AI system
- System
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Apple Watch heart-rate notifications, Irregular Rhythm Notification and ECG app
- Model
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Not assessed
- Release
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Exact release not established.
- Application developer
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Apple - Role
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The watch analyzed heart-rate signals and generated notifications about abnormal readings.
- Configuration
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The initial report concerned an Apple Watch Series 2. Later reports involved several other watch generations.
- Inputs and outputs
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Not assessed
- Autonomy
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Not assessed
- Workflow
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The wearer owns an Apple Watch with heart-rate notifications, Irregular Rhythm Notification or the ECG app enabled. An arrhythmia occurs while the watch is worn and the alert or recording leads the wearer to seek care. A clinician confirms the rhythm on a 12-lead ECG or monitoring and treats it.
- Human oversight
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Not assessed
- Relation to AI
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The watch's heart-rate algorithm generated the overnight alarms that brought the patient to hospital. Clinicians made the diagnosis on an ECG and chose treatment. In the echoes the notification or the ECG app's single-lead trace likewise triggered evaluation, with clinicians confirming the rhythm.
- AI contribution
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The watch's heart-rate algorithm generated the overnight alarms that brought the patient to hospital. Clinicians made the diagnosis on an ECG and chose treatment. In the echoes the notification or the ECG app's single-lead trace likewise triggered evaluation, with clinicians confirming the rhythm.
Benefits
- Outcome identifiers
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Not assessed
- Benefit
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her pulse exceeded 120 beats per minute while she was inactive
- Category
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Improved Physical Health
- Status
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Not assessed
- Beneficiary groups
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People.
- Beneficiaries
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Not assessed
- Reach
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Not assessed
- Distribution and access
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Not assessed
- Duration
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Not assessed
- Expected?
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Yes
- Costs and harms
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Not assessed
Measurement
- Studies
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Not assessed
- Study design
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Not assessed
- Measurement
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Not assessed
- Setting and sample
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Not assessed
- Measures
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her pulse exceeded 120 beats per minute while she was inactive
- Comparison
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Not assessed
- Results
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her pulse exceeded 120 beats per minute while she was inactive
- Additional value from AI
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Not assessed
- Limitations
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Not assessed
- Denominators
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Not assessed
- Materials for replication
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Not assessed
Money
- Kind of value
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Not assessed
- Amount
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Not assessed
- Currency and prices
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Not assessed
- Period and unit
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Not assessed
- Realization
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Not assessed
- Recipients and payers
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Not assessed
- Gross or net
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Not assessed
- Included costs
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Not assessed
- Comparison
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Not assessed
- Method
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Not assessed
- Return and payback
-
Not assessed
People and places
- Participants
-
Developer:
Apple. - Jurisdictions
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Benefit:
United Kingdom. Developer: 
United States. - Ownership and control
-
Not assessed
- Dependencies
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Not assessed
- Cross-border connections
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Not assessed
- Geopolitical implications
-
Not assessed
Follow-up
- Conditions for replication
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The alert or trace reaches a clinician rather than being dismissed. Confirmatory ECG or electrophysiology testing is available. A treatment pathway (anticoagulation, cardioversion, ablation, device) exists.
- Replication attempts
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16 follow-up entries. Benefit recurred: 15. Outcome unresolved: 1.
- Later findings
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25 April 2024. A 2024 systematic review of smartwatch arrhythmia case reports found 44 patients across 33 articles, with the Apple Watch used in 30 of them.
- Availability
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Not assessed
- Institutional decision
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Not assessed
- Grounds
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Not assessed
- Action and result
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Not assessed
- Success criterion
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Not assessed
Evidence
- Source numbers
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AIBD-0021-source-0001–0017
- Citations
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Numbered references below.
- Language
-
Not assessed
- Source relationships
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Independent
- Original evidence
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Not assessed
- Access and versions
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Not assessed
- Supported findings
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Not assessed
- Evidence links
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Not assessed
- Evidence strength
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Not assessed
- Missing evidence
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Not assessed
Grades
- Assessed benefits
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People.
- Depth
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People: 2.
- Reasons
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People: One woman with a recent TIA received an ECG-confirmed AF diagnosis, rate control and anticoagulation. A material benefit to one person. Several echoes (VT ablation with defibrillator, pacemaker for heart block) are deeper but are not the event.
- Observed or intended
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Not assessed
- Rubric
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Not assessed
- Assessor and date
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Not assessed
- Alternative assessments
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Not assessed
- Fill
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Independently studied
Entry details
- Kind
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Not assessed
- Related entries
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Same device: Apple Watch automatic sensor alerts; Crash Detection misclassified skiing as accidents and placed false 911 calls, burdening Apple Watch users, ski patrols and dispatchers, the inverse of a true heart-rate alarm sending one wearer to hospital.
- Field
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Healthcare (cardiology). Consumer wearables.
- Purpose
-
Apple Watch high/low heart-rate notifications, the Irregular Rhythm Notification and the ECG app are built to flag possible arrhythmias so the wearer seeks medical review. This benefit was that purpose.
- Dates
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Date basis unassessed: 2019 (precision unassessed). Updated: 21 October 2026.
- Stage
-
Not assessed
- Version
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SHA-256: 905a54793460…
References
- Other identifiers
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AI Incident Database: 463.
- Category mappings
-
Not assessed
- Brief
-
Not assessed
- Revisions
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7 revisions. Latest: 21 October 2026.
Sources
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Peer-reviewed study Independent author
Bogár B, Pető D, Sipos D, Füredi G, Keszthelyi A, Betlehem J, Pandur AA (2024). Detection of Arrhythmias Using Smartwatches—A Systematic Literature Review. Healthcare 12(9):892.
