{ "id": "AIBD-0284", "title": "Apple Watch Series 3 heart-rate drop from 99 to 65 bpm marks an 80-year-old woman's spontaneous reversion from atrial fibrillation, confirmed on a concurrent Holter", "summary": "Melbourne cardiologists matched 199 Apple Watch heart-rate readings to a Holter: the watch showed a sudden 99-to-65 bpm drop at 19:29 that coincided with reversion from AF to sinus rhythm.", "date_observed": "2020-02-04", "date_basis": "unassessed", "date_precision": "unassessed", "benefit_status": null, "source_collection": null, "source_entry": null, "account": "Toner, Al-Kaisey, Koshy and Lim of the Department of Cardiology, Austin Hospital, Melbourne, reported a case in BMJ Case Reports (published 4 February 2020). The event date is not given. An 80-year-old woman with known paroxysmal atrial fibrillation wore a 24-hour Holter monitor to assess rate control. On returning the monitor she reported feeling her heart “doing a flip” at 19:29. She noted her heart rate had suddenly dropped from 99 bpm to 65 bpm on her Apple Watch Series 3. The Holter showed she had reverted from AF to sinus rhythm at that time. The authors exported 199 watch readings over 22 hours and matched them to the Holter. The watch's average heart rate was 94 bpm in AF and 66 bpm after reversion. No notification, irregular-rhythm alert or electrocardiogram (ECG) app is described: the patient read the heart-rate display herself. The report documents no change in her treatment. The full text was not available from BMJ. The PMC copy is among the sources and names the device.", "category": "benefit created", "unexpected": false, "purpose": "The watch's optical heart-rate estimate is built to show the wearer their pulse. Its use here to time a rhythm change was that function, read by the patient rather than flagged by the device.", "system": "Apple Watch Series 3 heart-rate readings (optical photoplethysmography)", "model_version": "Apple Watch Series 3", "developer": "Apple", "deployer": null, "location": "Melbourne, Australia", "domain": "Healthcare (cardiology)", "segment": "Consumer wearables", "benefit_type": "Improved Physical Health", "taxonomy_note": null, "registry_ids": {}, "ratings": [ { "group": "personal", "depth": 1, "reason": "The patient learned from her watch, and had confirmed by Holter, that her rhythm had reverted at 19:29. The report records no change in management, so the benefit is informational only." } ], "ai_role": { "status": "assessed", "statement": "No alert, notification or rhythm classifier was involved. The watch displayed a photoplethysmographic heart-rate estimate, the patient noticed the drop, and the authors compared the readings with the Holter afterwards. The paper does not describe the heart-rate estimation as machine learning. So the AI character of the contribution is not established." }, "evidence": [ { "kind": "case report", "citation": "Toner L, Al-Kaisey AM, Koshy A, Lim HS (2020). Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch. BMJ Case Reports 13(2):e233431. doi:10.1136/bcr-2019-233431 (PMC7035811).", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7035811/", "date": "2020-02-04", "written_by": "independent", "quote": "she noted her heart rate suddenly drop from 99 bpm to 65 bpm as measured by her Apple Watch Series 3 (Cupertino, USA)" }, { "kind": "case report", "citation": "Toner L et al. (2020), BMJ Case Reports 13(2):e233431, Holter confirmation.", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://europepmc.org/article/MED/32024718", "date": "2020-02-04", "written_by": "independent", "quote": "Review of the Holter monitor revealed she had reverted from AF to SR at that time" }, { "kind": "case report", "citation": "Toner L et al. (2020), BMJ Case Reports 13(2):e233431, learning points.", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7035811/", "date": "2020-02-04", "written_by": "independent", "quote": "Sudden and persistent changes in heart rate as detected by smart watches should alert clinicians to the possibility of cardiac rhythm changes." } ], "replication": { "produced_by": [ "A patient with known paroxysmal AF wearing a heart-rate-displaying smartwatch while a Holter monitor was also fitted", "The patient noticing and reporting a sudden, persistent heart-rate drop with its time", "Clinicians willing to export the watch readings (Apple Health app to Excel) and align them with the Holter" ], "must_hold": [ "The rhythm change produces a heart-rate change large enough to be visible on the watch's optical estimate", "A reference recording (Holter) exists to confirm what the watch suggested" ], "echoes": [] }, "paired_incident": null, "headline": "Apple Watch Series 3 drop from 99 to 65 bpm marks AF reversion", "metric": "sudden 99-to-65 bpm drop at 19:29 that coincided with reversion from AF to sinus rhythm", "comparator": { "against": "a concurrent 24-hour Holter monitor", "before": null, "after": null, "basis": "measured", "quote": "A total of 199 heart rate readings were recorded from the Apple Watch and matched to 199 readings of the same time intervals on Holter monitoring over a 22-hour period as shown in figure 2 (median interval 6 min and IQR of 5.75 min). Moreover, the average HR as measured by smart watch in AF prior to reversion was 94 bpm compared with 66 bpm after reversion to SR.", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7035811/" }, "later": { "status": "unknown", "date": null, "note": "The report says only that outcomes of smartwatch-detected arrhythmias are the subject of ongoing research; nothing later was found.", "quote": null, "url": null }, "value": null, "developer_country": "United States", "deployer_country": null, "unrated_because": null, "brief_notes": null, "brief": null, "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "source": null, "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Knowledge Discovery among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/Apple_Inc.