Current Cardiology Reports

, 21:158 | Cite as

Wearing Your Heart on Your Sleeve: the Future of Cardiac Rhythm Monitoring

  • Mostafa A. Al-Alusi
  • Eric Ding
  • David D. McManus
  • Steven A. LubitzEmail author
Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Invasive Electrophysiology and Pacing


Purpose of Review

This review describes the novel category of wearable ECG monitors and identifies where patients, healthcare providers, and device manufacturers should focus efforts to maximize the clinical benefit of these devices.

Recent Findings

Notable wearable ECG monitors include the AliveCor Kardia devices, Apple Watch Series 4, and several others. The most common use case is monitoring for atrial fibrillation. The available evidence validates the ability of the Kardia devices and Apple Watch to distinguish atrial fibrillation from sinus rhythm. Key questions for manufacturers include how to calibrate each device’s algorithms and streamline workflows for healthcare providers.


Wearable ECG monitors are currently most useful to detect atrial fibrillation. Further study is needed to demonstrate whether wearable ECG monitors improve patient outcomes, and to expand their use into other indications. Device manufacturers and healthcare providers must work together to establish new workflows to process and act on wearable ECG data.


Atrial fibrillation Stroke Wearables Electrocardiogram Apple Watch AliveCor 



We are grateful to Daniel B. Kramer, MD, MPH, for critical review of the manuscript.

Funding Information

David McManus is supported by NIH grants R01HL126911, R01HL137734, R01HL137794, R01HL13660, R01HL141434, and U54HL143541.

Steven A. Lubitz is supported by NIH grant 1R01HL139731 and American Heart Association 18SFRN34250007.

Eric Ding is supported by a grant from the National Heart, Lung, Blood Institute (Grant #5T32HL120823).

Compliance with Ethical Standards

Conflict of Interest

Mostafa A. Al-Alusi and Eric Ding declare that they have no conflict of interest.

David McManus has received research support from Apple Computer, Bristol-Myers Squibb, Boehringher-Ingelheim, Flexcon, Fitbit Heart Rhythm Society, Pfizer, Samsung, Philips Healthcare, Biotronik, and has received consultancy fees or honoraria from Bristol-Myers Squibb, Pfizer, Flexcon, Boston Biomedical Associates, Samsung, and Rose Consulting.

Steven A. Lubitz receives sponsored research support from Bristol Myers Squibb / Pfizer, Bayer AG, and Boehringer Ingelheim, and has consulted for Bristol Myers Squibb / Pfizer and Bayer AG.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Mostafa A. Al-Alusi
    • 1
  • Eric Ding
    • 2
  • David D. McManus
    • 3
  • Steven A. Lubitz
    • 4
    Email author
  1. 1.Department of Internal MedicineMassachusetts General HospitalBostonUSA
  2. 2.Department of Population and Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Division of Cardiovascular Medicine, Department of Medicine and Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Cardiac Arrhythmia Service and Cardiovascular Research CenterMassachusetts General HospitalBostonUSA

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