Afib is caused by the upper and lower heart chambers not working together properly due to abnormal electrical signaling. Common symptoms include:
FatigueShortness of breathChest painDizziness
According to the National Heart, Lung, and Blood Institute, afib can also occur without symptoms and lead to serious, potentially life-threatening complications, such as blood clots and stroke. Receiving an afib diagnosis can be alarming for you and your family. To diagnose afib, your healthcare provider will ask you questions regarding your diet, physical activity, family history, afib symptoms you’ve noticed, and if you have any risk factors for the condition, such as heart disease, high blood pressure, diabetes, thyroid disease, obesity, and alcohol consumption. Your doctor will then give you a physical exam that involves listening to your heart rhythm and lungs with a stethoscope, checking your pulse and blood pressure, examining your feet and legs for swelling, and checking your thyroid gland for enlargement. After the physical exam, your doctor may run tests including electrocardiograms (ECG or EKG), echocardiograms, and blood tests to confirm a diagnosis. In some cases, your doctor may request a heart monitor be worn for anywhere from a few days to a month to monitor your heart rhythm in your daily life. But now, downloadable mobile apps have improved the screening process and management of afib, according to a clinical review published in the journal Heart Rhythm O2 in April 2020. You can use these apps to detect any irregular heart rhythms or signs of afib, then use that information to meet with your doctor, who can run tests and potentially diagnose your afib. “Apps can help alert patients to changes in their heart rate that may indicate a looming problem. For example, when the heart beats irregularly, it can form blood clots. In the case of atrial fibrillation, the earlier you detect an issue, the more likely the condition can be successfully treated to prevent an event such as a stroke,” says Emerson Perin, MD, a cardiologist and medical director at the Texas Heart Institute in Houston. While mobile apps can work great for taking a quick measure of your heart rhythm at home, there are some limitations. Charles Rouse, MD, a cardiac electrophysiologist with St. Vincent’s Medical Center in Bridgeport, Connecticut, says, “These apps do not monitor continuously, which is a major limitation. Only smartwatch devices have the ability to monitor continuously which is more useful in clinical practice.” Dr. Rouse adds that how frequently you need to measure your heart rate will vary based on the individual. Some may only need to use an app when symptoms occur, while others may take a reading once or twice a day as part of a treatment plan with their doctor. Nevertheless, apps hold tremendous potential for improving afib detection and management. Here are five that can help you and your doctor better manage your heart condition.
1. ReadMyECG: ECG Interpretations
App Store rating: 4.8Google Play rating: 4.9Free
Want to determine your heart rate quickly? This app can take an ECG/EKG in as little as 30 seconds using any wearable smart device that can measure your heart rate. These include the Apple Watch, Samsung Galaxy Watch, Fitbit, Withings Scanwatch, and KardiaMobile. For example, the Apple Watch contains optical heart sensors that measure your heart rate using photoplethysmography (PPG) technology. According to a review published in the International Journal of Biosensors & Bioelectronics in August 2018, PPG is a noninvasive, uncomplicated, and inexpensive optical measurement method used for monitoring heart rate. The technology involves a light source and a photodetector at the surface of skin to measure variations in blood circulation. After taking the reading, you can open the ReadMyECG app on your smartphone and view your ECG/EKG analysis. Then, click “Submit For Review.” A team of trained cardiographic technicians will then analyze your ECG/EKG anytime, anywhere. The technicians respond via the app’s messaging tool to notify you of any abnormalities in your heart rhythm and whether you should visit a doctor. This is a feature unique only to ReadMyECG as their website boasts itself as the only app of this kind that provides feedback from actual human experts. “On ReadMyECG, trained ECG technicians read every ECG you submit. If you want to learn what your ECG may be telling you, this is the place to start,” says Marco Perez, MD, cardiac electrophysiologist and cofounder of ReadMyECG.
