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I think the watch detected his fall (which was a result of the heart attack)
by function_seven 7y ago
I think the watch detected his fall (which was a result of the heart attack)
- selimthegrim 7y agoCorrect. I had heard speculation he may have noticed ECG stuff but he was still conscious enough to call his wife.
- joshvm 7y agoThe specs for the watch specifically rule out heart attack detection, by the way. > Apple Watch cannot detect heart attacks. If you ever experience chest pain, pressure, tightness, or what you think is a heart attack, call emergency services immediately.
- DuskStar 7y ago"What we list for legal purposes" and "what the device actually does" might not be the same thing. I imagine saying "my device detects heart attacks" gets the FDA involved and makes everything ten times more expensive...
- rootusrootus 7y agoDifferentiating between cardiac arrest and taking the watch off your wrist may be interesting. And I kinda wonder how good any single-lead EKG would be at detecting a heart attack when your heart is still beating. Even the expensive multi-lead machines usually auto-diagnose me with an old infarction, which is false.
- throwaway8689 7y agoI'd guess taking the watch off would produce a classic flat line. A heart in arrest which is in the process of dying will produce irregular electrical output.
- btach 7y agoSometimes the rhythm may degrade into a ventricular rhythm, like v-tach then into v-fib if not treated. A heart can still pump in v-tach, albeit very inefficiently, but in v-fib, no blood is pumped. On the other hand, taking the watch off results in no signal input which is different than what you would see on the monitor for asystole.
- manicdee 7y agoApart from the immediate “flatline” the watch also detects that it is not proximate to the skin. As soon as you take it off the watch disables things like ApplePay. It knows when it being/has been taken off.
- kirrent 7y agoWell the watch isn't measuring troponin levels so it's hard to imagine how useful it could ever be at MI detection, especially given the limitations of a poor contact single lead ECG.
- JshWright 7y agoEven if it could check a trop, that's a pretty late indicator. If you're having the big one, you're going to be dead before your troponin spikes.
- HeyLaughingBoy 7y agoIs that right? When I worked in medical instrumentation, I was always told that TnI was a leading marker.
- JshWright 7y agoIt will take up to 8 hours for troponin levels to rise after the onset of symptoms (typically 3-4).
- btach 7y agoER nurse here - some STEMIs I've taken care of had negative initial trop's (not all though). The 4 hr delta should of course be positive though - I don't typically check the 4 hr repeat for STEMIs though because they're long gone out of the ED to the cath lab then to CVICU.
- dreamcompiler 7y agoI could imagine the thing detecting Vfib but it would need to use some good AI signal processing to exclude artifacts. Elevated ST segments, probably not, even with good AI.
- dreamcompiler 7y agoOTOH doesn't the EKG feature only work when you touch the watch with your other hand? In which case it would be useless for heart attacks that caused you to lose consciousness.
- JshWright 7y agoThe watch doesn't have enough data to detect a heart attack. It's not possible for the device to do it (with current, or even near-future technology it's not possible for any wrist worn device to detect a heart attack as it's happening).
- StavrosK 7y agoSource: he's an EMT.
- JshWright 7y agoTechnically I'm a paramedic...
- StavrosK 7y agoI can never recall which is which. I assume paramedic is the better-credentialed?
- JshWright 7y agoYeah, technically they're all levels of EMT, but "EMT" generally refers to "EMT-Basic" (a few months of training, a couple nights a week). EMT-Paramedic is ~18 months of a couple nights a week, plus 1,000+ hours of clinical time.
- HeWhoLurksLate 7y agoThank you for your service.
- disabled 7y agoIt is theoretically possible now, with clunky technology that is not wrist-worn. Development of a 12-Lead ECG Signal Processing Algorithm Using NI LabVIEW® and NI ELVIS: https://ieeexplore.ieee.org/document/8574627 https://ieeexplore.ieee.org/document/8574627 You would most likely need a 12 lead ECG/EKG too, to detect it accurately.
- kohanz 7y agoWhether you officially list it or not, if your device is diagnosing and reporting heart attacks to people, the FDA will be involved sooner or later.
- galangalalgol 7y agoIf they only diagnosed but didn't report to the user but instead anonymized the data and used it for marketing would the fda care?
- Twisell 7y agoThe FDA was involved in the Apple Watch. That being said of course they will state that the watch can’t detect accurately hearth attack to avoid any liability.
- andy_ppp 7y agoAnd because it can’t...
- graeme 7y agoThe watch did an emergency sos. AFAIK no heart related notification triggers that - only fall detection can. Outside possibility is he felt bad, saw a heart rhythm notification, and manually triggered emergency sos by holding the power button. But a fall alert seems much more likely.
- ska 7y agoThe specific language you are looking for here is "indications for use". The way the FDA works, you cannot advertise (even directly) a medical device for a usage you have not indicated in your filing and backed up with the required evidence. The level and type of evidence will depend on the type of filing and claims. A medical professional can advise for a different use (called "off label") but you, as the device developer, cannot even hint at it. Aside: as others note, though, you can't really detect heart attacks well from something this simple.
- garmaine 7y agoIt absolutely can. It's more sensitive than equipment hospitals use. There's an ongoing data collection program to calibrate it for that purpose. But since it hasn't been approved by regulators for use as such, they'd be in legal trouble if they claimed otherwise.