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I Now Have a Cardiologist
- faitswulff 8y agoThis is the 2nd or 3rd story I've heard like this about the Apple Watch's new ECG feature. I wasn't interested in smartwatches before, but now I am considering getting an Apple Watch, even if it's just for my parents.
- ajeet_dhaliwal 8y agoFirst time I’m interested too. I hate wearing watches and stuck to an iPhone and MacBook only until now but I’m at a high risk for heart disease. My dad died when he was only 43 from clogged arteries. I have familial high cholesterol, but statins have helped me lower to normal levels. My dad died in 1992 before statins. With statins and ecg on a watch we are all very fortunate to live in the time we do.
- haukilup 8y agoEdit: Still not in Canada, though it seems to be in more countries. Very frustrating! Original: I don't think they enable the ECG feature for anyone outside the US. It's locked based on the point of sale last I checked. Very frustrating to buy something so expensive to find out it's been region-locked!
- peteretep 8y ago> The watchOS 5.2 update expands the availability of the ECG app to Hong Kong and 19 European countries, including Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Romania, Spain, Sweden, Switzerland, and the UK
- mr_toad 8y agoIt counts as a medical device, which means it has to go through extensive certification. Different countries have different procedures.
- haukilup 8y agoCorrect! The frustrating part (for me) is Apple’s lack of transparency in the extended delay in the release of this feature. It was heavily promoted, yet to find out that the ECG feature wasn’t available prior to purchase you had to dig through their support documents to find the list of countries it is available in - which at the time of my purchase, was between 1-4. But I only found that out after spending 3 days income on the device - because who would expect that a heavily promoted feature WASN’T available? I understand Apple’s choices of communication from their perspective as a for-profit business, which only makes me unhappier.
- deleted 8y ago[deleted]
- laurencei 8y agoIf you put a popular device, with a medical detection tool into the wider population, it would be logical that the device would pick up on patients who would other not notice the symptoms (at least initially, if any). So then the question becomes what other daily device(s) could be made to do automatic health checks of certain specific indicators, which would give an early indication to the possible condition, thus improving life expectancy and quality of life, while lowering associated medical costs. i.e. toothbrushes that detect cavities, sunglasses that check your pupils for certain symptoms, hats that monitor your EEG. These are obviously extreme examples, but you get the idea...
- gonzo41 8y agoI've read about automated phone calls to the elderly to build up data on response times. It was a dementia early detection tool. Seemed to be a pretty smart approach just to ring the home phone or mobile and ask for them to say a word. Takes no time.an requires recall and cognition. Also confirms the old person isn't dead.
- w-ll 8y agoI think this is an interesting idea, but it also reminds me of this youtube video https://www.youtube.com/watch?v=760uy8Oa_XM https://www.youtube.com/watch?v=760uy8Oa_XM The lady complains but I think she enjoins it. It's fun to complain and be heard, even if it seams minuscule annoyances to any observer.
- Latteland 8y agoWould you like this if you were an old person (maybe any person)? Faceless machine bugs you at home (were you napping?), rates you and you can't speak to a human about it. No one would like this. It is an interesting idea.
- dwhit 8y agoA toilet that monitored urine and stool samples would be a major lifesaver.
- morganw 8y agofrom the article: "Did my Apple Watch save my life? I think in my case, that’s a bit of an overstatement." Thanks to an Apple Watch w/ ECG, I now have a cardiologist, too. My A-fib burden is only 4% and at my age without diabetes my increased stroke risk is minimal, so my Dr. basically asked why I was bothering to wear this thing if it was just worrying me unnecessarily. I mostly agree. It is nice to finally know what's going on because I've been having irregular heartbeat when exercising for over 5 years & a stress test (ECG on a treadmill) didn't show anything. Now I've had 2 weeks of monitoring with an iRhythm Zio & an echocardiogram so I know I'm reasonably safe to continue exercising. Is it worth the $$$ insurance paid for all of it? I'm really not sure about that. I kind of wish the Dr. had told me "lose some weight or you'll drop dead" because I would have listened. I'm also not sure what I would have done if I hadn't been able to figure out what was happening. Probably just continue to keep my rate under 150 as it's a high rate that usually correlates with irregular beats.
