Wearable technologies have rapidly evolved from consumer wellness tools into clinically relevant instruments for arrhythmia detection, particularly atrial fibrillation (AF). For cardiologists and electrophysiology (EP) teams, modern wearables now offer scalable options for screening, continuous rhythm monitoring, and earlier diagnosis across diverse patient populations. Consumer-grade smartwatches, smart rings, and emerging smart textiles differ in sensing modality, regulatory status, and data integration—but collectively they are reshaping how arrhythmias are detected outside the clinic. Included below is a brief summary of some of the available wearables and their capabilities.
Consumer-Grade Smartwatches
Examples: Apple Watch Series/Ultra, Samsung Galaxy Watch, Withings ScanWatch
These watches use photoplethysmography (PPG) to continuously track heart rhythm and can alert users to irregular pulse patterns that may suggest AF. Some models also allow users to record a short, single-lead electrocardiogram (ECG) for additional review. These features are intended for screening rather than diagnosis, and abnormal findings need confirmation with a medical ECG. Smartwatches connect to smartphones for setup and data review, with compatibility depending on the brand.¹,2
Consumer-Grade PPG Wearables
Examples: Fitbit Sense, Fitbit Versa
Fitbit devices use a PPG algorithm that has shown a high likelihood of correctly identifying AF when it is present and can flag users who are likely to have AF confirmed on follow-up ECG patch monitoring. These devices are widely used and compatible with most smartphones. They are effective for identifying people who may need further testing, but any alert should be followed by a diagnostic ECG.3
Consumer-Grade Smart Rings
Examples: CART-I Ring (CardioTracker), Oura Ring
Smart rings are worn on the finger and continuously monitor heart rhythm using PPG. Some models also allow brief ECG recordings. Because they are small and comfortable, people tend to wear them consistently. In clinical studies, the CART-I Ring detected AF more accurately and produced fewer unclear results than smartwatch ECG recordings.4
Medical-Grade Portable ECG
Examples: AliveCor KardiaMobile, KardiaMobile 6L
These handheld devices record short ECGs when the user places fingers on the sensors. Both KardiaMobile (single-lead) and KardiaMobile 6L (six-lead) are FDA-cleared personal ECG devices that detect AF as well as other rhythm categories such as bradycardia, tachycardia, and normal sinus rhythm, providing medical-grade data directly to a smartphone.5,6
Smart Textile Wearables for ECG Monitoring
Examples: Hexoskin Medical System, Cardioskin (BioSerenity), and other ECG-enabled clothing
Smart textiles (ECG garments) embed textile-based ECG sensors into clothing to enable noninvasive, wearable heart rhythm monitoring. Advances in conductive polymers and nanofiber electrodes are improving comfort, durability, and long-term wearability, supporting better user adherence than traditional electrodes. While challenges such as motion artifact and skin contact remain, ongoing design improvements are enhancing signal quality and feasibility.7-9
References
- Zarak MS, Khan SA, Majeed H, et al. Systematic review of validation studies for the use of wearable smartwatches in the screening of atrial fibrillation. Int J Arrhythm. 2024;25:11. doi:10.1186/s42444-024-00118-5
- Badertscher P, Lischer M, Mannhart D, et al. Clinical validation of a novel smartwatch for automated detection of atrial fibrillation. Heart Rhythm O2. 2022;3(2):208-210. doi:10.1016/j.hroo.2022.02.004.
- Lubitz SA, Faranesh AZ, Selvaggi C, et al. Detection of atrial fibrillation in a large population using wearable devices: the Fitbit Heart Study. Circulation. 2022;146(19):1415-1424. doi:10.1161/CIRCULATIONAHA.122.060291
- Briosa E Gala A, Sharp AJ, Schramm D, et al. Diagnostic performance of single-lead electrocardiograms from a smartwatch and a smartring for cardiac arrhythmia detection. Heart Rhythm O2. 2025;6(6):808-817. doi:10.1016/j.hroo.2025.03.019
- Mittal A, Elkaldi Y, Shih S, Nathu R, Segal M. Mobile electrocardiograms in the detection of subclinical atrial fibrillation in high-risk outpatient populations: protocol for an observational study. JMIR Res Protoc. 2024;13:e52647. doi:10.2196/52647
- FDA grants first ever clearance for six-lead personal ECG device. AliveCor. Published May 12, 2019. Accessed January 19, 2026. https://alivecor.com/press/press_release/fda-grants-first-ever-clearance-for-six-lead-personal-ecg-device
- Avanu AE, Dodi G. Wear your heart on your sleeve: smart textile ECG wearables for comfort, integration, signal quality and continuous monitoring in paroxysmal atrial fibrillation. Sensors (Basel). 2025;25(3):676. doi:10.3390/s25030676
- Hexoskin Medical System receives FDA 510(k) clearance for long-term ECG and respiratory monitoring. Hexoskin. Published November 19, 2025. Accessed January 19, 2026. https://hexoskin.com/blogs/news/a-breakthrough-in-remote-care-hexoskin-medical-system-receives-fda-510k-clearance-for-long-term-ecg-and-respiratory-monitoring
- Guedeney P, Silvain J, Hidden-Lucet F, et al. First clinical experience with the wearable cardiac rhythm long-term monitoring cardioskin device. Eur Heart J. 2020;41(Suppl_2):ehaa946.3464. doi:10.1093/ehjci/ehaa946.3464