What Heart Monitor Is Best at Detecting Irregular Heartbeats?

Heart patients have options to manage abnormal rhythms

A smartwatch with heart monitor, wearable device.

Heart patients have options to manage abnormal rhythms

Remote heart monitoring has been an effective part of heart treatment plans for more than two decades and continues to grow in importance.

People with an irregular heartbeat — known as arrhythmia — who are under a doctor’s care, can help manage their heart condition from home via remote monitoring. There are several types of remote heart monitoring devices, including wearable devices and smartphones.

“In some cases, it’s now possible to do routine checks on both the heart and the device remotely without the need for a visit to the hospital or a clinic,” says Douglas Gibson, MD, director of cardiac electrophysiology at Scripps Clinic John R. Anderson V Medical Pavilion.

“The doctor who receives the transmitted information can look for changes that have occurred either with the rhythm of the heart or device used,” Dr. Gibson says.

What is arrythmia?

An arrythmia is an irrigular heartbeat. It can be harmless or life-threatening. It may be brief or last longer.

The condition can cause the heart rate to be too slow or too fast. It can also cause the heart rhythm to be erratic.

There are different types of arrythmias. The most common is atrial fibrillation (AFib), where the upper heart chambers contract irregularly.

AFib can lead to blood clots, stroke, heart failure and other heart-related complications. More than 450,000 hospitalizations with AFib as the primary diagnosis occur each year in the United States. AFib contributes to about 158,000 deaths each year.

It is estimated that 12.1 million people in the U.S. will have AFib in 2030, according to the Centers for Disease Control and Prevention (CDC).

What are risk factors?

Advancing age and high blood pressure are leading risk factors. High blood pressure accounts for 1 in 5 cases of AFib. People of European descent are also more likely to have AFib than African-Americans.

Other risk factors for AFib include:

  • Obesity
  • Diabetes
  • Heart failure
  • Ischemic heart disease
  • Hyperthyroidism
  • Chronic kidney disease
  • Moderate to heavy alcohol use
  • Smoking
  • Enlargement of the chambers on the left side of the heart


Symptoms related to arrythmias may include:

  • Extreme fatigue
  • Irregular heartbeat
  • Lightheadedness
  • Shortness of breath
  • Chest pain

In extreme cases, AFib can lead to sudden cardiac arrest.

What does a clinical heart monitor do?

The heart has an electrical system that tells it when to beat. An electrocardiogram (ECG or EKG) measures the electrical signals of the heart.

Your doctor may order a clinical or hospital-grade electrocardiogram (ECG or EKG) to diagnose an abnormal heart rhythm. Sensors or electrodes are attached to the chest and sometimes a limb to assess the heart rate and rhythm.

ECGs are often done in a doctor’s office, clinic, or hospital, but can also be done from home. If your symptoms are sporadic, a standard ECG may not capture the necessary information. Your doctor may recommend using a remote heart monitor.

“In cases when the information sent or shared indicates an emergency, the patient will be asked to go to the emergency room,” Dr. Gibson says.

Types of heart monitors

There are several different types of heart monitors. Several are clinically approved.

Holter monitor

A Holter monitor is a wearable device that records a continuous ECG, usually for one to two days. Newer Holter monitors allow continuous monitoring for weeks.

Event monitors

A cardiac event monitor is similar to a Holter monitor. It is used for long-term monitoring of symptoms that occur infrequently.

Heart patients can wear these pager-sized devices for longer periods, typically 30 days. They can use them to record heart activity as symptoms occur. In some devices, the ECG can be sent by telephone to the patient’s health care team.

“With the push of a button, an event monitor will record and store your heart’s electrical activity as symptoms occur. Your doctor analyzes and interprets the results and recommends treatment,” says Dr. Gibson.

There are different types of event monitors, including wearable and implanted devices.

Loop memory monitor

A looping memory monitor stores your ECG for the period before and during your symptoms.

Patch recorder

A heart monitor patch is an adhesive that is applied to the chest region. They are typically worn for up to two weeks and then returned to the doctor to have the recordings analyzed.

Symptom event monitor

The symptom event monitor is a hand-held or wearable device that is activated and placed in the chest during symptoms.

Implanted loop recorder

The implantable looping monitor is a pager-sized heart activity recorder that is placed under the skin of the chest for up to three years.

New generation devices

People can now use smartphones and smartwatches to monitor their heart rate and detect issues, such as irregular heart rhythm.

In 2018, Apple introduced the Apple Watch Series 4. It was the first smartwatch that could monitor heart activity and detect an irregular heart rhythm. Moreover, it had the ability to record the event. Cloud-based technology is used for virtual storage and secure sharing of medical information.

There have been many other wearable devices with an ECG feature that have received Food and Drug Administration clearance since then.

Check with your doctor

Make an appointment with your doctor if you think you have AFib or an irregular heartbeat and need treatment and check if a heart monitoring device is right for you.

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