Smartwatches are now among the most widely used heart-monitoring tools in the world — but how accurate are they really at detecting AFib?
In this December 2025 Issue 3 of EP-Edge Journal Watch, Dr. Niraj Sharma, cardiologist and cardiac electrophysiologist, breaks down the strongest evidence to date on smartwatch AFib detection, Apple Watch ECG performance, false alerts, AF burden tracking, and post-ablation monitoring.
With more than 450 million global smartwatch users and growing, both clinicians and patients rely on devices like the Apple Watch, Fitbit, Samsung Galaxy Watch, and Withings for early arrhythmia detection. This episode answers the questions everyone is asking:
What You’ll Learn in This Episode
• How accurate are smartwatches for detecting atrial fibrillation (AFib)?
A breakdown of major meta-analyses across Apple Watch ECG, PPG sensors, and multi-device comparisons — including real numbers on sensitivity, specificity, and real-world diagnostic performance.
• Why do so many smartwatch alerts end up being false positives?
Dr. Sharma explains the positive predictive value problem in low-prevalence populations and why young, healthy users often receive incorrect AFib notifications.
• Apple Watch ECG vs. Holter monitor vs. implantable monitor
Find out when a smartwatch is good enough, when a clinical monitor is necessary, and when an implantable cardiac monitor (ICM) remains the gold standard.
• Can smartwatches reliably detect AFib recurrence after ablation?
Review of the CIRCADOSE data showing smartwatch AFib-burden algorithms compared with implantable monitors — and when they outperform intermittent Holters.
• Why EP patients get so many inconclusive smartwatch readings
Including pacing, left bundle branch block, low-voltage signals, and ectopy — and when to move directly to patch or implantable monitoring.
Clinical Framework & Real-World Decision Pathways
Dr. Sharma provides practical, evidence-backed direction for:
Who This Episode Is For
About EP-Edge Journal Watch
EP-Edge Journal Watch delivers high-level electrophysiology insights, clinical trial reviews, and real-world practice frameworks — with every episode designed to help clinicians make smarter, faster, evidence-based decisions.
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