Research & Development
UHN testing diagnostic ability of Apple Watch
September 23, 2020
TORONTO – Apple announced that it will collaborate with investigators at the Ted Rogers Centre for Heart Research and the Peter Munk Cardiac Centre at the University Health Network, one of the largest health research organizations in North America, to better understand how blood oxygen measurements and other Apple Watch metrics can help with management of heart failure.
The study will investigate how physiological signals from Apple Watch – such as heart rate and the new blood oxygen feature – can help with better management of heart failure with the goal of driving better clinical outcomes for heart failure patients.
The study will be led by Dr. Heather Ross (pictured), division head of Cardiology at UHN’s Peter Munk Cardiac Centre and Scientific Lead at the Ted Rogers Centre for Heart Research, and participation will be by invitation to heart failure patients receiving care at the Peter Munk Cardiac Centre.
Traditionally, management and assessment of congestive heart failure patients takes place in a clinic, utilizing a number of diagnostic exercise tests that are expensive and can be difficult for some patients. This study will investigate the ability for patients to perform these assessments in the comfort of their own home.
“Congestive heart failure is one of the most serious heart conditions that can cause symptoms such as shortness of breath and is a major cause of morbidity and mortality for millions of persons around the world,” said Dr. Ross. “Understanding and learning how physiologic signals from Apple Watch and iPhone can be utilized, may lead to innovative solutions for management of this disease and allow us to intervene early and prevent poor clinical outcomes.”
The study will launch later this year with privacy and transparency for participants as a priority. All user data will be encrypted, and participants have the ability to opt-out at any time.
Dr. Ross, a world-renowned cardiologist, leads a team of clinician-scientists that are setting the standard of care and research for heart failure patients both in Canada, and around the world.
“Our team is always asking ourselves how we can meaningfully improve patient outcomes for what has become the most rapidly rising cardiovascular disease in Canada,” explains Dr. Barry Rubin, medical director and chair of the Peter Munk Cardiac Centre. “We look forward to joining with the team at Apple to continue transforming the future of heart failure management.”
UHN is the largest hospital-based research program in Canada, and is uniquely positioned with both talent, and infrastructure, to lead this important research.
“The combination of Apple Inc., the Ted Rogers Centre for Heart Research and UHN’s Peter Munk Cardiac Centre is a very exciting partnership, said Dr. Kevin Smith, president and CEO of University Health Network. “When I think of what may be possible for patients and clinicians, it underlines the importance of thinking in new ways about giving people the care they need where they would like to receive it – in their home. Apple is known for innovation around the world and it will be exciting to have our researchers and clinicians working with them on the devices of the future.”
See video at https://www.youtube.com/watch?v=IFVOYCIhZ1Q
The research project was announced earlier this month as Apple introduced the Apple Watch Series 6. The new product contains a blood oxygen feature that offers users even more insight into their overall wellness.
Oxygen saturation, or SpO2, represents the percentage of oxygen being carried by red blood cells from the lungs to the rest of the body, and indicates how well this oxygenated blood is being delivered throughout the body.
To compensate for natural variations in the skin and improve accuracy, the Blood Oxygen sensor employs four clusters of green, red, and infrared LEDs, along with the four photodiodes on the back crystal of Apple Watch, to measure light reflected back from blood. Apple Watch then uses an advanced custom algorithm built into the Blood Oxygen app, which is designed to measure blood oxygen between 70 percent and 100 percent.
On-demand measurements can be taken while the user is still, and periodic background measurements occur when they are inactive, including during sleep. All data will be visible in the Health app, and the user will be able to track trends over time to see how their blood oxygen level changes.
The company had already built healthcare applications into earlier iterations of the Apple Watch. For example, Apple Watch checks for unusually high or low heart rates in the background, which could be signs of a serious underlying condition. This could help you and your patients identify situations which may warrant further evaluation.
If a patient’s heart rate is above 120 bpm or below 40 bpm while they appear to have been inactive for 10 minutes, the user will receive a notification. Patients can adjust the threshold bpm or turn these notifications on or off. All heart rate notifications – along with date, time and heart rate – can be viewed in the Health app on iPhone.
The irregular rhythm notification occasionally checks for signs of irregular rhythms that may be suggestive of atrial fibrillation (AFib). This feature won’t detect all instances of AFib but may catch something that can provide your patients with an early indication that further evaluation may be warranted.
Irregular rhythm notifications use the optical heart sensor to detect the pulse wave at the wrist and look for variability in beat-to-beat intervals when the user is at rest. If the algorithm repeatedly detects an irregular rhythm suggestive of AFib, your patient will receive a notification and the date, time and beat-to-beat heart rate will be recorded in the Health app.
With the ECG app on Apple Watch Series 4 or later, patients who experience symptoms such as rapid or skipped heartbeat, or receive the irregular rhythm notification, can capture an ECG and record their symptoms. This real-world data can enable you to make more informed and timely decisions regarding further evaluation and care.
The ECG app uses the electrical heart sensor built into the Digital Crown and the back crystal of Apple Watch Series 4 or later to record a single lead ECG similar to a Lead I ECG. The ECG app then provides a result of sinus rhythm, atrial fibrillation or inconclusive, and prompts the user to enter any symptoms such as rapid or pounding heartbeat, dizziness or fatigue. The waveform, results, date, time and any symptoms are recorded and can be exported from the Health app as a PDF to share with a clinician. If the patient notes symptoms that indicate a serious condition, they are prompted to immediately call emergency services.
For more information about the healthcare technology that’s build into the Apple Watch, see https://www.apple.com/ca/healthcare/apple-watch/