A 42-year-old man presented to the emergency department (ED) with newly diagnosed atrial fibrillation of unknown duration. Interrogation of the patient’s wrist-worn activity tracker and smartphone application identified the onset of the arrhythmia as within the previous 3 hours, permitting electrocardioversion and discharge of the patient from the ED. [Ann Emerg Med. 2016;-:1-3.]
Appearing in the Annals of Emergency Medicine, the case study involves the unnamed man arriving at Our Lady of Lourdes Medical Center following a seizure. The staff quickly noticed he had an atrial fibrillation (an irregular heart beat) but couldn’t know for sure whether it was chronic or triggered by the seizure.
That may sound like an insignificant detail, but it’s potentially a matter of life and death. If the atrial fibrillation was triggered by the seizure, then the hospital’s preferred course of action is to electrically cardiovert the patient to restore the heart rate to normal levels – and not doing so could result in a stroke. On the other hand, if the high heart rate was chronic, then the same treatment could also trigger a stroke by dislodging an appendage clot.
The doctors quickly noticed the patient’s Fitbit Charge HR, and consulted the heart rate record on the accompanying app. Or as the report puts it: “The application was accessed on the patient’s smartphone and revealed a baseline pulse rate between 70 and 80 beats/min, with an immediate persistent increase to a range of 140 to 160 bpm at the approximate time of the patient’s seizure. The pulse rate remained elevated until administration of the diltiazem in the field.”
If only the patient was wearing some kind of device that passively tracks heart rate for the past few hours…