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The two main technologies equipped with smart watch products are PPG and ECG.

The full name of PPG is photocapacitance pulse wave tracing. In principle, it emits a light beam of a certain wavelength (generally green light) to the skin, and then it is received by the photoelectric receiver through transmission or reflection. It processes and displays the periodic light intensity changes detected in this process due to blood circulation, and generates pulse data.

PPG can also be used to measure the blood oxygen value. The principle is that the blood reflectivity with different oxygen content is different. It can also be detected by photoelectric receiver, and then processed and estimated by algorithm to obtain the blood oxygen value.

PPG technology can calculate pulse, blood oxygen and even blood pressure, which is more suitable for normalization monitoring. Therefore, some smart watch products are equipped with small air bags and pressure sensors for specific blood pressure measurement needs, and use more traditional and clinical oscillographic methods to accurately measure blood pressure.

ECG refers to electrocardiogram, but when applied to smart watches, there is a big gap in scale with the monitoring methods of large equipment and multiple patch electrodes commonly used in hospitals. The principle is to collect bioelectric signals, and the potential differences and changes in different parts of the human body can be restored to a variety of values including heart rate after algorithm processing.

The measurement method of ECG principle on intelligent wearable devices is more accurate than PPG, but the coverage is relatively smaller. The ECG itself can reflect quite a lot of data on human health.

The PLUS101 module of Plus1Health uses PPG and ECG detection to realize monitoring, analysis and early warning. Based on pulse wave technology and hardware standards, ECG measurement principle is used to collect cardiac bioelectric signals, and real-time detect atrial fibrillation, premature beats and other arrhythmia problems. It is suitable for irregular work and rest, high intensity, elderly people, professional ECG auxiliary report, and understand physical conditions at any time and anywhere. Monitor the heart rate, blood oxygen, blood pressure, ECG and other data from time to time. The APP dynamically reminds the family of the health status. If the background analysis is completed, it will timely send early warning information to the watch and relatives, tachycardia/bradycardia alarm, atrial fibrillation monitoring alarm, abnormal alarm, etc.

It has been widely recognized that excessive exercise or fatigue exercise can cause sports injury, but it is still difficult to judge. Smart watches with ECG function mainly rely on accurate measurement of exercise heart rate and fatigue test to prevent sports injury. Exercise heart rate monitoring is used to monitor exercise intensity in real time during exercise, prevent sports injury and provide exercise efficiency; fatigue test is used to evaluate the physical condition before exercise to prevent sports injury caused by excessive exercise.

The main functions of heart rate monitor are：

1. It can reflect the real information of the user’s body when exercising. If the heart rate is too high and the exercise is too intense, and the user’s body water evaporates too fast, then this exercise is not beneficial to the body. If the heart rate is not high enough for light exercise, the user will not be able to burn enough calories, thus not achieving the expected exercise effect.

2. By monitoring whether the resting heart rate is within the normal range, monitoring cardiac arrest and abnormal increase of heart rate in daily activities can play a timely role in preventing disease, and even detecting whether the heart rate is abnormal by monitoring the heart rate. In addition, the pulse wave signal PPG changes can also be monitored through the optical capacitance pulse wave sensor to analyze the pulse rate, blood oxygen concentration, microcirculation and peripheral vascular status of diabetes patients.

3. The monitored HRV heart rate variability can be used to analyze the assessment of autonomic nervous function, such as mental stress, tension and relaxation, and sleep quality.

The main functions of ECG monitor are：

1. Prevention of sports injury: monitor the intensity of sports in real time to prevent sports injury and improve sports efficiency; the fatigue and stress tests are used to evaluate the physical condition before exercise to prevent sports injury caused by excessive exercise.

2. Prevention of sudden death from exercise: before sudden death from exercise, abnormal changes will occur in the electrocardiogram of sudden death. If the abnormal changes of ECG can be captured and treated in time, it will make a great contribution to the prevention of sports sudden death.

The PLUS101 module adopts a self-developed high-sensitivity ECG acquisition module, which can directly collect ECG data, and convert the measured HRV value to fatigue and stress, and achieve the purpose of convenient testing and use on the premise of ensuring accuracy. Users can adjust the exercise intensity according to fatigue.

The PLUS101 module adopts single-lead ECG monitoring, which has good reference value for arrhythmia detection, such as ventricular premature beats, atrial fibrillation, etc.; at the same time, single-lead ECG also has certain diagnostic value for myocardial ischemia.

In the daily cardiac health management, users can use the ECG watch as a daily monitoring and abnormal prompt tool. When the ECG data is abnormal, they can go to the hospital for detailed ECG monitoring and detection, so as to play the role of prevention and treatment.

