Revista Fisio&terapia · Jun 30, 2026
Eficácia de dispositivos vestíveis (wearables) na detecção precoce de arritmias: revisão narrativa
By Araújo JDMA, Silva AARCE, Fernandes RM et al.
Introduction: Early detection of arrhythmias, especially atrial fibrillation (AF), is essential for preventing stroke and other complications. Wearable devices—including PPG-based smartwatches, portable single-lead ECG devices, and continuous monitoring adhesive patches—have been increasingly used for screening and monitoring in outpatient settings. Objective: To critically review the literature on the diagnostic efficacy and clinical impact of wearables in the early detection of arrhythmias, synthesizing evidence on sensitivity/specificity, diagnostic yield, comparative advantage over traditional monitors, and impact on clinical studies. Methods: Narrative review with searches in electronic databases (PubMed/Medline, PMC, Embase, Scopus, IEEE Xplore) from September to 2025, selecting clinical trials, observational studies and systematic reviews. We provide a qualitative synthesis and critical discussion of gaps and practical implications. Results: Validation studies and meta-analyses demonstrate that wearables (PPG and single-lead ECG) have high sensitivity and specificity for detecting AF in controlled settings; prolonged patches (e.g., Zio XT) detect significantly more AF compared to 24-hour Holter monitoring. Screening trials (e.g., mSToPS, GUARD-AF, and large-scale studies such as the Apple Heart Study) indicate increased AF detection, but evidence of a reduction in stroke or mortality is still insufficient or inconclusive. Problems such as false positives, inconclusive readings, selection bias, and cost-effectiveness and privacy issues are barriers to large-scale population screening. Conclusion: Wearables represent a promising technology for early arrhythmia detection and longitudinal monitoring, especially in at-risk groups; however, adoption for population screening should await robust evidence of benefit in clinical studies, cost-effectiveness analyses, and clear protocols for diagnostic confirmation and referral.