Reliability of Wearable Technology in Atrial Fibrillation Detection: A Clinical Review

Atrial fibrillation (AF) continues to remain one of the leading causes of stroke. Its asymptomatic and paroxysmal nature often makes it evade the traditional 24-hour monitoring procedures that are classic in clinical settings. As consumers rapidly adopt wearable technology, it offers a potential opportunity for non-invasive monitoring and detection. This especially applies to situations where the wearable technology uses single-lead electrocardiography (ECG) and photoplethysmography (PPG). In this review, the goal is to evaluate the diagnostic reliability and the clinical utility of FDA-cleared wearable devices. The focus is on finding how reliable these technologies are in detecting AF. We synthesize pivotal studies as well as randomized trials published from 2018 up until 2025. An analysis reveals that leading devices provide a high level of sensitivity (>95%) in controlled settings. In realworld settings, there are still challenges. False positives, inconclusive tracings, and motion artifacts are problems that need to be addressed by manufacturers. Current evidence suggests that wearables can serve as an adjunct screening tool but require 12-lead ECG confirmation for better diagnostic accuracy.