Your Watch Says Your Heart Rhythm Is Irregular. Now What?

If you have the alert AND symptoms — chest pain or pressure, breathlessness, fainting or near-fainting, or feeling severely unwell — call 911 now. The symptoms are the emergency. The watch is just what made you look.

An alert on your wrist is not a diagnosis, and the FDA says so plainly.

From the FDA’s own evaluation of these features:

“While these wearables are not meant to provide diagnoses, when problems are found and doctors and/or patients are notified, doctors can prescribe tests, drugs, or other treatments.”

Read both halves of that sentence, because they pull in opposite directions and both are true. It is not a diagnosis. And it is the start of a path that ends in real treatment for some people.

So the alert is not an answer. It is a reason to go and get one.

First: are there symptoms?

This is the only question that decides what happens in the next hour.

Call 911 if the alert comes with any of these:

• Chest pain, pressure or tightness — see chest pain and when to go
• Shortness of breath
• Fainting, or nearly fainting — which is a 911 call in its own right
• Severe dizziness
• Confusion
• Feeling profoundly unwell, or that something is badly wrong

In that situation the watch is irrelevant to the decision. Those symptoms are an emergency whether a device said anything or not, and the alert has simply spared you the argument with yourself.

And if there are no symptoms?

This is the common case, and it is genuinely not an emergency room dash at three in the morning.

But it is not nothing, and it should not be dismissed. An irregular rhythm found incidentally can matter a great deal over years even when it causes no symptoms today — which is exactly why the FDA sentence above talks about tests and treatments following a notification.

So: get it looked at, properly, soon. A clinic appointment is the right setting — somebody with your history, time to take it seriously, and the ability to arrange proper testing. Our clinics are open Monday to Thursday and Friday mornings, with appointments by phone.

And if it keeps happening, or you would simply rather be checked tonight than wait, come in. That is a reasonable choice and nobody will treat it as a waste of anybody’s time.

Bring the data with you

This is the part people forget, and it is the most useful thing you can do.

Your watch or phone has stored the alert history, and on most devices you can record and export a trace. Bring it. Not a description of it — the actual thing, on the device, or exported as a file or printout.

A recording of your rhythm at the moment you felt something is worth a great deal, because an irregular rhythm that comes and goes may have gone by the time you are being examined. The watch was there and the clinic was not.

Also bring: how many alerts, over what period, and whether you noticed anything at the time. Write it down before you go — it is the sort of detail that evaporates in a consulting room.

What this page is not going to tell you

Whether your watch is right. Anybody claiming a general answer to that is overreaching, and the FDA’s position is the honest one: these features are not meant to diagnose. Whether this particular alert reflects something real is a question for testing, not for a web page and not for a forum.

Whether no alert means no problem. A device that has not notified you has not cleared you of anything. If you have symptoms, the absence of an alert is not reassurance — it is simply an absence.

Whether to stop wearing it. That is up to you. What the alert has done is send you to ask a question, which is the useful thing it can do.

Come in

Call 911 for the alert plus any symptom in the first list.

Come to an emergency room for repeated alerts with any symptoms at all, for a first alert that is frightening you, for palpitations that will not settle, or if you cannot get a timely appointment and would rather be checked.

Our emergency rooms are open every hour of every day and are walk-in, with an ECG and a full laboratory in the building — and an ECG is the test that answers what a watch can only suggest. What an ECG is.

Go to the nearest one, and if another emergency department is closer, that one is the right answer tonight.

If you are unsure, come in — this list is not exhaustive and you are not expected to interpret your own heart rhythm.

Questions people actually ask

I got one alert, once, and I feel fine. Get it checked without panicking. A clinic appointment, the data from the watch, and a conversation. Not an emergency, and not nothing.

I have had several this week. That is worth acting on sooner. If any came with symptoms, treat those as the emergency.

Should I go to an emergency room just to get an ECG? If you have symptoms, yes. If you do not, a clinic can arrange testing in a more useful way — and if you cannot get seen and it is worrying you, coming in is legitimate and we are open.

My watch also gives me a heart rate. Is a high one an emergency? A number on its own is not, and how you feel is. Breathlessness, chest pain, faintness or feeling severely unwell with a racing heart is a 911 call regardless of the figure.

Can you read the trace off my watch? Bring it and ask. It is genuine information and worth showing to whoever sees you, and it is read alongside a proper ECG rather than instead of one.

Does an alert mean I will need medication? That is a long way down the road and it depends on what testing shows. Some people need treatment, many do not. The alert has not decided anything.

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Alert plus symptoms — chest pain, breathlessness, fainting, feeling severely unwell — call 911. Alert with no symptoms — get it properly checked, and bring the data. Both of our emergency rooms are open 24 hours a day, every day of the year — walk in, no appointment and no referral. Find your nearest emergency room →

Related reading: chest pain and when to go · what an ECG is

Sources

60. Post-Market Evaluation of Smartwatch Cardiovascular Notifications — U.S. Food and Drug Administration. https://www.fda.gov/science-research/advancing-regulatory-science/post-market-evaluation-smartwatch-cardiovascular-notifications

This article is general information, not a diagnosis, and it cannot tell you whether your device is correct. It gives no doses. If you are unsure, come in — this list is not exhaustive and you are not expected to interpret your own heart rhythm. If it might be an emergency, treat it as one and call 911.