My cousin died last week of a heart attack on the way from his house in a village south of Nuremberg to the bakery 10 minutes away to get bread for breakfast. His Apple Watch (presumably because of the fall detection) called emergency services for him and gave him time to call his wife.
My condolences, it's always painful losing family. I too lost a cousin about six years ago due to heart failure, he had just about turned 21. I wish he'd had an Apple Watch (or similar device) at the time.
A dear colleague died of a heart attack a couple months ago. His Apple Watch didn't save him. He collapsed at work.
The Apple Watch is very explicit about not being a panacea, and currently only advertises detection of a specific kind of arythmia or elevated heart rate. Note that the original comment mentioned that fall detection was probably the trigger.
I'm still pretty angry at the universe about my colleague's sudden death. I just want to temper expectations about what the Watch can or cannot do.
Heart attacks are sudden and sometimes nothing could save you. My mother is a medical professional, and she told me the story about a doctor in her hospital: one morning he realized he was about to have a heart attack, called emergency services himself and left the door open; he was dead by the time the ambulance arrived, five to ten minutes later.
There was a legendary cardiologist at my medical school who predicted his own demise, took a Holter monitor home with him one night, wired himself up, went to sleep, never woke up, and left his colleagues with the 12-lead trace of his death.
It is a reference to the number of electrodes attached to the monitor. A 12 lead setup can provide a much more detailed signal and thus be used in different diagnostics than a lower lead obtained trace.
A 12-lead ECG report/graph/whatever it's called. 12 wires collecting data (versus eg the Apple Watch implementation which is equivalent to a 1-lead ECG)
I wouldn't be to sure the Apple watch is even comparable to 1-lead ECG, simply due to the difference of how ECG is attached to you and how the Apple watch is.
Through this doesn't mean the Apple watch can't be a useful addition, just don't rely on it.
12 lead ECG is just a technology. There could be other techniques. However, the Apple Watch might be comparable to higher number of leads but never be identical to the number of leads.
Except, when you wear additional bracelets at your both legs, the other hand, both shoulders and another 6 on your chest. Then yes ;). And consider the continuous cyborgization of our society, that is not that far away.
The 12 lead ECG is about detecting the electrical impulses
of heart beats from different angles of your bodies.
If you found a technology to detect these mV values from a meter away ... tell me ;) We will be rich ;)
There's a reason ECG probes are attached to multiple points on the body, and you can infer quite a bit of info from just comparing multiple signals alone, including if you have your heart flipped, for some reason. :D You'll not get that from your watch.
Some heart attacks kill faster than others. They are not all sudden. My friend, a doctor, had a heart attack and decided to go to the second nearest hospital because it had a better reputation than the nearest. He's still alive today.
It doesn't just detect arrhythmia -- it also detects if you have fallen and are not moving (and will automatically call emergency services after some duration, if configured as such). More details at https://support.apple.com/en-us/HT208944 if you're interested to know more.
I can't speak for all cases but there are often unknown medical conditions involved. My aunt got the flu one year and it weakened her heart so much that she required a transplant and while she lived for a while after that, she died at 27.
Please vaccinate yourselves and loved ones even for the flu.
A friend of mine runs a charity [1] that deals with providing AED (Automated External Defibrillator) devices to organisations. These things save lives. They can deliver shocks to the heart if necessary and can guide laypeople through giving CPR until help arrives (I think many models now actually tell you if you aren't giving strong enough compressions, for example).
I would also highly recommend people go through this app [2] to get some familiarity with CPR. Then take a proper CPR course (I need to take my own advice on doing a proper course, actually).
i see those AEDs popping up around, ie in the office, train station, every pharmacy around has them. My wife is an emergency doctor, an she has clear opinion about those - yes they save lives, but in most cases, people will end up as 'vegetables' (not sure what's the proper english term for +-brain death). I only presume she meant more severe heart attacks that would normally result in death prior to emergency arriving or shortly after.
So don't expect miracles where none are currently possible. Do all you can obviously in case of need, and ideally make yourself familiar with procedures a bit, any delay will worsen the chances.
Just like with old school CPR, there's really no guarantee you won't be a vegetable. Maybe you get lucky and the person doing CPR does it right, the AED arrives soon enough, and the paramedics arrive soon enough. Always make sure you have a living will to cover such kinds of situations. I would hate having my vegetable body ending up in a fight between loved ones who want to keep me alive and loved ones who want to do the humane thing.
Here in Denmark there's a volunteer "heart runner" programme. If someone calls 911 and has a cardiac arrest, people in the programme that nearby can be notified to fetch an available public AED and run to the patient (or attempt manual resuscitation).
