roake

AliveCor got greedy.  They started requiring you to pay a subscription to see the previous EKG’s that you had stored in your own memory on your own device. That kind of greed is always the beginning of the end.  Then Karma killed them.

sflagel said:

roake said:

sflagel said:

bageljoey said:

I have been happy with my Series 3 Apple Watch. I was planning on skipping 4 even though I like the better screen.
...but should I risk my life to save a few hundred dollars?

I read that atrial fibrillation is not life threatening. It increases your chances of a stroke (but so does eating too much chocolate). And it does not require an “ECG” to recognise it, it’s symptom is an irregular pulse, which is why Series 2 and 3 can also detect it. So what the ECG for? Is there a doctor in this forum that can explain it better than the NHS website? 

Afib is an irregular heart rhythm that increases risk of stroke, among other things.  There are other irregular heart rhythms besides afib that do not have the associated risk of stroke.  A typical ECG is called a 12-lead ECG (I still call it an EKG), and allows us to “see” the heart electrical conduction/rhythm from multiple viewpoints, over a few seconds of time.  This way, we get a much better view of what’s going on, allowing us to differentiate between the rhythms (we can see other stuff as well, but that’s another topic).  The Apple Watch does not utilize multiple leads, so we only see the heart’s electrical conduction from a single perspective, but many times, that can be good enough.

Afib causes blood flow from the top chambers of the heart to be inefficient, and not empty as well.  There is a tiny pouch adjacent to one of the chambers called the left atrial appendage.  Normally, the blood gets squeezed out of the pouch with every heartbeat.  With afib, the blood doesn’t empty out all the way.  Blood that isn’t moving can clot.  A clot in the pouch can later dislodge and go to the brain to cause a stroke, or can go to other organs and cause serious damage.  Clots can from in other areas of the heart, but this is the “classic” example.

The increased risk of stroke is based on several factors, and varies from person the person with afib.  The risk is usually a few percent per year.  People with afib get put on blood thinners and other medications to reduce this risk.

Afib can cause problems in other ways: low blood pressure, low energy, reduced ability to exercise, heart failure, etc., especially if if the heart rate with afib is very fast.

If your watch or other source says you have afib, you should always get it checked out by a physician immediately, for the reasons above, and because it’s usually easy to treat.

Source: I’m an ICU doctor who sees this all the time.

This is very interesting. So you think the ECG on the Series 4 is worth having, or the continuous pulse reading that all Apple watches can do is good enough to recognise it? 

I am uncertain how the continuous pulse reading on the Apple Watch distinguishes between the various irregular rhythms (one of which is afib), or if, in fact, it does.

If Apple has algorithms to accurately detect afib with the pulse readings, that would make the ECG on the Series 4 little more than a novelty to most lay people, with the exception that you could show the ECG to your doctor.

To a physician, the ECG on an Apple Watch offers much more information that a simple yes/no on afib.  There is potentially a wealth of information about a myriad of heart issues.  This potential makes me think that Apple may later expand the problems that can be automatically detected.

For example, there is another irregular rhythm called aflutter (atrial flutter instead of atrial fibrillation).  They both carry the risks for stroke, and are treated much the same way.

I definitely think that over the next several years, we will see an increased ability for the watch to detect health issues.

sflagel said:

bageljoey said:

I have been happy with my Series 3 Apple Watch. I was planning on skipping 4 even though I like the better screen.
...but should I risk my life to save a few hundred dollars?

I read that atrial fibrillation is not life threatening. It increases your chances of a stroke (but so does eating too much chocolate). And it does not require an “ECG” to recognise it, it’s symptom is an irregular pulse, which is why Series 2 and 3 can also detect it. So what the ECG for? Is there a doctor in this forum that can explain it better than the NHS website? 

Afib is an irregular heart rhythm that increases risk of stroke, among other things.  There are other irregular heart rhythms besides afib that do not have the associated risk of stroke.  A typical ECG is called a 12-lead ECG (I still call it an EKG), and allows us to “see” the heart electrical conduction/rhythm from multiple viewpoints, over a few seconds of time.  This way, we get a much better view of what’s going on, allowing us to differentiate between the rhythms (we can see other stuff as well, but that’s another topic).  The Apple Watch does not utilize multiple leads, so we only see the heart’s electrical conduction from a single perspective, but many times, that can be good enough.

Afib causes blood flow from the top chambers of the heart to be inefficient, and not empty as well.  There is a tiny pouch adjacent to one of the chambers called the left atrial appendage.  Normally, the blood gets squeezed out of the pouch with every heartbeat.  With afib, the blood doesn’t empty out all the way.  Blood that isn’t moving can clot.  A clot in the pouch can later dislodge and go to the brain to cause a stroke, or can go to other organs and cause serious damage.  Clots can from in other areas of the heart, but this is the “classic” example.

The increased risk of stroke is based on several factors, and varies from person the person with afib.  The risk is usually a few percent per year.  People with afib get put on blood thinners and other medications to reduce this risk.

Afib can cause problems in other ways: low blood pressure, low energy, reduced ability to exercise, heart failure, etc., especially if if the heart rate with afib is very fast.

If your watch or other source says you have afib, you should always get it checked out by a physician immediately, for the reasons above, and because it’s usually easy to treat.

Source: I’m an ICU doctor who sees this all the time.

Updated my LTE Series 4 using my XS Max.  Bricked.

i called Apple.  They said the engineers knew of the issue but were still trying to collect info.

They asked me to hold down both volume controls and briefly press (half a second) the main button on the other side, causes it to briefly vibrate.  They said this would cause the phone to generate diagnostic logs.

The technition said he would call me back in a few minutes after the logs have had time to generate.

Could be that the consulate had public WiFi that the watch synced across.  If he had ever connected to it before, the info would have synced across his iOS devices.  It would be plausible that his watch and both phones (see below) would have automatically joined the network.

The watch could have a third-party recording app that also has an iPhone version.  These apps could have synced across WiFi, via iCloud, possibly even Bluetooth (I have a set of apps that sync recordings between Apple Watch and iPhone).

At least one story said he had two phones, left one with his fiancée, took one in with him.  What I don’t know is if the phone that was with him could have been used to unlock the watch, and the other phone set up to sync the file.  I suppose the watch app could sync with any number of iOS devices on the same account, though.