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ESC Working Group on e-Cardiology Position Paper: Use of Commercially Available Wearable Technology for Heart Rate and Activity Tracking in Primary and Secondary Cardiovascular Prevention

Jensen, Magnus T.; Treskes, Roderick W.; Caiani, Enrico G.; Casado-Arroyo, Ruben; Cowie, Martin R.; Dilaveris, Polychronis; Duncker, David; Frederix, Ines; De Groot, Natasja; Kolh, Philippe H; Kemps, Hareld; Mamas, Mamas; McGreavy, Paul; Neubeck, Lis; Parati, Gianfranco; Platonov, Pyotr G.; Di Rienzo, Marco; Schmidt-Trucksäss, Arno; Schuuring, Mark J.; Simova, Iana; Svennberg, Emma; Verstrael, Axel; Lumens, Joost


Magnus T. Jensen

Roderick W. Treskes

Enrico G. Caiani

Ruben Casado-Arroyo

Martin R. Cowie

Polychronis Dilaveris

David Duncker

Ines Frederix

Natasja De Groot

Philippe H Kolh

Hareld Kemps

Mamas Mamas

Paul McGreavy

Gianfranco Parati

Pyotr G. Platonov

Marco Di Rienzo

Arno Schmidt-Trucksäss

Mark J. Schuuring

Iana Simova

Emma Svennberg

Axel Verstrael

Joost Lumens


Commercially available health technologies such as smartphones and smartwatches, activity trackers and eHealth applications, commonly referred to as wearables, are increasingly available and used both in the leisure and healthcare sector for pulse and fitness/ activity tracking. The aim of the Position Paper is to identify specific barriers and knowledge gaps for the use of wearables, in particular for heart rate and activity tracking, in clinical cardiovascular healthcare to support their implementation into clinical care. The widespread use of heart rate and fitness tracking technologies provides unparalleled opportunities for capturing physiological information from large populations in the community, which has previously only been available in patient populations in the setting of healthcare provision. The availability of low-cost and high-volume physiological data from the community also provides unique challenges. While the number of patients meeting healthcare providers with data from wearables is rapidly growing, there are at present no clinical guidelines on how and when to use data from wearables in primary and secondary prevention. Technical aspects of heart rate tracking especially during activity need to be further validated. How to analyze, translate, and interpret large datasets of information into clinically applicable recommendations needs further consideration. While the current users of wearable technologies tend to be young, healthy and in the higher sociodemographic strata, wearables could potentially have a greater utility in the elderly and higher risk population. Wearables may also provide a benefit through increased health awareness, democratization of health data and patient engagement. Use of continuous monitoring may provide opportunities for detection of risk factors and disease development earlier in the causal pathway, which may provide novel applications in both prevention and clinical research. However, wearables may also have potential adverse consequences due to unintended modification of behaviour, uncertain use and interpretation of large physiological data, a possible increase in social inequality due to differential access and technological literacy, challenges with regulatory bodies and privacy issues. In the present position paper, current applications as well as specific barriers and gaps in knowledge are identified and discussed in order to support the implementation of wearable technologies from gadget-ology into clinical cardiology.

Journal Article Type Other
Acceptance Date Jan 19, 2021
Online Publication Date Feb 8, 2021
Publication Date 2021-05
Deposit Date Jan 20, 2021
Publicly Available Date Feb 8, 2021
Journal European Heart Journal – Digital Health
Electronic ISSN 2634-3916
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 2
Issue 1
Pages 49-59
Keywords wearables, digital health, innovation, prevention, cardiovascular, telemonitoring
Public URL


ESC Working Group On E-Cardiology Position Paper: Use Of Commercially Available Wearable Technology For Heart Rate And Activity Tracking In Primary And Secondary Cardiovascular Prevention (accepted version) (584 Kb)

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