Which Heart Monitor Is Best for Detecting Irregular Heartbeats?

An arrhythmia is an abnormal heart rhythm that causes the heart to beat too fast, too slow or with an uneven rhythm. Some arrhythmias are harmless, while others can be serious or even life-threatening.  The most common type is atrial fibrillation (AFib), where the heart’s upper chambers beat irregularly.

AFib increases the risk of blood clots, stroke and heart failure. This condition affects millions of Americans and continues to increase in prevalence. The Centers for Disease Control and Prevention estimates that 12.1 million people in the United States will have AFib by 2050.

Symptoms can vary and may come and go. They include: 

• Extreme fatigue or weakness
• Irregular or rapid heartbeat 
• Palpitations, a sensation that the heart is racing, fluttering or skipping beats
• Lightheadedness or dizziness
• Shortness of breath 

"Some people experience no symptoms at all, which is why heart monitoring can be so important in helping detect irregular rhythms that might otherwise go unnoticed. For example, atrial fibrillation increases the risk of stroke even if it doesn’t cause physical symptoms,” Dr. Gibson says.  

Advancing age, sleep apnea and high blood pressure are among the leading risk factors for AFib. High blood pressure is one of the most common and important contributors to AFib risk. 

AFib is diagnosed more often in people of European descent than in African Americans, although differences in diagnosis and outcomes may reflect a range of social and health care factors.

Other risk factors for AFib include:

• Obesity
• Diabetes
• Heart disease
• Thyroid disorders
• Smoking
• Excessive alcohol use

Heart monitors track your heart’s electrical activity using a test called an electrocardiogram (ECG or EKG). These devices record heart rhythm data. 

Your doctor may order a clinical or hospital-grade ECG 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. They can also be done at home. If your symptoms come and go, a standard ECG may not capture the necessary information. Your doctor may recommend a remote heart monitor for a longer duration.

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

There are several types of heart monitors, each designed for different needs and lengths of use. Most are clinical-grade devices (also called “hospital-grade”). A doctor prescribes them and clinicians review the heart rhythm recordings to look for abnormal patterns and guide diagnosis. 

Consumer wearables offer easy tracking, but they do not diagnose conditions.

1. Holter monitor: A wearable device that continuously records heart activity for 24 to 48 hours (sometimes longer with newer models).

Best for: frequent symptoms

2. Event monitor: Worn for several weeks. The device records heart activity when you activate it during symptoms or suspected cardiac events.

“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.

Best for: Occasional or unpredictable symptoms. Episodes must be symptomatic

3. External loop recorder: Continuously monitors heart rhythm and saves recordings from moments before, during and after a symptom, either automatically or when activated.  

Best for: Capturing short, unexpected episodes. Episodes can be either symptomatic or asymptomatic

4. Patch monitor: A small adhesive patch worn on the chest that continuously records heart rhythm for up to four weeks.

Some patch monitors include real-time monitoring through a cellular signal that can transmit urgent heart rhythm data to healthcare providers. This type of monitoring is often called Mobile Cardiac Outpatient Telemetry (MCOT) monitor and is commonly used when serious arrhythmias are suspected.

Best for: comfortable, continuous monitoring

5. Implantable loop recorder: A small device placed under the skin that monitors the heart rhythm for years if necessary. These devices are about the size of a clip on a pen. They are placed by a medical professional in an office or hospital using local anesthesia only.  

Best for: infrequent, long-term or unexplained symptoms

6. Smartwatches and wearable devices: Modern wearable devices — such as Apple Watch, Fitbit and Samsung Galaxy Watch — can track heart rate and identify patterns that may suggest irregular rhythms like AFib.

Some models include FDA-cleared EKG apps and irregular rhythm notification features (availability varies by device and region). These tools can:

• Record EKG readings
• Alert users to possible irregular rhythms
• Allow data sharing with healthcare providers

While useful for early detection and ongoing monitoring, wearable devices do not replace clinical diagnosis. Medical-grade monitors, interpreted by clinicians, are the standard for diagnosis, while consumer wearables serve as screening and support tools.

Make an appointment with your doctor if you think you have AFib or an irregular heartbeat and want to know whether a heart monitoring device is right for you.

If you experience symptoms of an irregular heartbeat — or receive an alert from a heart monitor or smartwatch — contact a healthcare provider promptly.

In emergencies, such as severe chest pain, fainting or trouble breathing, call 911 and seek immediate medical care.

“Whether using a clinical device or a smartwatch, tracking your heart rhythm at home can help detect problems earlier and support better long-term outcomes,” says Dr. Gibson.

Yes. Some modern smartwatches include FDA-cleared features that can identify irregular heart rhythm patterns and alert users to possible AFib. These alerts should be confirmed by a healthcare provider.

Medical-grade ECG monitors, such as implantable loop recorders or Holter monitors, are the most accurate because they are reviewed by clinicians and used for diagnosis. Wearable devices are useful for screening and initial arrhythmia recording and long-term tracking. These devices require a medical professional to confirm the diagnosis.  

Clinical monitors require a doctor’s prescription. Consumer wearables do not, but they should not replace medical evaluation.