In recent years, heart rate monitors and electrocardiogram (ECG) sensors have begun to rise, and most new smart watches are equipped with these two sensors. These allow users to track heart rhythm and ECG activity, making it very suitable for tracking health and fitness data. It can also help you track your progress and bring you closer to your goal.

For example, some of the best smart watches with ECG function are introduced below. Some of these products have been approved by FDA (Food and Drug Administration), and some have hardware but are waiting for approval. What has not been approved does not necessarily mean that they are inaccurate.

1、Apple Watch Series 7

It is seamlessly paired with all compatible iPhones and has a built-in ECG function. Users can easily turn on the ECG function by placing their fingers on the digital watch crown and pressing it according to the instructions on the smart watch display. Reliable and accurate information can be obtained in a few seconds.

After ECG tracking, the results will be provided in simple English. This information is also recorded in the Apple Health smart watch application and can be shared with doctors. The Apple Watch Series 7 has been approved by FDA, and the ECG function has been provided in many countries/regions in North America, Europe and Asia.

2. Samsung Galaxy Watch 4 series

The first smart watch pre-installed with Wear OS 3 software, with ECG function. It only takes 30 seconds to complete the ECG measurement, and the user is required to put his finger on the top button, and must remain motionless during the whole tracking process. In order to obtain the most accurate results, their arms must also be placed on a flat surface.

After the measurement is completed, the user can go to the Samsung Health App on the mobile phone to view the results, and some basic information will also be displayed on the watch. The ECG function of Galaxy Watch 4 series has been approved in the United States, Europe, South Korea and several other Asian regions.

3、Fitbit Sense

Another excellent wearable device on the market supports ECG tracking function. Like other smart watches above, it has been approved by FDA and can be used in specific countries/regions including the United States and Europe.

To check the ECG, the user needs to touch the shell with his finger while holding still, and then the sensor obtains the ECG and displays the results on the watch and mobile application. This information can also be exported as PDF, which can detect abnormal rhythms, including high heart rate and low heart rate.

Fitbit Sense has an ECG sensor and can track many sports activities. It is one of the best fitness equipment. It is fully supported on both iPhone and Android devices, and has many powerful functions to help you stay motivated and keep fit.

4、HUAWEI Watch GT 3 Pro

Available in ceramic and titanium models. The smart watch can answer the phone through Bluetooth. Its fashionable design is integrated with modern wrists and smart watches. There is a customizable dial and even an ECG sensor, which can automatically detect more than 100 exercise modes to help you track your progress.

HUAWEI Watch GT 3 Pro supports sleep tracking, heart rate monitoring, SPO2 and ECG. It can be used for about 14 days for a single charge and about 8 days for heavy use. Like most other smart watches in this list, it has a 5ATM waterproof certificate up to 30 meters and is compatible with Android and iOS platforms. However, some features may be limited to Android.

The built-in health sign monitoring function of smart watch plays a strong guiding role in our health. For example, heart rate monitoring, many precursors of atrial fibrillation will be reflected in heart rate. The portable intelligent wearable device can help us detect data abnormalities in time, inform us and detect them in time, and let us find professional doctors for treatment. Similarly, ECG can help us to judge the condition of heart beating, as well as the frequency and rhythm, and can diagnose some cardiovascular diseases.

After the smart watch is equipped with the ECG function, it can record the graphics of ECG signals in detail. For the detection of abnormal cardiac rhythms such as atrial fibrillation and premature beats (premature ventricular beats and premature atrial beats), it can help users identify arrhythmia more accurately, provide arrhythmia risk screening, personalized guidance, appointment and integrated management services, and independently manage cardiac health. Especially for people who often stay up late, live irregularly, are obese, and have occasional cardiac discomfort, the monitoring of these functions has important reference value for personal health management.

The audience of medical and health intelligent hardware has the characteristics of segmentation, and users may develop from health needs to medical needs at any time.

At present, in the field of medical and health intelligent hardware mobile devices, the competition between blood pressure meters and blood glucose meters is the most intense. However, in the face of sophisticated and complex ECG devices and unpredictable ECG waveforms, most companies still have no confidence to take the initiative, and can only marvel at the market of hundreds of millions of cardiovascular people.

Cardiovascular patients are characterized by a large number of patients, large reserve population, high mortality rate and high difficulty in emergency treatment. For the long-term management of cardiovascular diseases, it is mainly phased health care. In order to better conduct disease screening and postoperative monitoring, systematic and intelligent management is the development goal.

