I am a 94-year-old physician who would like to share a recent experience in which my Apple Watch played a critical role in the detection of a life-threatening event.
Over the course of my career, I focused on early detection and prevention in medicine, particularly in colorectal cancer. This made my recent personal experience with early detection of a cardiac event and prevention of its serious consequences through wearable technology especially meaningful. The advances in technology have also had an effect on detection and prevention of another medical condition. The National Polyp Study, which I led, demonstrated that detection of polyps and their removal by colonoscopy prevented fatal colorectal cancers. A front-page New York Times story called attention to this development, and an accompanying editorial stated that this was “a test in time.” National and international guidelines, many of which I chaired, now recommend colonoscopy as one of the most effective screening tests for both colorectal cancer and polyps. The life-saving technology in the Apple Watch resonated with me in parallel with the life-saving technology in colorectal cancer.
A personal experience with wearable technology
I became immersed with the various apps on my new Apple Watch and especially with the many health features. I decided to wear it more constantly, including at night during sleep. I awoke early one morning with epigastric discomfort and concern about a possible cardiac event. I was aware that certain myocardial infarcts, especially in the inferior location, can present this way. Since I was wearing my Apple Watch, I clicked on the electrocardiogram (ECG) app, which showed a heart rate of 40, markedly abnormal! I quickly confirmed it several times on the heart rate app, became worried, and decided to get to my cardiologist as soon as possible. My wife, however, urged us to go to an emergency room (ER) instead since there would be more extensive emergency treatment available. Good decision!
A life-saving trip to the emergency room
When I arrived, I was in serious bradycardia with heart rates in the 20s and blood pressure at shock levels. The ER team jumped right in, worked fast, inserting intravenous lines in order to administer various medications that would rapidly correct the abnormalities. They also put a line into a small artery in my wrist to better monitor my blood pressure, which was becoming difficult to keep at a good level. The team finally brought the blood pressure up but could not increase the ventricular rate; there was a complete heart block. I became alarmed when they positioned a defibrillator and an emergency pacemaker at my bedside.
After stabilizing me over the course of a few hours, I was transferred to the cardiology electrophysiology division where a permanent pacemaker was implanted. My heart rate and blood pressure quickly reverted to normal. I was informed later that I was one of the sickest patients encountered in that division, and that my early detection of the severe bradycardia followed by the rapid ER team’s response was life-saving. Kudos to my wife, Barbara, for being an effective patient advocate who was in my corner constantly. Fortunately, I never lost consciousness, which was a good sign that I would survive this episode without brain deterioration. While the Apple Watch did not diagnose the acute heart block, it did identify a clinically significant bradycardia that made me seek immediate medical attention.
The expanding role of early detection
Given the expanding role of wearable technology in early detection, I thought that my experience would be of interest to other people concerned with their health and especially with the early detection of warning signs. Wearable technology can detect other cardiac abnormalities including atrial fibrillation, which is important to detect and treat early. This condition is being diagnosed more often since wearable technology has become increasingly prevalent. I also hope that when folks look at their Apple Watch to check on possible early detection and prevention in their health, they are also reminded of colorectal cancer detection and prevention through appropriate screening.
Sidney J. Winawer is a gastroenterologist.