- azinman2 8y agoSo you’re cardiologist is saying it’s not a big deal to be in afib (unless you’re on blood thinners)? I don’t understand how that could be a reasonable thought.
- Tharkun 8y agoAnd that's exactly why anyone who isn't a cardiologist shouldn't be making judgements about the state if your heart. The heart is pretty complex for being 'just a pump'. Things can and do go wrong in ~100% of the population. Whether or not that's a problem that should be monitored, medicated or operated on, depends on many factors. It isn't as clearcut as saying "you've got afib and we need to fix that".
- morganw 8y agoMy cardiologist is saying that it's not a big deal for me to be in afib 4% of the time with the longest lasting 3 hours 10 mins over a 2 week period. I haven't had a stroke or transient ischemic attack previously, don't have diabetes, hypertension or congestive heart failure. I'm male and 51 years old. Thus, my CHADS₂ and CHA₂DS₂-VASc scores are zero.
- maxgee 8y ago> resting heart rate being in the 113-120 bpm That seems insanely high
- fermentation 8y agoMaybe it was a result of the medication he mentioned? It wasn't exactly clear. edit: just checked again and nope, that was pre-doctor visit. Something that high would certainly cause me to worry.
- pubby 8y agoThat's what a-fib is: unusual rapid heart rhythm.
- rincebrain 8y agoI thought specifically a-fib referred to irregular heartbeat, e.g. premature or absent beats, not "just" faster.
- avemg 8y agoNo, that's not quite what it is. You can have an unusually rapid, but regular (i.e. normal sinus) rhythm and that's called tachycardia. During tachycardia, the electrical impulses that control the muscles of your heart fire in the correct sequence, intensity, and spacing between impulses, they just go through a cycle much more quickly. If you looked at an ECG and measured the distances between the peaks and valleys, they'd be at consistent distances, just really close. During a-fib, the electrical impulses are all off. The peaks and valleys are irregularly spaced and the amplitudes vary from cycle to cycle. This usually results in a rapid heart rate as a second order effect because, due to the "misfiring" not enough blood is pumping through and your heart is working harder to make up for the difference.
- treis 8y agoYeah, he didn't exactly need an Apple watch to tell him something is going on. That's a bit under double what his heart rate should be. Equivalent to what someone in reasonable shape would have when they're jogging. It's amazing he never got it checked out before.
- Waterluvian 8y agoA friend of mine in his early twenties drowned a few months back due to a cardiac event related to atrial fibrillation. He was otherwise in phenomenal shape and living life to the fullest.
- kbos87 8y agoI’m really sorry that happened to your friend and to you. I think the best outcome of tech like this is that it makes what seems like maybe small and maybe seemingly mundane improvements that reduce the frequency that things like this happen.
- avemg 8y agoI'm sorry about your friend. I hope this isn't insensitive, but could you elaborate any more on what happened? I'm an a-fib sufferer with a pool so I'm quite curious.
- chirau 8y agoIf the Apple Watch can be credited for new detections, can we also blame it for non-detections? Just asking... Because if the value prop is that they can detect, then they should have some accountability for non-detected positives, no?
- deleted 8y ago[deleted]
- urda 8y agoWhen it comes to your heart, you want a false positive rather than a false negative. This is just basic medical stuff.
- gshulegaard 8y ago"Better a diamond with a flaw than a pebble without." [1] Are people be better off without the watch altogether if it does not have perfect detection? Don't let perfection be the enemy of good. I don't think we should hold Apple/the watch accountable for type II errors for similar reasons as to why we have Good Samaritan laws. [1] https://www.brainyquote.com/quotes/confucius_107048 https://www.brainyquote.com/quotes/confucius_107048
- mr_toad 8y ago> they should have some accountability for non-detected positives The device has been given a class II clearance by the FDA, which means it has to “ provide reasonable assurance of safety and effectiveness “. False negative rates are definitely one of the things that are considered in getting this. That doesn’t mean false negatives aren’t possible.