At present, the operation modes of ECG equipment manufacturers in the market mainly include:

1. Only R&D and manufacturing of ECG hardware equipment

Most of these ECG devices are integrated terminals with display screens, which are not equipped with professional ECG analysis software and services. The ECG devices only produce waveforms and no diagnostic results.

2. Both ECG hardware equipment and algorithm

The R&D team makes automatic analysis software. The ECG equipment is equipped with automatic analysis software with different functions to prompt the ECG results, making the professional and complex ECG waveform easier to understand and more suitable for home users.

3. In addition to hardware, algorithms and software, we also provide various services based on ECG products

Considering the particularity of ECG equipment and cardiovascular diseases, various follow-up services must be an essential part of the ECG market, such as remote ECG monitoring and rescue, cardiac health management, etc. Such comprehensive businesses require higher requirements for the company.

Plus1Health is the third kind of ECG equipment manufacturer, which includes ECG hardware equipment, algorithms and software, and services based on ECG products. It can provide ECG products and solutions, such as ECG stickers, ECG watches/bracelets, and remote ECG monitoring.

The combination of Internet technology and elderly care services has become more common. The continuous development of new technology application scenarios such as the Internet of Things, big data, artificial intelligence and blockchain has provided unlimited possibilities for the development of intelligent elderly care. With the support of high-tech, smart pension can extend to all aspects of the elderly’s life, including food and drink, medical care, leisure and entertainment, home safety, and other aspects, and the services provided are more timely, efficient and landing. For example, the application of Internet of Things technology can monitor the health of the elderly in a timely manner, respond to emergencies in a timely manner and notify relevant guardians to rescue them in a timely manner, which is a function that traditional elderly care services can’t match. This requires that intelligent elderly care equipment must be intelligent and accurate in data collection.

According to the research, the proportion of elderly people suffering from cardiovascular diseases has reached more than 50%. The elderly are prone to chronic diseases such as cardiovascular diseases, which often leads to the decline of immune function. Therefore, the middle-aged and elderly, especially those with cardiovascular diseases, need to be more vigilant.

ECG can detect and diagnose heart disease in the elderly at an early stage. The elderly with basic diseases should check ECG regularly to strengthen the management and control of chronic diseases. For the elderly without basic diseases, it is difficult to detect abnormalities in ordinary ECG, so remote dynamic ECG real-time monitoring can be selected to detect cardiovascular diseases at an early stage.

The remote ECG monitoring system of Plus1Health combined with remote ECG, AI, cloud data service and Internet industry technology, takes the artificial intelligence ECG analysis software as the core, automatically identifies the early warning value of ECG terminals, uploads data to AI cloud service quick diagnosis, and professional ECG analysts review, and provides remote all-weather high-quality real-time cardiac monitoring, realizing effective interaction between patients, guardians, and nursing homes, Timely detect, prevent and track heart disease to reduce the risk of disease outbreak.

Advantages of remote ECG monitoring system：

1. Automatic analysis and early warning: real-time online monitoring, finding abnormal data of patients exceeding the valve value, triggering early warning, realizing ECG data collection and front-end analysis, abnormal ECG data analysis and early warning.

2. Real-time monitoring: through mobile signals, real-time abnormal ECG data is monitored 24 hours a day, without geographical restrictions, and ECG information is recorded safely and completely everywhere.

3. Data storage: the terminal automatically records the working status and important patient information in a circular manner, which cannot be deleted or modified manually.

4. Data sharing: real-time monitoring data and reports can be sent to guardians or other binding personnel remotely.

5. Cloud service: the whole ECG analysis and monitoring process is based on Internet cloud service. Health care institutions do not need to add special supporting equipment. As long as the elderly are equipped with ECG equipment, they can achieve efficient processing by connecting to the cloud platform with Internet data.

The remote ECG monitoring system of Plus1Health all adopts the Internet and medical mode, so that the elderly ECG monitoring service can be seen, touched, and no distance. Continuous real-time monitoring allows the elderly to do a good job in the early prevention of sudden onset, and can detect their own routine ECG data anytime and anywhere, providing good protection and major disease prevention for themselves.

Remote dynamic ECG can help the rapid development of the Internet and medical service model in the health care industry, achieve 24-hour continuous remote ECG monitoring, timely detect hidden ECG abnormalities, and play an early warning role in disease prevention and treatment; The system utilizes the national 4G data coverage to realize the cross-regional extension from the service hospital to the health care and then to the home care. The service breaks through the geographical and time constraints, and seamlessly connects with the health care institutions and the home care; The multiple efficient models of Internet, AI and cloud services shorten the distance between hospitals, health care institutions and elderly patients, and provide heart care services for the majority of elderly patients.

