Use of the Apple Watch iECG in Children with Congenital Heart Disease

Objectives: The development of smart technologies paves the way for new diagnostic possibilities. In the case of the Apple watch, after the mobile application is installed, it records an ECG Einthoven-I like ECG when a finger is placed on the watch's digital crown. A 30-second ECG tracing is stored in a PDF file that can be retrieved from the application. Currently, the Apple Watch provides an FDA approved iECG function. Yet, the Apple Watch ECG is only evaluated for users from 22 years of age. The aim of this study was therefore to evaluate the accuracy of Apple Watch 1-lead ECG (iECG) measurement in comparison to a standard ECG in children with and without congenital heart disease.

Methods: Consequtive children presented to the Outpatient Clinic of the Department for Pediatric Cardiology, Leipzig Heart Center, and aged 0 to 16 years with and without congenital heart disease were included into the study. Patients underwent 12 lead ECG, and an Apple Watch iECG was recorded simultaneously. Data were analyzed using Pearson's correlation coefficient and Bland–Altman plot.

Result: A total of 184 children were included into the study. Excellent correlation between 12 lead ECG and Apple Watch iECG could be seen. (K = 0.83, p < 0.001).

Conclusion: The Apple Watch iECG provides an excellent modified lead I in children with and without congenital heart disease. As a result, the Apple Watch iECG may represent a promising tool for recording arrhythmias in children.

Publication History

Article published online:
21 February 2021