According to their material, the 30-day survival rate in Denmark has gone from 3.8% (2001) to 10.4% in 2016, with 67.5% bystander assistance: https://hjertestarter.dk/english/you-can-save-lives though it's not clear how much the programme itself can claim.
According to various papers, rapid CPR/AED after a heart attack can triple survival rates.
It's still pretty bleak outcome, but better than e.g. in 2002 Detroit, where 1 out of 471 out of hospital cardiac arrests (OHCA) survived to hospital discharge. In USA, all those stats are apparently being tracked by a programmed called CARES.
Nah, vast majority aren't locked up here, from experience. Pubs in the UK tend to have them, as do larger shops, community halls, libraries, I've seen old red phone booths repurposed as AED storage, in Birmingham city centre I saw a really modern one like one of those light-up ad screen / phone booth / touchscreen signs, which could simultaneously call emergency services, deliver CPR advice on the screen and dispatch the AED stored underneath - was awesome. Honestly I'm surprised (and pleased) that they don't get stolen/vandalised more considering the amount that are just out there - though I don't know what you'd do with a black market AED lol.
I have yet to see one that's properly locked up [that didn't have easy to break emergency glass, anyway]. My workplace has a few in special AED boxes, but those have the emergency glass and the hammer.
Must be a southern thing. I've never seen an outdoor (or phoebox) one that doesn't have a keycode lock on it. You're supposed to call 999 before using one anyway, so it's not a major impediment.
There has been quite a bit of study of intercessory prayer. i.e. for people that don't know they are being prayed for.
No affects have been found.
> In 1872, the Victorian scientist Francis Galton made the first statistical analysis of third-party prayer. He hypothesized, partly as satire, that if prayer were effective, members of the British Royal Family would live longer than average, given that thousands prayed for their well-being every Sunday, and he prayed over randomized plots of land to see whether the plants would grow any faster, and found no correlation in either case.
The wiki page contradicts your statement about "no effects".
there's been a number of studies showing lots of effects. Most studies seem to show slight positive effects from prayer, some show none and some show negative effects.
You don’t get to take the “no effect” over the “small effect” just because you’re an atheist. That is precisely what taking faith over data looks like!
My answers would be that we're arguing over statistical noise.
I take what I consider to be the simplest explanation in the absence of a credible alternative, that prayer does nothing when the recipient is unaware of it.
I take that view because I've never heard an alternative explaination that didn't appear to break the second law of thermodynamics.
A magical, invisible, omnipresent, omnipotent "all known laws of nature defying"-being that answers prayers, requires significantly more evidence than a small effect in some meta study.
Absolutely. My point is that "I'm an atheist so I'll take the option that agrees with my personal beliefs" isn't a valid line of reasoning. You could symmetrically argue "I'm a catholic so I'll take the option that suggests there is an effect, albeit a small one". Now we're just arguing whose personal beliefs are right.
A more properly scientific line of reasoning would be to instead say that you'll assume the small-to-nonexistent effect is nonexistent until somebody produces a model capable of predicting the proposed small effect, or a myriad other arguments along the same general lines.
"the overall estimated effectiveness of seasonal influenza vaccine for preventing medically attended, laboratory-confirmed influenza virus infection was 47%"
I can’t find the source now but I remember hearing about a study into the efficacy of prayer. Briefly, the study recruited several Christians to pray for patients in a hospital. The patients were split into three groups: a control group who weren’t prayed for, a group who were prayed for but who weren’t told, and a group who were prayed for and were informed that they were being prayed for. Allegedly the patients in the last group had the most issues with concern and depression, allegedly because they assumed that because they were being prayed for, they were in fact really seriously ill.
Years ago, I joined a health list for parents of children with a very serious medical condition. When I joined, the discussion involved a lot of "Our child is facing X surgery. Please pray for us."
The longer I was there, the more the discussion became "Our child is facing X surgery. Have you or your child had this surgery? Pros? Cons? Any good tips?"
Prayer very often means "It's hopeless. Humans can't fix this. Our only hope is divine intervention." And it's hugely depressing and disempowering.
Prayer is a human act of connection that has been going on longer than recorded history. Evolutionarily, if most people felt it was hopelessness, it wouldn’t have lasted so long.
Modern feelings of hopelessness and nihilism extremely common in the western world, many people are dealing with these feelings through medication. The effectiveness of regular prayer on mental health is surprising according to studies and demographic data.
