Should you buy an Apple watch? You know if you're a geek and interested in that
kind of watch and you've been wanting to buy one, I think I'm gonna give you a
good reason to justify it. It has to do with stroke. See there's a thing called
atrial fib. It is atrial fibrillation. It is by far
the most common heart dysrhythmia that we see. It happens more in 50- and 60-year-
olds, and it multiplies a risk for stroke by a factor of five. There is a stroke of
unknown origin. There are several different names for it, and what we found
was these people had atrial fib that it was paroxysmal. In other words, it just
happened every now and then. They didn't know it. We didn't know it occasionally.
They would feel a little bit of flutter in their chest, but they would ignore it
and move on. Then we found out later they had atrial fib. See, what happens is
there's an area where blood pools in what's called the auricle or the atria.
Blood can pull there if the atria is not contracting and squeezing it all out, and
that can cause a clot. So the Apple watch actually looks for atrial fib. And here's
a study. Now you say, okay, you know that's the it's some study, and we've seen
this before. New England Journal. I don't think you've
seen it before. And it's not silly, it's real.
This actually ushers in a whole new area. In 8 months, they recruited over
400,000 participants to this study. They had zero study centers. It was all done
online. It's just like my telemedicine practice. So here we go with the article.
New England Journal, November 14 2019, "Large Scale Assessment of Smartwatch
to Identify Atrial Fib." Now some cardiologists have criticized, and they
said, you're just gonna pick up a bunch of the worried well with young people.
We'll talk about that in a few minutes. Background: optical sensors on these
watches can detect irregular pulses. The participant without atrial
fib as reported by the participants themselves use a smartphone to say, okay,
if I get a warning from my smartphone that I may have this, I'll write in. They
will give me a Holter monitor, and they will wear it for 7 days. 7 days
is a key point to it. Has to do with false positives. In other words, if
somebody didn't come up positive on that Holter monitor, does that mean the atrial
fib was not true on the Apple watch? No, but we'll get to that a little bit
later. Again, large study, 8 months, 420,000
participants, 117 days. Didn't take long to get this study done again and it was
a huge one. Now atrial fib was present in 34% of the people that had been notified.
Now, it turned out to be like what four hundred or so. It wasn't that many
because the vast majority of these people were young people, and they never
got notified. So that's a comment to the cardiologists who are saying this is
gonna get the worried well and fill up the already overtaxed medical community.
No, it's not. It's not gonna picking up young people. So here's the other thing.
Conclusions. What did they find the probability of receiving an irregular
pulse warning from the Apple watch was low, the probability. If you went ahead
and sent in your information in and got the seven-day holter monitor was pretty
high at 1/3. And as we mentioned false positives maybe really aren't false
positives because of that whole thing with paroxysmal atrial fib. It goes away
and then comes back. So we see that all the time. We see that with 2 3 week
and even 1 month long Holter monitors that they had symptoms. We think they had
atrial fib but we just didn't pick it up on the ultra monitor during those two
weeks to a month that they were wearing it. So as we said, it's important to know
if you have it. It quintuples your risk of stroke. Now, what do you do for
that? We'll talk about that a little bit later too.
So again, we've basically covered most of this information. 420,000, about 400 out
of the total picked up 400 new cases of atrial fib people that had 5 times
risk for stroke didn't know it. And again, as you see in this picture, I'm gonna
skip over that picture and go to this one. This shows basically again the
groups that actually had atrial fib. The ones that got notices were in the 55 and
older, especially the older than 65 age group detected other things too. But the
bottom line was it detected atrophy and that's what we want I asked the question.
Well, what do you do for it? One thing is obesity. Another is high blood pressure.
Another is sleep apnea. All these things greatly increase your body's time in
fibrillation if you do have a fibrillation. Actually, if I get typically
way around 155 to 160, if I start getting over 160 pounds, my atrial fib kicks up.
When we did a Holter monitor on mine, I was at 30% fibrillation. Now, the
cardiologist wanted to do ablation on me, but I know a little bit more about
this than your average patient. And I also know that I'm homozygous 4Q25.
I've got both genes switched tend to take my heart muscle and turn it from
muscle into more of a conduction system. In other words, it helps create all of
these short circuit my atria. So these things... typically these ablations lasts.
And let me go up and find in a picture of an ablation. An ablation is where they
go in, and they basically cauterize or burn an area around the space where
these tend to come in in the pulmonary arteries. These ablations typically often
will work. They'll take a couple hours to get the thing done, and they'll last like
2 years. My mother had it. Remember, I'm homozygous so that means I
got one 4Q25 gene from my mom, one 4Q25 gene from my dad. And my mom has
had atrial fib for years, decades. She's had four ablations because
yep she'll have them. I mean that's just typical of what happens. She'll have them
then she'll grow some more short circuits and then she will go back into
atrial fib. So what do you do? Lose that weight. I declined getting the ablation. I
lost weight, and my symptoms went away Make sure you manage that blood pressure.
Make sure you get good sleep and exercise. Now, don't exercise too much, and
be careful with prolonged endurance exercise. That was another thing that
probably contributed to mine. I've run half marathon a week, and that was in
addition to playing 3 to 6 hours of full court basketball the week. And
that was in my 40s and 50s, and we didn't really know that that kind of endurance
training was that much of a risk for Afib. Back at that point in time, I
wish we had known. Now, so again, you want to get that exercise. You want to get the
weight loss. You want to manage your diet, manage your blood pressure, manage your
sleep. But be careful being one of those
marathon level and sort of stuff endurance training. If you've made it
this far, thank you very much for your interest and consider getting that Apple
watch.
Continue to get great feedback regarding the webinars, and here's what you know. On
the Internet, when you hear a webinar, you expect for somebody to try to sell you
something. We're not doing that. We're trying to tell you something. People are
coming in with their labs from Quest - inflammation panel, OGTT, insulin survey
response. And then they're finding out, do I have inflammation, do I have insulin
resistance, and where does that fit in terms of other folks. We're getting ready
to start one for CIMT as well. So again, people are really excited about finding
out their own status. Looking forward to seeing you there. Thanks.