In most cases (n = 30), the Apple Watch was used, while Samsung Galaxy Fit was used for arrhythmia registration in one patient.
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Case report Independent author
Weichert I (2019). 'My watch kept on alarming all night about my heart rate': diagnosis of asymptomatic atrial fibrillation with fast ventricular response in a patient with a recent TIA as the result of a smartwatch alarm. Oxford Medical Case Reports 2019(3):omz014.
Her smartwatch had alarmed several times during the preceding night that her pulse rate exceeded 120 beats per minute (bpm) whilst she was inactive
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Case report Independent author
Overbeek DL, Hogikyan EM, Davis M, McGillicuddy DC (2019). A unique case of bradycardia recognized by wearable technology as first presentation of complete heart block. American Journal of Emergency Medicine 37(10):1989.e5-e7.
A previously-healthy mid 60s-year-old-woman presented to the Emergency Department (ED) stating that her 'Apple Watch' wearable device was alarming due to a low heart rate.
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Case report Independent author
Yerasi C, O'Donoghue S, Satler LF, Waksman R (2020). Apple Watch detecting high-grade block after transcatheter aortic valve implantation. European Heart Journal 41(10):1096.
He subsequently underwent urgent biventricular pacemaker implantation
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Case report Independent author
Goldstein LN, Wells M (2019). Smart watch-detected tachycardia: a case of atrial flutter. Oxford Medical Case Reports 2019(12):omz137.
a consistent rate of 150 bpm for the previous 4 days
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Case report Independent author
Siddeek H, Fisher K, McMakin S, Bass JL, Cortez D (2020). AVNRT captured by Apple Watch Series 4: Can the Apple watch be used as an event monitor? Annals of Noninvasive Electrocardiology 25:e12742.
captured an episode on the Apple watch that demonstrated tachycardia at a rate of about 225 bpm
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Case report Independent author
Samal S, Singhania N, Bansal S, Sahoo A (2020). New-onset atrial fibrillation in a young patient detected by smartwatch. Clinical Case Reports 8(7).
He was chemically cardioverted using intravenous flecainide per cardiology recommendations. He maintained sinus rhythm afterward and was discharged home on metoprolol and apixaban.
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Case report Independent author
Ahmed AS, Golden KM, Foreman JR, Padanilam BJ (2020). Using a smartwatch to identify the morphology of atrial flutter. HeartRhythm Case Reports 6.
ECG revealed typical atrial flutter with variable atrioventricular conduction
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Case report Independent author
Burke J, Haigney MCP, Borne R, Krantz MJ (2020). Smartwatch detection of ventricular tachycardia: Case series. HeartRhythm Case Reports 6.
The patient has not experienced further symptoms suggestive of arrhythmia, nor has he reported detection of event recordings on his smartwatch
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Case report Independent author
Patel D, Tarakji KG (2021). Smartwatch diagnosis of atrial fibrillation in patient with embolic stroke of unknown source: A case report. Cardiovascular Digital Health Journal 2(1):84-87.
Given her elevated CHA2DS2VASC score of 5 (age, female, previous stroke, and hypertension), the patient was started on a direct oral anticoagulant, and the aspirin was stopped.
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Case report Independent author
Kassam N, Aziz O, Aghan E, Somji S, Mbithe H, Bapumia M, Mvungi R, Surani S (2021). Smart Watch Detection of Supraventricular Tachycardia (SVT): First Case from Tanzania. International Medical Case Reports Journal 14.
a high resting heart rate of 210 beats/min
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Case report Independent author
Itoh A (2022). Apple Watch is useful in demonstrating coffee-triggered atrial fibrillation with a very short duration. European Heart Journal - Case Reports 6:ytac252.
After that, the patient stopped drinking coffee in the morning, and AF hardly occurred.
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Case report Independent author
Hawryszko M, Sławiński G, Kozłowski D, Lewicka E (2022). Apple Watch-guided diagnosis of AVNRT in a pregnant woman. Frontiers in Cardiovascular Medicine 9:985421.
narrow QRS complex tachycardia of 216 bpm, and short RP interval
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Case report Independent author
Heringer GV, Vinson DR (2024). Utility of smart watch in expediting diagnosis of cold drink-triggered atrial fibrillation: a case report. International Journal of Emergency Medicine 17.
Had it not been for his smart watch, the etiology of his transitory palpitations would have remained undiagnosed.
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Case report Independent author
Guarnieri G, Mapelli M, Moltrasio M, Agostoni P, Tondo C (2024). Connected health: Ventricular tachycardia detection with Apple Watch—A case report. Heliyon 10:e40595.
An alert message of 'Elevated Heart rate' from his Apple Watch® prompted him to record a single-lead ECG using the smartwatch.
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Case report Independent author
Rushakoff JA, Flores Rosario K, Grover P, Wang A (2025). Smartwatch bradycardia alarms leading to a diagnosis of lamin A/C cardiomyopathy: a case report. European Heart Journal - Case Reports 9(9):ytaf415.
An asymptomatic 47-year-old man from Costa Rica presented to cardiology clinic for evaluation of recurrent bradycardia alarms on his smartwatch (Apple Watch).
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Case report Independent author
Shroddha AD, Mukherjee I, Lambiase PD (2026). Apple Watch Saves an Athlete: Unmasking Early Detection of Arrhythmogenic Cardiomyopathy. Cureus 18:e113337.
In the early hours of Thursday, at 3:00 am, he awoke with frequent ectopic beats noted on his smartwatch single-lead ECG, which progressed to a broad complex tachycardia.