I actually believe in the power of prayer and considered commenting on that specifically to try to avoid someone replying in this fashion. I didn't because this is HN and saying something like that can be a convenient excuse for a bunch of people to accuse you of being "woo," irrational, etc.
Let me rephrase that: When the people around you offer nothing but prayers, it's often because they don't believe there is any practical support they are capable of offering. In a group setting, if everyone offers you prayers and zero practical support, the signal it sends is pretty depressing.
To be clear, this was a support group for a deadly genetic disorder that frequently kills children before they reach adulthood. It is classified as a dread disease for a reason. The psychological effect of the diagnosis is huge.
It's practically a sign on the wall a la "All those who enter herein are damned." kind of thing.
Sorry to read your cousin died this way. I don't understand.
The Apple Watch told him his heart isn't working right - automatically calling emergency services - and he also called his wife to let him know the watch says there is an emergency with his heart?
Or was it that he too passed out, the Apple Watch called emergency services, who resuscitated him enabling him to call his wife?
> and he also called his wife to let him know the watch says there is an emergency with his heart
The watch will call emergency services, then it will text your emergency contact(s) and let them know you've experienced a hard fall. I don't know exactly how, in this instance, that was then converted to a voice call.
Edit: I see in another comment that he initiated a call himself because he was conscious enough to do so.
The specs for the watch specifically rule out heart attack detection, by the way.
> Apple Watch cannot detect heart attacks. If you ever experience chest pain, pressure, tightness, or what you think is a heart attack, call emergency services immediately.
"What we list for legal purposes" and "what the device actually does" might not be the same thing. I imagine saying "my device detects heart attacks" gets the FDA involved and makes everything ten times more expensive...
The watch doesn't have enough data to detect a heart attack. It's not possible for the device to do it (with current, or even near-future technology it's not possible for any wrist worn device to detect a heart attack as it's happening).
Yeah, technically they're all levels of EMT, but "EMT" generally refers to "EMT-Basic" (a few months of training, a couple nights a week). EMT-Paramedic is ~18 months of a couple nights a week, plus 1,000+ hours of clinical time.
Well the watch isn't measuring troponin levels so it's hard to imagine how useful it could ever be at MI detection, especially given the limitations of a poor contact single lead ECG.
ER nurse here - some STEMIs I've taken care of had negative initial trop's (not all though). The 4 hr delta should of course be positive though - I don't typically check the 4 hr repeat for STEMIs though because they're long gone out of the ED to the cath lab then to CVICU.
I could imagine the thing detecting Vfib but it would need to use some good AI signal processing to exclude artifacts. Elevated ST segments, probably not, even with good AI.
OTOH doesn't the EKG feature only work when you touch the watch with your other hand? In which case it would be useless for heart attacks that caused you to lose consciousness.
The watch did an emergency sos. AFAIK no heart related notification triggers that - only fall detection can.
Outside possibility is he felt bad, saw a heart rhythm notification, and manually triggered emergency sos by holding the power button. But a fall alert seems much more likely.
The specific language you are looking for here is "indications for use". The way the FDA works, you cannot advertise (even directly) a medical device for a usage you have not indicated in your filing and backed up with the required evidence. The level and type of evidence will depend on the type of filing and claims. A medical professional can advise for a different use (called "off label") but you, as the device developer, cannot even hint at it.
Aside: as others note, though, you can't really detect heart attacks well from something this simple.
Differentiating between cardiac arrest and taking the watch off your wrist may be interesting. And I kinda wonder how good any single-lead EKG would be at detecting a heart attack when your heart is still beating. Even the expensive multi-lead machines usually auto-diagnose me with an old infarction, which is false.
Sometimes the rhythm may degrade into a ventricular rhythm, like v-tach then into v-fib if not treated. A heart can still pump in v-tach, albeit very inefficiently, but in v-fib, no blood is pumped. On the other hand, taking the watch off results in no signal input which is different than what you would see on the monitor for asystole.
Apart from the immediate “flatline” the watch also detects that it is not proximate to the skin. As soon as you take it off the watch disables things like ApplePay. It knows when it being/has been taken off.
I'd guess taking the watch off would produce a classic flat line. A heart in arrest which is in the process of dying will produce irregular electrical output.
It absolutely can. It's more sensitive than equipment hospitals use. There's an ongoing data collection program to calibrate it for that purpose. But since it hasn't been approved by regulators for use as such, they'd be in legal trouble if they claimed otherwise.
Condolences from my side too. My dad suddenly died in 2011 from a heart attack. It runs in the family so I have to be vigilant. I do love hearing about these Apple Watch stories though.