Plus1Health ECG patch is continuously monitoring 24 hours of ambulatory ECG. It can be measured not only by chest heart patch, but also by handheld devices. It is very portable. ECG patch is composed of wireless ECG monitor and ECG patch. It adopts high-precision biosensor, flexible circuit design, and perfectly fits the skin. Connect the mobile intelligent terminal applet to wirelessly transmit the ECG waveform in real time. After the monitoring is completed, the automatic analysis report of dynamic electrocardiogram can be generated, and the doctor can also be applied for online consultation.

There are two detection methods for ECG stickers: handheld and heart stickers.

1. Handheld mode:

When the user suddenly feels unwell and wants to quickly detect the electrocardiogram, he can choose to use the method of holding hands to detect the routine electrocardiogram for a short time, which is convenient and fast, and can be measured anytime and anywhere. After the detection, a reference report will be automatically generated. The user only needs to use the host alone, touch the metal electrode on the host with both fingers, and connect the small program to complete the measurement.

2. Heart sticking method:

When users want to continuously monitor the ECG for a long time, they can choose to use the chest patch to detect the dynamic ECG. This function can collect the dynamic ECG for 24 hours. After the measurement is completed, the reference report of the dynamic ECG will also be automatically generated. Users only need to install the host into the ECG stick shell, use two disposable electrodes to stick to the chest position, fix the whole device, and connect the applet to start collecting the dynamic ECG.

The latest tweet from IANS India said: “It is reported that the family of a 12-year-old girl believed that the heart monitoring function of Apple Watch saved her life – helping to find a rare cancer in children.”

One night, Imani Mile’s Apple Watch began to remind her of abnormal heart rate rise.

Jessica Kitchen, Imani Mile’s mother, took her to the hospital and the doctor diagnosed her with appendicitis. During the operation, they found a neuroendocrine related cancer in her appendix, which is rare in children.

The doctor later learned that the cancer had spread to other parts of Imani Mile’s body. She underwent surgery at C.S. Mott Children’s Hospital and removed the remaining cancerous disease. “If she didn’t have that watch, the situation would be worse,” Jessica Kitchen told Hour Detroit.

In July this year, Apple Watch helped doctors find a rare tumor in the heart of a woman who had received many warnings of atrial fibrillation.

This is a real case, which can be viewed on OrissaPOST——“Apple Watch helps detect rare cancer in 12-yr-old girl ”.

How does the ECG Watch monitor your ECG？

Every heartbeat produces a tiny amount of electricity. The ECG smart watch can track and analyze these electrical signals with its advanced ECG sensor.

ECG is a diagnostic test used to diagnose cardiac abnormalities, such as arrhythmia, cardiovascular disease, cardiac arrest, etc.

If the ECG smart watch cannot detect cardiac arrest, but can detect arrhythmia or irregular rhythm, this may be an early signal of cardiac arrest. Therefore, if your smart watch detects and reminds you of arrhythmia, you must rush to the nearby hospital immediately.

Plus1Health can provide the solution of ECG smart watch, and health starts from the core.

Atrial fibrillation, referred to as atrial fibrillation for short, is one of the most common arrhythmias. It refers to the loss of regular and orderly atrial electrical activity, which is replaced by rapid and disorderly fibrillation waves. It is a serious disorder of atrial electrical activity. It usually shows irregular and fast heart rate, which is caused by the loss of normal rhythm of the atrium. Atrial fibrillation not only affects the quality of life of patients, but also causes thromboembolism, heart failure and other complications in severe cases. The most serious complication is stroke.

Atrial fibrillation is generally divided into the following categories according to the frequency and duration of attack:

1. Paroxysmal atrial fibrillation: duration ≤ 7 days (generally ≤ 48 hours);

2. Persistent atrial fibrillation: duration>7 days;

3. Long-term persistent atrial fibrillation: the duration is ≥ 1 year, and the patient has the desire to restore normal rhythm and receive corresponding treatment to restore sinus rhythm;

4. Permanent atrial fibrillation: lasting for more than 1 year, which cannot be stopped or recurred after termination. The doctor and the patient jointly decided to give up the restoration of sinus rhythm.

In addition to the above categories, there are some special types of atrial fibrillation in clinic, such as:

1. First diagnosis of atrial fibrillation: atrial fibrillation found in the first diagnosis;

2. Non-valve ward fibrillation: duration>1 year, refers to atrial fibrillation without rheumatic mitral stenosis, mechanical/biological valve replacement, mitral valve repair, etc;

3. Silent atrial fibrillation: also known as asymptomatic atrial fibrillation, refers to atrial fibrillation without clinical symptoms.