- tasty_freeze 8y agoIt is odd to me how he keeps describing his $500/month insurance as being useless: he is generally in excellent health and his yearly expenditures are low enough that he is always paying down the deductible. Does he feel car insurance and home insurance are useless since he didn't total his car last year and his house didn't burn down? He knows this (as he mentions it obliquely) that he could lower his deductible but his costs would go up. Is he complaining that he is on the wrong part of that tradeoff curve? Or does he expect low-cost insurance with a low deductible that covers all of his routine medical expenses?
- kbos87 8y agoIt feels useless when you know that after paying in $500 a month for decades your insurance could be cancelled for making a claim.
- Waterluvian 8y agoAre there any quality alternatives for literally just monitoring your heart? I don't like the watch but I want that feature pretty badly.
- __blockcipher__ 8y agoWhy not buy the cheapest S4 model for around $400 or so and just only do the ECG? Or are you looking for a less expensive option? The reason is I would suggest the watch is their ECG is tuned quite well.
- atomical 8y agoGo to a doctor for a physical every year.
- Waterluvian 8y agoSo I do. But nothing he does touches on this subject, at least I think. Maybe I'm not in the right age group for him to bother. He listens to my heart and checks blood pressure. My sense is that this is just so unlikely given what he does know about my health that he doesn't explore further.
- deleted 8y ago[deleted]
- __blockcipher__ 8y agoBut...most doctors don't give ECGs at physicals?
- peteretep 8y agoWorth inquiring about the add-on price for it, then. I also add a skin-cancer check with a dermatologist to my yearly check-up as I'm very high risk.
- 8y ago
- est31 8y agoIDK about this. I find it kinda creepy to have my heart beat monitored & sent to a server far away and not under my control. I mean, ad companies already have so much data about me, do they also need to know how my heartbeat reacts to an ad? Does my insurer need to know it? I wonder whether it can detect sex and be used to e.g. track infidelity. On the other hand, of course it's great to save lives and help you detect possibly harmful conditions. The thing that makes me uneasy is not the idea of a heart tracker watch per se, but the possibility that maybe one day the facebook app wants access or chrome because of WebHeartBeat API or whatever. This trend of constantly increasing amounts of data sources sent to the cloud is sick.
- saagarjha 8y ago> I find it kinda creepy to have my heart beat monitored & sent to a server far away and not under my control. Heart rate information, like all health information gathered by Apple Watch, stays on your device unless you choose to back it up to iCloud. In this case it is end-to-end encrypted.
- throwaway_8371 8y agoThis can be issue with any service which you are using
- jessaustin 8y agoThe remote monitoring won't seem so bad once TPTB start setting up remote control.
- DoreenMichele 8y agoI saw some variation of this story around the time it came out: Grandfather discovers heart condition thanks to children’s museum exhibit https://kdvr.com/2019/02/21/grandfather-discovers-heart-condition-thanks-to-childrens-museum-exhibit/ https://kdvr.com/2019/02/21/grandfather-discovers-heart-cond... I don't think I submitted it to HN. I felt it would be viewed as fluff. But we have incredible and constantly increasing opportunities to casually check biometrics that previously required serious medical exams and lab work, etc. It's absolutely changing things.
- itissid 8y agoWhile this is great for Afib detection it's its very rare CDC says 2.7-6 Million people[1]. Still great for those people! I still think we need to do much better. High BP and hypertension is way more important to measure since they can be diagnostic in a larger percentage. My dad is a triple bypass heart patient. ECG and stress tests did diddly squat to detect it, until it was too late and it was diagnosed by a CT Angiogram. I now get CT Angiogram with contrasts every few years just to be safe because of family history. [1]https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atr...