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "source": null, "editor": "AIBD" }, { "date": "2026-10-21", "change": "Notes about which sources could be read were reworded for readers; facts, figures and quotations unchanged.", "source": null, "editor": "AIBD" } ], "confidence": "studied", "shade": "high", "claim_status": "Independently studied", "claim_basis": "Sources: two independent case reports. The cited evidence includes no finding by a regulator or court.", "profile": { "case_id": "AIBD-0284", "catalog_version": "1.0.0", "source_fingerprint": "21ad16cb86c219fb89e5514f46842e2eef6316bcd0595a6f644bce5798f809ad", "collection_refs": [ { "collection_id": "aibd", "version": "snapshot-8bf7cfec9cb185aa" }, { "collection_id": "aibd", "version": "2026-10-25" }, { "collection_id": "viator", "version": "2026-10-25" } ], "source_ids": [ "AIBD-0284-source-0001", "AIBD-0284-source-0002", "AIBD-0284-source-0003" ], "families": { "strategic assessments": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "evaluations": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "monetary observations": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "institutional decisions": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] } }, "fields": { "actors[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "developer": "Apple" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "developer" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "actors[].ownership_control": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "ai_contribution": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ai_role": { "status": "assessed", "statement": "No alert, notification or rhythm classifier was involved. The watch displayed a photoplethysmographic heart-rate estimate, the patient noticed the drop, and the authors compared the readings with the Holter afterwards. The paper does not describe the heart-rate estimation as machine learning. So the AI character of the contribution is not established." } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "ai_relationship": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "category": "benefit created", "ai_role": { "status": "assessed", "statement": "No alert, notification or rhythm classifier was involved. The watch displayed a photoplethysmographic heart-rate estimate, the patient noticed the drop, and the authors compared the readings with the Holter afterwards. The paper does not describe the heart-rate estimation as machine learning. So the AI character of the contribution is not established." } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ai_role", "category" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "assessments[].alternatives": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "assessments[].assessor_date": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "assessments[].depth": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ratings": [ { "group": "personal", "depth": 1, "reason": "The patient learned from her watch, and had confirmed by Holter, that her rhythm had reverted at 19:29. 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The event date is not given. An 80-year-old woman with known paroxysmal atrial fibrillation wore a 24-hour Holter monitor to assess rate control. On returning the monitor she reported feeling her heart “doing a flip” at 19:29. She noted her heart rate had suddenly dropped from 99 bpm to 65 bpm on her Apple Watch Series 3. The Holter showed she had reverted from AF to sinus rhythm at that time. The authors exported 199 watch readings over 22 hours and matched them to the Holter. The watch's average heart rate was 94 bpm in AF and 66 bpm after reversion. No notification, irregular-rhythm alert or electrocardiogram (ECG) app is described: the patient read the heart-rate display herself. The report documents no change in her treatment. The full text was not available from BMJ. The PMC copy is among the sources and names the device.", "benefit_type": "Improved Physical Health" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "benefit_type" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].distribution": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].duration": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].id": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].stakeholder_group": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ratings": [ { "group": "personal", "depth": 1, "reason": "The patient learned from her watch, and had confirmed by Holter, that her rhythm had reverted at 19:29. The report records no change in management, so the benefit is informational only." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ratings" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].status": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].tradeoffs": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].unexpected": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "unexpected": false, "purpose": "The watch's optical heart-rate estimate is built to show the wearer their pulse. Its use here to time a rhythm change was that function, read by the patient rather than flagged by the device." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "unexpected", "purpose" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "places[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "location": "Melbourne, Australia", "developer_country": "United States" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "location", "developer_country" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "purpose": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "purpose": "The watch's optical heart-rate estimate is built to show the wearer their pulse. Its use here to time a rhythm change was that function, read by the patient rather than flagged by the device." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "purpose" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "record_dates": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "date_observed": "2020-02-04", "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Knowledge Discovery among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/Apple_Inc.