When you have atrial fibrillation, you can use the following app to monitor your heart rate, record it, and give it to the doctor for reference.

A free check atrial fibrillation app——”AFibCheck“：‎AFibCheck on the App Store (apple.com).

There are many reasons for atrial fibrillation, including both heart and lung diseases and endocrine system diseases. Normal people may also have atrial fibrillation under the conditions of emotional excitement, alcohol consumption and tiredness, and the incidence of atrial fibrillation will also increase with age. The elderly with upper respiratory tract infection or water sodium retention are also easy to induce atrial fibrillation.

1. Organic heart disease

(1) Rheumatic heart disease

About 33.7% of the causes of atrial fibrillation are caused by mitral stenosis and insufficiency.

(2) Coronary heart disease

The incidence of atrial fibrillation was 1.5% in patients with coronary heart disease and angina pectoris confirmed by coronary angiography, and 3.8% in patients with old myocardial infarction; the incidence of acute myocardial infarction was 8.2%. The incidence of atrial fibrillation was 11% in patients with normal coronary artery confirmed by coronary angiography due to chest pain.

(3) Hypertensive heart disease

Many small arterial lumens of the atrial muscle can be narrowed or completely occluded due to the thickening of the intima, resulting in ischemic changes and fibrosis of the local myocardium.

(4) Hyperthyroidism

In the early stage, there was focal necrosis and lymphocyte infiltration in the myocardium. In patients with a long course of disease, the myocardium often presented small and localized fibrosis, with an incidence of 5%. It was mostly seen in patients aged 40 to 45 years old, and it was mostly paroxysmal in young patients.

(5) Sick sinus syndrome

The occurrence of atrial fibrillation can be promoted when the local muscular fiber structure of the sinus node artery is poorly developed, the collagen structure is abnormal, and the degeneration around the sinus node, especially the degeneration around the sinus node and the abnormality of sinus impulse.

(6) Cardiomyopathy

All types of cardiomyopathy are often accompanied by focal atrial muscle inflammation, degeneration or fibrosis, and atrial enlargement, which easily lead to the occurrence of atrial fibrillation. Among them, atrial fibrillation in patients with alcoholic cardiomyopathy is often the first manifestation of the disease, with a high incidence.

(7) Other heart diseases

Such as pulmonary heart disease (the incidence is 4% – 5%, most of which are paroxysmal, and the incidence will decrease after the improvement of respiratory function), chronic constrictive pericarditis, congenital heart disease, etc. Atrial fibrillation belongs to focal origin atrial fibrillation with increased self-discipline, while partial paroxysmal, partial persistent and chronic atrial fibrillation is caused by local micro-return mechanism in atrium, pulmonary vein and vena cava.

2. Preexcitation syndrome

It may be due to the short refractory period of the accessory pathway in patients with preexcitation syndrome. Once the reentry condition is established, the impulse through the accessory pathway increases, and this impulse reenters into the left atrial stress phase, which can induce atrial fibrillation. The incidence of atrial fibrillation complicated by preexcitation was 11.5%~39%. Atrial fibrillation associated with preexcitation syndrome is considered to be serious, because the bypass does not have the protective effect of physiological conduction delay like the atrioventricular node, so the ventricular rate transmitted via the bypass is more than 180 times/min, which seriously affects the cardiac output.

3. Other diseases

(1) Systemic invasive diseases: systemic lupus erythematosus, scleroderma, leukemia, amyloidosis, etc.

(2) Pulmonary and systemic infections and chronic pulmonary insufficiency.

(3) Heart surgery and trauma.

(4) Digitalis poisoning, aconitine poisoning, nicotine poisoning can induce atrial fibrillation.

(5) Various cardiac catheterization, transesophageal electrical stimulation and electrical cardioversion can directly induce atrial fibrillation.

(6) Alcoholism,smoking, emotional excitement, excessive smoking and urination can directly occur or induce atrial fibrillation on the basis of the original heart disease.

4. Familial atrial fibrillation

It is caused by gene mutation. The genetic mode belongs to AD inheritance. It mostly occurs after adulthood and is paroxysmal. Atrial fibrillation occurs and terminates unconsciously. The symptoms of atrial fibrillation attack are relatively mild, which are mainly induced by fatigue, nervousness, infection, pain, drinking, smoking and the cardiac function remains normal. Generally, the prognosis is good.

5. Cause unknown

Idiopathic atrial fibrillation in healthy people often has no basis for organic heart disease.

When you have atrial fibrillation, you can use the following app to monitor your heart rate, record it, and give it to the doctor for reference.

A free check atrial fibrillation app—”AFibCheck”：AFibCheck on the App Store(apple.com).