How do you counsel patients on wearable heart monitor devices when they ask about specific products and diagnostic accuracy of these devices available on the market?

It depends on the device. If a patient is experiencing palpitations infrequently, or there is an ongoing need to identify the cause of palpitations, I typically recommend a consumer-facing ambulatory ECG device that is FDA-cleared. They are quite accurate for detecting AFib and ectopic beats such as APCs and PVCs. They may be less accurate for other arrhythmias. They are considered pre-diagnostic and need to be verified by a clinician; often, a subsequent medical-grade ambulatory ECG monitor is required. I typically show them a few examples online from different companies, along with the price point, since they are not covered by insurance. I also encourage them to upload the ECGs into MyChart if they have questions. In general, I have foun...

Particularly in AF patients, we use a consumer-facing ambulatory ECG device that is FDA-cleared for diagnostic purposes. For data trending and follow up, we use both the above device (typically at 6 month intervals post-intervention) and wearables (predominantly Apple watches currently) and intermittent recording devices like Kardia. We track the correlation of the daily tracking by wearables (and Kardia, if the patients use it frequently and regularly, as recommended) with AF recurrences, further documented through formal EKG and 14 day monitors. We have found it to be overall excellent and the early alert to recurrences from wearables allows us to intervene sooner. This is a tactic we have reported in abstract form and on which we are wor...