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Review

Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches

by
Panagiotis Stachteas
1,*,
Marios G. Bantidos
1,
Nikolaos Papoutsidakis
1,
Athina Nasoufidou
1,
Paschalis Karakasis
1,
Georgios Sidiropoulos
1,
Christos Kofos
1,
Dimitrios Patoulias
2,
Vasileios Ediaroglou
3,
George Stavropoulos
1,
Efstratios Karagiannidis
3,
Barbara Fyntanidou
3,
Dimitrios Tsalikakis
4,
Emmanouil Smyrnakis
5,
George Kassimis
1,
Christodoulos E. Papadopoulos
6 and
Nikolaos Fragakis
1
1
Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
2
Second Propedeutic Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
3
Department of Emergency Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
4
Department of Electrical and Computer Engineering, University of Western Macedonia, 50100 Kozani, Greece
5
Laboratory of Primary Health Care, General Practice and Health Services Research-Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
6
Third Cardiology Department, Medical School, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(1), 14; https://doi.org/10.3390/jcm15010014
Submission received: 25 November 2025 / Revised: 14 December 2025 / Accepted: 17 December 2025 / Published: 19 December 2025
(This article belongs to the Special Issue Advances in Ablation Therapy for Atrial Fibrillation: Innovations and Clinical Applications)
Versions Notes

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia and a growing global health burden, yet conventional monitoring with Holter devices, event recorders and implantable loop recorders often fails to adequately capture recurrence. Rapid advances in digital health, wearable biosensors and artificial intelligence (AI) have transformed consumer smartwatches and wearables into potential clinical tools capable of continuous, real-world rhythm surveillance. This narrative review synthesizes contemporary evidence on smartwatch-based AF monitoring, spanning core technologies—photoplethysmography, single-lead electrocardiography and AI fusion algorithms—and validation studies across post-ablation follow-up. Compared with traditional modalities, smartwatch-based AF monitoring demonstrates improved detection of AF recurrence, enhanced characterization of AF burden, symptom–rhythm correlation, and greater patient engagement. At the same time, key limitations are critically examined, including motion artifacts, false-positive alerts, short recording windows, adherence dependence, digital literacy and access gaps, as well as unresolved issues around regulation, interoperability and data privacy. By integrating engineering advances with guideline-directed care pathways, smartwatch-based AF monitoring holds promise to complement, rather than immediately replace, established diagnostic tools and to enable more proactive, individualized AF management. Future work must focus on robust clinical validation, equitable implementation and clear regulatory frameworks to safely scale these technologies.
Keywords: artificial intelligence; atrial fibrillation; digital health; monitoring; single-lead electrocardiography; smartwatch; wearables artificial intelligence; atrial fibrillation; digital health; monitoring; single-lead electrocardiography; smartwatch; wearables

Share and Cite

MDPI and ACS Style

Stachteas, P.; Bantidos, M.G.; Papoutsidakis, N.; Nasoufidou, A.; Karakasis, P.; Sidiropoulos, G.; Kofos, C.; Patoulias, D.; Ediaroglou, V.; Stavropoulos, G.; et al. Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches. J. Clin. Med. 2026, 15, 14. https://doi.org/10.3390/jcm15010014

AMA Style

Stachteas P, Bantidos MG, Papoutsidakis N, Nasoufidou A, Karakasis P, Sidiropoulos G, Kofos C, Patoulias D, Ediaroglou V, Stavropoulos G, et al. Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches. Journal of Clinical Medicine. 2026; 15(1):14. https://doi.org/10.3390/jcm15010014

Chicago/Turabian Style

Stachteas, Panagiotis, Marios G. Bantidos, Nikolaos Papoutsidakis, Athina Nasoufidou, Paschalis Karakasis, Georgios Sidiropoulos, Christos Kofos, Dimitrios Patoulias, Vasileios Ediaroglou, George Stavropoulos, and et al. 2026. "Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches" Journal of Clinical Medicine 15, no. 1: 14. https://doi.org/10.3390/jcm15010014

APA Style

Stachteas, P., Bantidos, M. G., Papoutsidakis, N., Nasoufidou, A., Karakasis, P., Sidiropoulos, G., Kofos, C., Patoulias, D., Ediaroglou, V., Stavropoulos, G., Karagiannidis, E., Fyntanidou, B., Tsalikakis, D., Smyrnakis, E., Kassimis, G., Papadopoulos, C. E., & Fragakis, N. (2026). Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches. Journal of Clinical Medicine, 15(1), 14. https://doi.org/10.3390/jcm15010014

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