iPhone Heart App Atrial Fibrillation & Irregular Heart Rate Notifications

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Level 1

51 points

iPhone Heart App Atrial Fibrillation & Irregular Heart Rate Notifications

Why can't all types of heart irregularities be mingled into one application so users can make sure all arrhythmia's show together on my iPhone ? For Instance, I have always kept my heart app on irregular heart rate (IHR) in hopes of catching all irregularities. When I had 3 days of continuous AF this past year (ended up ER), I looked under the atrial fibrillation (AF) section on the Heart app and no data showed. I thought that was strange. In searching further, I looked under IHR and saw the beat-to beat measurements. Other than feeling like when this started and then running a rhythm strip, my watch did not notify me I was in AF. Will the watch alert me now if I have a run of AF since I changed the notification?

[Edited by Moderator]

iPhone 14 Pro, iOS 18

Posted on Feb 26, 2025 5:54 AM

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Answer 1

Top-ranking reply

MrHoffman

Level 10

148,569 points

Feb 26, 2025 6:46 AM in response to isj1

Watch provides intermittent lead one monitoring, arm to arm across the left lateral aspect of the heart.

Twelve cardiac leads are commonly used for a more complete picture of the electrical activity of the heart, and that isn’t always enough given metabolic and other potential causes of arrhythmias.

Detecting all possible arrhythmias from one cardiac lead located on a wrist (lead one monitoring) is impossible.

And that’s before we get to discussions of monitoring artifacts, whether due to muscle movement or “road rhythms” as routinely arise in EMS transports, and other sorts of cardiac issues and monitoring errors.

You’ll need a purpose-built cardiac monitor for better coverage, either temporally for more continuous monitoring coverage, or with more leads for more complete monitoring.

Here? Check with your primary care physician or cardiologist. Ask them what they recommend.

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Answer 2

Feb 26, 2025 6:21 AM in response to isj1

The watch does not constantly monitor your heart rate for AFib. It only checks periodically. If you have Irregular Heart rhythm notifications enabled, and the watch detects it during it's periodic checks, you will be notified.

Heart health notifications on your Apple Watch - Apple Support

Now that you have a diagnosis of AFib, you should enable AFib tracking. You will then get estimates of how much time you have spent in AFib and what other factors may be associated with it.

Track your AFib History with Apple Watch - Apple Support

The Apple Watch is not a subsitute for something like a Holter monitor.

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Answer 3

MrHoffman

Level 10

148,569 points

Mar 12, 2025 7:20 AM in response to isj1

Artifact is commonly encountered in cardiac monitoring, with causes including muscle activity and movement, and due to skin conductivity.

We routinely encountered artifact on three- and twelve-lead cardiac monitors and defibrillators, particularly during patient transport. That was with well-regarded ten-thousand-dollar medical electronics.

Automated rhythm interpretation with that gear was variously quite wrong, too.

I expect there will be improvements in Apple Watch monitoring and detection, but I don’t expect it will soon replace a cardiac monitor.

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Answer 4

isj1 Author

Level 1

51 points

Mar 9, 2025 2:12 PM in response to IdrisSeabright

I did have irregular notifications for the past year as I interpreted the instructions that the watch would monitor all rhythms intermittently. So last month, I switched to Afib only. I did see a percentage noted that really tells you nothing without any capture of the rhythm. I had a Watch Series 4 until last year. That watch after 2 years did the same thing and could not get my tracing. The rhythm would start and stop after a few seconds. I was not moving. Finally spoke with tech support who was awesome (Caleb) on the phone and he had me send it in to be looked at. They sent me a new watch, not refurbished. It worked well afterwards but decided to upgrade to the 9. This one doing the same thing. Tech support had me on for over an hour. I was not happy. They wanted my permission to have some of my data so they can review it. I said no and asked why I could not send it back like the last time. They wanted me have me unpair and then repair it back. I had a friend do it for me on Friday but no change. It keeps starting and stopping and not allowing all 30 sec strip. Not happy with my service this time. I was told by tech support they have a new system to follow now...... yea.... how to **** off a customer with a 1,001 questions. Will go back and wear my regular watch now.

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Answer 5

isj1 Author

Level 1

51 points

Mar 9, 2025 2:23 PM in response to IdrisSeabright

Don't need a Holter monitor as I've worn several ZIO monitors and they do show I exhibited different rhythms. I can feel my Afib now and trying to match it with other symptoms that are concurrent. My Afib was basically non-existent for several years so this is making me anxious. I am trying to figure out if they are real or not. I can interpret if the rhythm is regular or irregular. However, I still walk my 3 miles without any other problems. Thanks

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Answer 6

isj1 Author

Level 1

51 points

Mar 12, 2025 5:33 AM in response to MrHoffman

Just an FYI.... went to cardiologist for my yearly. Brought him 3 tracings taken from watch that indicated Afib. He told me the tracings were not Afib but artifact. They were all taken at different times and dates. So now I don't know if the Afib history is accurate. Maybe a future watch could pick up the tracing automatically when this occurs and save it.... especially if these episodes happen at sleep.

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iPhone Heart App Atrial Fibrillation & Irregular Heart Rate Notifications

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