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Notes about which sources could be read were reworded for readers; facts, figures and quotations unchanged.", "editor": "AIBD" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "date_observed", "revisions" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "replication.attempts[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "replication.conditions": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "replication": { "produced_by": [ "A patient with known paroxysmal AF wearing a heart-rate-displaying smartwatch while a Holter monitor was also fitted", "The patient noticing and reporting a sudden, persistent heart-rate drop with its time", "Clinicians willing to export the watch readings (Apple Health app to Excel) and align them with the Holter" ], "must_hold": [ "The rhythm change produces a heart-rate change large enough to be visible on the watch's optical estimate", "A reference recording (Holter) exists to confirm what the watch suggested" ], "echoes": [] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "revision_history[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Knowledge Discovery among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/Apple_Inc.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Notes about which sources could be read were reworded for readers; facts, figures and quotations unchanged.", "editor": "AIBD" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "revisions" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sector": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "domain": "Healthcare (cardiology)", "segment": "Consumer wearables" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "domain", "segment" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].access_version": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "sources[].citation_locator": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "evidence": [ { "kind": "case report", "citation": "Toner L, Al-Kaisey AM, Koshy A, Lim HS (2020). Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch. BMJ Case Reports 13(2):e233431. doi:10.1136/bcr-2019-233431 (PMC7035811).", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7035811/", "date": "2020-02-04", "written_by": "independent", "quote": "she noted her heart rate suddenly drop from 99 bpm to 65 bpm as measured by her Apple Watch Series 3 (Cupertino, USA)" }, { "kind": "case report", "citation": "Toner L et al. (2020), BMJ Case Reports 13(2):e233431, Holter confirmation.", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://europepmc.org/article/MED/32024718", "date": "2020-02-04", "written_by": "independent", "quote": "Review of the Holter monitor revealed she had reverted from AF to SR at that time" }, { "kind": "case report", "citation": "Toner L et al. (2020), BMJ Case Reports 13(2):e233431, learning points.", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7035811/", "date": "2020-02-04", "written_by": "independent", "quote": "Sudden and persistent changes in heart rate as detected by smart watches should alert clinicians to the possibility of cardiac rhythm changes." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "evidence" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].id": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "AIBD-0284-source-0001", "AIBD-0284-source-0002", "AIBD-0284-source-0003" ], "role": "Existing evidence items, in their original order" }, "provenance": { "kind": "curatorial", "basis": "Stable within the fingerprinted record version; no source content or source review has been added.", "record_fields": [], "source_refs": [] }, "review_state": "record_mapped", "coverage": "complete" }, "sources[].language": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "sources[].relationship": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "evidence": [ { "kind": "case report", "citation": "Toner L, Al-Kaisey AM, Koshy A, Lim HS (2020). 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(2020), BMJ Case Reports 13(2):e233431, learning points.", "title": "Spontaneous reversion of paroxysmal atrial fibrillation detected by smart watch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7035811/", "date": "2020-02-04", "written_by": "independent", "quote": "Sudden and persistent changes in heart rate as detected by smart watches should alert clinicians to the possibility of cardiac rhythm changes." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "evidence" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].upstream_sources": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "strategic_assessments[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "family": "strategic assessments" }, "summary": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "summary": "Melbourne cardiologists matched 199 Apple Watch heart-rate readings to a Holter: the watch showed a sudden 99-to-65 bpm drop at 19:29 that coincided with reversion from AF to sinus rhythm.", "account": "Toner, Al-Kaisey, Koshy and Lim of the Department of Cardiology, Austin Hospital, Melbourne, reported a case in BMJ Case Reports (published 4 February 2020). 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The PMC copy is among the sources and names the device." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "summary", "account" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].autonomy_permissions": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].component_role": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].deployment_configuration": { "state": "value_present", "value": { "kind": "text", "text": "The participant used an Apple Watch Series 3." }, "provenance": { "kind": "legacy_record", "basis": "Separated the model, software, hardware, or operation already described in the existing record. 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The PMC copy is among the sources and names the device.", "replication": { "produced_by": [ "A patient with known paroxysmal AF wearing a heart-rate-displaying smartwatch while a Holter monitor was also fitted", "The patient noticing and reporting a sudden, persistent heart-rate drop with its time", "Clinicians willing to export the watch readings (Apple Health app to Excel) and align them with the Holter" ], "must_hold": [ "The rhythm change produces a heart-rate change large enough to be visible on the watch's optical estimate", "A reference recording (Holter) exists to confirm what the watch suggested" ], "echoes": [] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" } }, "summary": { "total": 91, "addressed": 91, "known": 30, "reviewed": 0, "record_mapped": 30, "not_assessed": 61, "complete": false, "by_state": { "value_present": 30, "not_reported": 0, "unresolved": 0, "not_assessed": 61, "not_applicable": 0, "withheld": 0, "source_unavailable": 0 } } } }