUARY 2023 issue of Pediatrics by Leroux, et al.

For a study, researchers sought to assess the agreement between smartwatch-derived single-lead electrocardiogram (ECG) recordings and 12-lead ECGs for diagnosing electrocardiographic abnormalities.

About 110 children (1 week to 16 years old) with normal (12-lead) or abnormal (12-lead) 12-lead ECGs (atrioventricular block, supraventricular tachycardia [SVT], bundle branch block, ventricular preexcitation, and long QT were given an ECG utilizing an Apple Watch and a 12-lead ECG. When a child was younger than six years old, an adult actively assisted in the ECG recording by placing the baby or toddler’s finger on the watch’s crown. 

After a brief lesson without adult supervision, older kids’ tracings might be made. Two cardiologists who were blinded independently assessed each 12-lead ECG. Another cardiologist who was blinded analyzed Apple Watch ECGs independently.

Smartwatch tracings were of sufficient quality for evaluation in 109 children (99.1%). The sensitivity of the smartwatch tracings was 84%, while the specificity was 100% for detecting abnormal ECGs. All 75 normal tracings were correctly identified. Of the 35 children with abnormalities on 12-lead ECGs, 5 (14%) were missed, primarily due to baseline wander and artifacts. Rhythm disorders, such as atrioventricular block or supraventricular tachycardia, and bundle branch blocks were correctly detected in most cases (11 of 12 and 11 of 12, respectively). Preexcitation and long QT were detected in four of six and four of five cases, respectively.

Smartwatch ECGs recorded with parental assistance in children aged up to six years and independently in older children have the potential to detect clinically relevant conditions. However, smartwatch ECGs should be interpreted cautiously, as they may miss certain abnormalities due to baseline wander and artifacts.

Reference: jpeds.com/article/S0022-3476(22)00811-3/fulltext