ecg/wearable

Wearable & Single-Lead ECG

Smartwatch and handheld ECG strips: rhythm, AF, heart rate, QRS and QTc, and strip quality.

Coming soonECGECG & Cardiac Signals

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Overview

What it does

Wearable & Single-Lead ECG reads the 30-second strips that patients record on a smartwatch or a handheld recorder, with one lead or up to six limb leads. Patients bring them to the general practitioner or the emergency department as a PDF export, a screenshot of the app, or a photo of the screen, often with the device's own verdict of "inconclusive".

The clinical question is nearly always the same: what rhythm is this, and is it atrial fibrillation? The run digitises the strip when it is an image, classifies the rhythm, measures heart rate, adds QRS duration and QTc when the leads allow it, rates how readable the strip is, and says when a 12-lead ECG is the next step.

Intended use

Decision support for physicians who are handed a patient-recorded strip and need a structured second opinion on the rhythm, particularly when the device reports the recording as inconclusive.

Who it is for

General practitioners, emergency physicians, cardiologists and arrhythmia nurses who receive patient-recorded strips, and developers of remote-monitoring and telecardiology services who need a vendor-neutral rhythm read.

Inputs and protocol

Accepted input

PDF exports of smartwatch or handheld-recorder strips; lead I exports are often vector PDFs and are read from their drawing paths.
Screenshots and photos of the app or of a printed strip.
CSV sample exports from the device or its app.
One to six leads; several strips of the same episode can be uploaded together.

The device's own printed verdict is masked before the strip is read, so it does not influence the result.

Requirements

Requirement	Why
The whole strip visible, including its scale	Heart rate and intervals depend on the time base and gain
Readable trace without heavy tremor	Tremor and motion artefact can imitate atrial fibrillation
Sampling rate in CSV files	Converts samples to time
Patient age and sex	Normal ranges and QTc thresholds

Optional context

Symptoms at the time of recording, known AF or flutter, rate- or rhythm-control drugs and a prior 12-lead ECG can be passed in clinical_context and prior_files.

Outputs and standards

The result

One structured result per upload with the rhythm finding, measurements, a quality rating and guidance. The digitised trace is returned with the beats that support the finding highlighted.

Section	Content
Rhythm	Sinus rhythm, atrial fibrillation, atrial flutter, bradycardia, tachycardia, ectopy or unreadable, with heart rate, QRS and QTc where the leads allow, strip quality and guidance
Draft report	Opt-in (`options.report`): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

Interchange: FHIR R4 Observation with LOINC 11524-6 "EKG study" and heart-rate and interval components.
Definitions: atrial fibrillation per the 2024 ESC and 2023 ACC/AHA/ACCP/HRS atrial fibrillation guidelines.
Statements: findings are coded with AHA/ACCF/HRS 2007 diagnostic statements and SNOMED CT.

What a single lead cannot show

P waves are small on lead I, which limits how atrial flutter and AV block can be read. No ST-segment or ischaemia conclusion is drawn from one lead, and the result points to a 12-lead ECG when one is needed to answer the question.