Introduction: Traditional monitoring of athletes with cardiac symptoms is limited due to sport-specific considerations and the intermittent nature of symptoms. Some portable electrocardiogram (ECG) devices may have more diagnostic utility than traditional monitoring. Their accuracy, advantages, and limitations should be considered when a clinician is considering the most appropriate device for investigation of an athlete's symptoms.
Areas covered: There are six main categories of portable ECG devices: smartwatches, handheld devices, mobile cardiac telemetry (MCT), patches, rings, and chest sensors. The aim of this review is to highlight to a clinician the potential benefits of some devices over others to assist the physician in identifying the most appropriate device. We present peer-reviewed literature on the accuracy of each type of device along with advantages and limitations.
Expert opinion: For a user-initiated capture of an ECG, smartwatches and handheld devices are easy to use and supported by peer-reviewed literature. Rings can also provide a user-initiated ECG, though there is limited evidence to support their usage. For continuous monitoring, patches and MCT are both useful, though there is limited access to these devices. Chest sensors show some promise, although access is currently limited in some countries.
Keywords: Athlete; arrhythmia; cardiology; digital health; electrocardiogram.
Athletes occasionally experience heart rhythm problems that can be difficult to diagnose. An electrical trace of the heart, called an electrocardiogram (ECG), is a helpful first test, when looking for the cause of a heart problem. Some rhythm problems cannot be detected with a single ECG, and so longer heart monitoring is needed to find the cause. This review provides a helpful summary of current portable devices that can be used to diagnose rhythm problems in athletes. There are six different kinds of portable devices that are discussed in this paper. They are smartwatches, handheld devices, mobile cardiac telemetry, patches, rings, and chest sensors. Each of the portable devices has potential benefits and limitations when used in this setting. This review describes the different devices, summarizes how these can be useful, and also when they are not the best choice for diagnosing rhythm problems. This review encourages physicians who look after athletes to consider the best type of portable device for their specific situation.