Smartwatch alert under 40 bpm reveals ciprofloxacin bradycardia

AI system

System: Smartwatch low-heart-rate alert (brand and model not stated)
Model: Not assessed
Release: Not assessed
Application developer: Not stated (the report does not name the device's maker)
Role: Not assessed
Configuration: Not assessed
Inputs and outputs: Not assessed
Autonomy: Not assessed
Workflow: A wearer on a newly prescribed drug whose smartwatch has a low-heart-rate alert enabled. Symptoms vague enough that the alert, not the symptoms alone, prompted presentation. Clinicians who excluded other causes and withdrew the suspected drug.
Human oversight: Not assessed
Relation to AI: The watch's sustained low-heart-rate alert, combined with her symptoms, is what the authors say prompted the hospital visit. Telemetry confirmed the rate and clinicians identified ciprofloxacin by exclusion and re-challenge-free withdrawal. The threshold alert is a simple rule on a photoplethysmographic heart-rate estimate, and the brand is unknown, so no learned model can be credited.
AI contribution: The watch's sustained low-heart-rate alert, combined with her symptoms, is what the authors say prompted the hospital visit. Telemetry confirmed the rate and clinicians identified ciprofloxacin by exclusion and re-challenge-free withdrawal. The threshold alert is a simple rule on a photoplethysmographic heart-rate estimate, and the brand is unknown, so no learned model can be credited.

Studies: Not assessed
Study design: Not assessed
Measurement: Not assessed
Setting and sample: Not assessed
Measures: by the next day her heart rate was 60–70 bpm
Comparison: Assumed alternative: presentation without the smartwatch alert
Results: Assumed comparison. Reference: a potential adverse event. Result: Early recognition of bradycardia.
Additional value from AI: Not assessed
Limitations: Not assessed
Denominators: Not assessed
Materials for replication: Not assessed

Participants: Developer: Not stated (the report does not name the device's maker).
Jurisdictions: Benefit: Syracuse, United States.
Ownership and control: Not assessed
Dependencies: Not assessed
Cross-border connections: Not assessed
Geopolitical implications: Not assessed

Conditions for replication: The bradycardia is sustained long enough to trip the watch's threshold. The wearer treats the alert as a reason to seek care.
Replication attempts: Not assessed
Later findings: Nothing after discharge on cefpodoxime and metronidazole was found.
Availability: Not assessed
Institutional decision: Not assessed
Grounds: Not assessed
Action and result: Not assessed
Success criterion: Not assessed

Assessed benefits: People.
Depth: People: 2.
Reasons: People: The alert led to recognition of symptomatic drug-induced bradycardia and a change of antibiotic, after which her heart rate normalized. The authors say a potential adverse event was prevented but document no event that was imminent.
Observed or intended: Not assessed
Rubric: Not assessed
Assessor and date: Not assessed
Alternative assessments: Not assessed
Fill: Independently studied

Kind: Not assessed
Related entries: Not assessed
Field: Healthcare (cardiology; adverse drug reaction). Consumer wearables.
Purpose: Smartwatch low-heart-rate alerts are built to prompt the wearer to seek review; this alert was that purpose. The authors add that consumer wearables may surface less commonly reported medication side effects.
Dates: Date basis unassessed: 2022 (precision unassessed). Updated: 21 October 2026.
Stage: Not assessed
Version: SHA-256: ca30118c9445…

Case report Independent author

Cordova Sanchez A, Chohan M, Olatunde O, White C (2022). A Rare Case of Ciprofloxacin-Induced Bradycardia Recognized by a Smartwatch. Journal of Investigative Medicine High Impact Case Reports 10:23247096211069761. doi:10.1177/23247096211069761 (PMC8793425).