Apple enriches its shows a function electrocardiogram : what to do ?

30 March 2019

“Easy to use” or ” intuitive “, that is how qualified the professor Antoine Leenhardt, head of the unit of rhythmology at the reference centre of the heart disease hereditary, within the cardiology department at Bichat hospital, the provision, on Thursday 28 march at Hong Kong – and in several european countries, including France, of an electrocardiogram on the AppleWatch Series 4, the last model shows connected to the company founded by Steve Jobs. To activate this function, it is necessary, after installing the update iOS 12.2 and WatchOS 5.2, to press his finger for thirty seconds on the crown. When the watch you are warned already of heart beats too fast, she here gives a graphical representation of your pace, as well as indications on a possible risk of atrial fibrillation.

The shows will offer via its application an ECG.

© AppleComment it works ? The latest version of the device benefits from an electric sensor on the crown digital in addition to the two optical sensors on the back of the watch and, when the finger is in contact with the crown, this creates a loop electrical. This means that one arm crosses the chest and then returns in the other arm. The application ECG to measure the electrical impulses that make your heart pumping and the analysis helps to determine if the upper and lower chambers of your heart are in phase. On the screen, a “sinus rhythm” means that your heart beats in a consistent way, while irregular heartbeat or uncontrolled can be a sign of atrial fibrillation. Attention, the watch the ad from the start : it cannot detect any single heart attack, blood clots, a stroke, or other cardiovascular pathologies. In the case of a graphic outside the norm, this is the doctor who will determine whether there is a ” false positive “, that is to say, a false alarm, or if the watch has detected a concern.

If the professor Leenhardt regrets that the measures do that for thirty seconds every two hours, or the equivalent of six minutes per day – ” The ideal would be to have sensors to operate 24 hours on 24 “, it sees the technology as an aid to the detection of the risk of arrhythmia. But beware, it is in no case to replace the doctor. “Apple plays a role of prevention, then, must be a place for a diagnosis,” the professor continues.

A tool to help in the detection

Even the sound of a bell on the side of professor Gilles Montalescot, professor at the Institute of cardiology at the hospital of the Pitié-Salpêtrière hospital in paris : “It is an electrocardiogram mono-derivation, that is to say that it is not going to observe the fifteen-lead ecg that can lead to the hospital, but it gives a good indication of the most common arrhythmia : atrial fibrillation, or atrial fibrillation. “This fibrillation corresponding to non-coordinated action of the myocardial cells in the ear, resulting in a contraction rapid and irregular atria in the heart. “This last is the origin of 30 % of cerebral vascular accidents. “The professor does not, therefore, the replacement work of a doctor, but rather the making available to the general public a tool to help in the detection with the CE marking,” as has been a time the making available of blood pressure monitors in patients ‘ own homes “. In case of detection of irregularities, the watch will be five-additional readings within a period of sixty-five minutes, and then it will send a notification of the irregular rhythm to his bearer, who will decide whether, or not, to prevent his physician.

Read also Charles-Édouard Bouée : “With artificial intelligence, we are entering the fourth wave of the digital revolution”

At Apple, it is, of course, add to the usefulness of this product, the companion of our wrist, arrived on the market in April 2015, and must face the competition from many other models of watches connected to it, from Samsung, Huawei, or even LG. “We are convinced that these features will promote better exchanges between the users and their doctors. With the application of ECG and the function of notification of arrhythmia, customers receive an overview of the different aspects of their heart health, they can now better understand, ” says Sumbul Desai, the vice-president in charge of the health Apple. “With the arrival of these features of heart rate monitoring, the AppleWatch goes into high gear, allowing users to be better informed about their health status,” says Jeff Williams, chief operating officer of Apple, that is to say, number two of the company, which explains the Point : “We do not want innovations in gadgets. We are working on the commitment of the watch as a phone. Today, patients see their physicians only once or twice per year. However, our health is constantly evolving, ongoing monitoring is so valuable. “

“Higher, quicker, faster”

in The United States, this function ECG has already served as a warning and saved many lives in the last year, and it was still the case a few weeks ago with Liz Turner, an American aged 75 years. Remains the thorny issue of privacy. For the moment, Apple says that the data will remain private and that they will in no case disclosed to third parties, insurance companies, or potential future employers. “It is the wearer of the watch to decide whether to talk or not to her doctor,” says Sumbul Desai. But how to make progress in medical knowledge so that several figures of artificial intelligence, as the researcher, and investor from taiwan’s Kai-Fu Lee, explained that only an amount exponential to the data allows to make progress in artificial intelligence ? The california-based company began by conducting a broad study of 400, 000 patients at the university of Stanford. Then it appeared that ” only 0.5% of participants in this study received a notification of arrhythmia. This result is important given concerns about a potential glut of notifications “. But most importantly, to collect data that is essential to the development of its product, the company, which has beaten the iron against Facebook for lack of privacy, relied on the volunteerism of its employees.

To make this account, go to a few hundred meters from the Apple Park, the headquarters of the brand, in a small street in a neighborhood of Monte Vista. Behind a rosebush and tinted windows is the Fitness Lab, a center where dozens of employees are busy constantly. In the first room, some of them, full of motion sensors, but also impressive masks of breathing, engage in exercises of any type : to climb stairs, do core training, running on a treadmill, and even swimming in a pool, when some are simply tai-chi. In a room, a “runner” runs at 38 degrees Celsius, another runner turns to 35 degrees, and, in a neighbouring room, a colleague of only 0.5 degree. Some of the rooms bear the names of ” Dynamic “, ” Synergy “, ” Endurance “, or ” Calisthenics “. On some panels, there are the inscriptions of ” higher “, “quicker” or ” faster “, that make us think of the words of a song of Daft Punk.

In this laboratory is confidential, the challenge is therefore to succeed to make medical progress without having to stalk the customers in order not to break the promise of “privacy” repeated regularly by Tim Cook. In total, not less than 100 000 hours of data heart under conditions sports have been harvested in the Fitness Lab, just as 2.5 million calories burned. We dare, therefore, a last question : Apple a-t-he in his drawers the secret project to lead us to immortality through an object that he is preparing at this moment ? “After the phone and the watch, we do we forbid not work on new devices. And progress is sure to come when we see the discoveries in medicine and genetics, but we are moving so very humble and always to serve the greatest number, “explains the Point by Jeff Williams,” because we touch what humankind has most precious : the living “.