- ebg13 8y ago> it's very rare CDC says 2.7-6 Million people There are 329 million people in the US. 1 in 122 (329/2.7) people is not "very rare". 1 in 55 (329/6) people is even less so.
- milemi 8y agoDo you know how many sieverts you get each time? I had one of those and I think I got one year's worth of background radiation in those few seconds that it lasted.
- 1000units 8y agoA lot of people get blasted with obsene amounts of ionizing radiation so the insurance pool can save a few bucks over an MRI. Disgusting.
- deleted 8y ago[deleted]
- intrasight 8y agoMy health and my retirement depend upon Apple getting this right :)
- skizm 8y agoOne thing to note: portable ECGs are <$100 on amazon. Not as feature rich as the apple watch, sure, but the watch only measures from one location, normally you want to measure from a few, usually at least 3: leg, arm, and chest.
- mach5 8y agothe watch measures from two locations actually, through the wrist and through a finger on the crown. you're still right that 3 (and more) is better.
- skizm 8y agoFor each of the three locations I mentioned, you also need to contact the portable ECG with your finger. The finger is being used to create a closed loop. It is not a measurement site.
- dis-sys 8y agofrom the article > resting heart rate being in the 113-120 bpm range with such readings, I guess one would just go to see a doc?
- dheera 8y agoI have had a couple instances of ventricular fibrillation. I have an implant which brings me back to life when that happens; I would be dead without it. However, I do go unconscious for a few seconds until I get shocked back to life. Although my case is infrequent enough that it is not thought of as a risk by the medical community, for peace of mind what I would really like to have is a link between a watch of some sort and a car capable of self driving. Should I be driving when I go unconscious, all the car would need to do is automatically kick in autopilot mode while gradually slowing down, until a heart rhythm is detected again. The risk is small, if you consider the percentage of time I'm behind the wheel, but it would be good for peace of mind. It would also be helpful for others who do not yet know they have a heart condition, or those who are having a stroke or epileptic attack while at the wheel. There are others with worse conditions than mine who are basically advised not to drive, so it would help them as well. If falling asleep can be detected by any biological signals, that would also be a useful autopilot trigger while waking the driver up, for the general population. Currently most cars require manually activating the autopilot mode; what I'm proposing is a vital sign monitor to automatically begin self-driving if the human is incapacitated. If the human doesn't wake up within a half a minute or so, the car could also self-drive itself to a hospital. I think we're far enough with self-driving tech that that saved life would far outweigh the risks of the self-driving system having any issues en route.
- dreamcompiler 8y ago> the car could also self-drive itself to a hospital I think you're onto a good idea, except for the above quote. It would be a much better idea to have the car automatically pull over to the shoulder, stop, engage the flashers, and call 911. Paramedics can keep you alive en route to the hospital with drugs, cardioversion, and CPR. Your car cannot.
- microcolonel 8y agothey could meet half way maybe.
- killjoywashere 8y ago
- rsync 8y agoI also have a cardiologist. It takes the form of a combination of very high output training (BJJ) coupled with regular, sustained aerobic training at a high percentage of my aerobic capacity (running and plyometrics). It sounds like I'm being flip, or worse, self-satisfied - but I am quite serious. If my heart started behaving strangely, or weakened in some way, I would notice immediately. It would be quite marked. Things that I partake in, and think about, and feel, would suddenly be off. Or to put it more technically, I am running my body at a much lower set of tolerances where defects are immediately identifiable.[1] I have a suspicion that my cardiologist is actually better than the apple one, since I could feel some differences that might not yet manifest themselves in some kind of measurable heart output. The downside to all of this, in the faraway future (I am currently 42 years old) is that "heart trouble" might manifest itself during exercise in a sudden and acute fashion that leaves me dead. On the other hand, the exercise makes that, statistically, less likely. I also enjoy it very much, so there's that. [1] https://www.keyence.com/ss/products/measure/measurement_library/basic/tolerance/ https://www.keyence.com/ss/products/measure/measurement_libr...