2. KardiaMobile by AliveCor
App Store rating: 4.7Google Play rating: 3.5Free with in-app purchases
AliveCor combines the use of a heart-monitoring device with their mobile app, KardiaMobile, to conveniently provide you with medical-grade electrocardiograms (EKGs) 24/7. Instead of using PPG technology to monitor irregular heart rhythms, you purchase a personal EKG monitoring device that you can attach to the back of your smartphone and carry with you wherever you go. Then, when it’s time to check your heart rhythm, simply place your fingers on the sensor pads to get an accurate reading of your heart rate within seconds. “[Kardia] is an outlier because it doesn’t use PPG. It uses EKG instead, so I would consider that a different class of device. It’s also FDA [U.S. Food and Drug Administration]–cleared. I routinely recommend [Kardia] … to patients due to the EKG functionality,” states Rouse. If you don’t want to carry around the portable monitoring device and have an Apple Watch band, you can sync KardiaMobile with your smartwatch to monitor your heart rhythm instead since the Apple Watch contains the required sensors for delivering EKGs.
3. Qardio Heart Health
App Store rating: 4.7Google Play rating: 4.4Free with in-app purchases
Qardio provides vital stats regarding your heart health. The app automatically detects and records irregular heartbeats so you can keep your healthcare provider updated with your heart rhythms. Before tracking, you’ll have to purchase Qardio’s smart wearable ECG/EKG monitor that uses Bluetooth to track your heart rhythms. Besides tracking irregular heart rhythms, Qardio also monitors blood pressure, body temperature, pulse rate, blood oxygen levels, and body composition metrics, such as body mass index (BMI). BMI is an important biomarker to measure since it’s been correlated with afib, according to a comprehensive review published in The Cureus Journal of Medical Science in September 2020. You can download the app free from the App Store or Google Play, but a paid subscription of $9.99 per month or $99.99 per year is required to login and use the app. but to reap any benefits you’ll need to subscribe for $9.99 per month or $99.99 per year.
4. FibriCheck
App Store rating: 4.6Google Play rating: 3.5Free with in-app purchases
FibriCheck is a medically certified app that you can use to quickly and easily measure your heart rate. All you do is place your finger over the camera on your smartphone and let PPG do its work. Alternatively, you can use your smartwatch’s optical sensors. After 60 seconds, you’ll have an accurate reading of your heart’s rhythm. “A bright light is used to illuminate the blood under the skin and a camera detects small changes that occur with each heartbeat. It’s the same information you would get by checking your pulse with your finger at the wrist or neck,” explains Rouse. “After recording the heart rate for a period of time, an algorithm is used to determine whether the rhythm is regular or irregular. An irregular rhythm can be a sign of atrial fibrillation.” The app is free to download on Google Play and the App Store, but you’ll need to sign up for a monthly subscription after a three-day free trial. Also, FibriCheck is currently only available in Europe. You can sign up for FibriCheck’s Essential plan at €6.99 per month or get their Premium plan for €24.99 per month. The Premium plan has the added benefits of providing detailed weekly reports and your results get reviewed by a team of medical experts.
5. Afib Manager
App Store rating: 4.1Free
Afib Manager is currently only available to Apple users. This free tool works by integrating with Apple’s Health app on an iPhone or Apple Watch to monitor your heart rate data. Moreover, the app will send your data directly to your doctor. You can also choose which information gets sent, giving you total privacy control over your health stats. Ultimately, it’s important to remember that these tools should only be used to augment doctor-prescribed methods of management and care, not supplement medical advice. “These apps shouldn’t be used for patients who think they have afib symptoms but haven’t been formally diagnosed,” Rouse says. “Given the limitations in the accuracy of the PPG method and the high consequences of a missed afib diagnosis, these patients should see their doctor for more sophisticated testing.” Rouse adds that these apps are still a convenient method for tracking afib episodes since they can give you a better understanding and control over your heart condition. However, before using an app to manage your afib, talk to your doctor who can work with you to develop a monitoring strategy that best suits your needs.