- gotocake 8y agoThe downside to all of this, in the faraway future (I am currently 42 years old) is that "heart trouble" might manifest itself during exercise in a sudden and acute fashion that leaves me dead. On the other hand, the exercise makes that, statistically, less likely. Actually depending on your condition and your activities, it’s entirely possible that the first warning you’d have is dropping dead. I’m also not being flip or self-satisfied, and I also have an anecdote to share. A good friend of mine who was a serious tennis players, and later an equally serious swimmer and runner got his “warning” about two years ago. He was at a conference and complained of feeling a bit ill. Then he experienced sudden cardiac arrest and despite an AED on premises he died. He wasn’t much older than you, was in perfect shape and ate well his whole life, saw his doctor and had good lab numbers. The “far future” you imagine is hopefully just that, far in the future, but it might not be. Like a lawyer as their own client, don’t be a fool and pretend to be your own cardiologist.
- rsync 8y ago
- deleted 8y ago[deleted]
- BasicObject 8y agoI wonder when there will be tech like this for epilepsy.
- underwater 8y ago> It’s also worth noting at this point in the story that Atrial Fibrillation is extremely rare in men my age. Less than two percent of people in my demographic have it. Go figure. When I do something, I go big I guess. This is looking at it backwards. How many serious health problems have similar rates of affliction? If there are 50 different potential health problems then he has a 2 in 3 chance of having at least one of those.
- Gibbon1 8y agoThis reminds me of Lupus and Guillain-Barre syndrome both rare diseases. But I know half a dosen people with lupus and four people that had Guillain-Barre and suffer lingering effects. So if you're a doctor it's really unlikely that you patient has either of those. But start adding up all of those rare syndromes and it starts getting scary.
- antirez 8y agoHere in Italy in order to subscribe to a gym you need to bring your ECG (not mandatory by law but a number of gyms will ask for it), and every year you need to make a new one, so I would say that the percentage of "active" population that is not regularly checked is small. How is this matter in the rest of the world?
- inglor 8y agoIsrael used to be this way and it used to be a requirement by the government (not an ECG but a doctor note). Like a lot of other regulation it made it less likely for people to work out. Now it's a questionnaire instead. I think the new system works better here since it's one less hurdle to get over before you can sign up for a gym and work out.
- antirez 8y agoI would say yes and not: yes it may become a barrier, but no, here most gyms organized that they have a doctor inside and for 40 euros they do the doctor checkup + ECG.
- inglor 8y agoOh, in Israel getting a doctor checkup or an ECG is free and most gyms don't have doctors or even a nurse (all gym instructors must get CPR certification though).
- twic 8y agoI've never heard of a gym asking for an ECG, or anything like that, in the UK.
- simonebrunozzi 8y ago> "Since I don’t have a “job job,” I pay roughly $500 a month for “health insurance” out of my own pocket" Tangential question, related to the above: I am currently paying for COBRA, and the amount paid is outragerous. Anyone has suggestions for a cheaper, good enough alternative?
- Topolomancer 8y agoI love the matter-of-factness of this article. Not only is it a great example of how technology can have unexpected positive outcomes for users, the author also manages to sneak in some extremely relaxed observations about the ACA and having to subsidise healthcare of others. I am impressed!
- raverbashing 8y ago> (a direct result of my resting heart rate being in the 113-120 bpm range) Yeah that should have been a red flag in itself Also remember that while it will give "true positive" results, there will be a lot of borderline or non-worrying alarms that will need to be checked.
- sneak 8y ago> "I continue to pay for my insurance because thanks to the Affordable Care Act, I have to. It’s the law. And I’m okay with that. Because I know paying into the system helps others who make less money than me have access to care." One had better be okay with it, because if you don't consent, they'll take the money from you by force.