Reliability of smartwatches in the management and follow-up of patients with Atrial fibrillation on the waiting list for ablation

Atrial fibrillation (AF) is a common cardiac arrhythmia associated with a higher risk of stroke and hospitalization. Due to the long waiting list for ablation procedures at Lanspítali, the only tertiary hospital in Iceland performing such interventions, there is a growing interest in using digital tools to support patient monitoring and prioritization. This study aimed to explore the feasibility and user experience of using the Apple Watch as a digital support tool for patients with AF awaiting ablation and to evaluate whether smartwatch data could inform clinical prioritization. A feasibility study using a mixed-method approach was conducted. Patients on the ablation waiting list were invited to use an Apple Watch with ECG functionality. Quantitative data from smartwatch recordings were complemented with qualitative feedback from participants about usability and engagement. Semi-structured interviews were conducted with 11 participants, and ECG measurements from 7 of them over the 12-week study period. Results showed that Smartwatch ECG recordings were technically feasible, and the device was generally well-received by participants. Healthcare professionals noted that patient-generated ECG data could support more informed prioritization during long waiting periods. In conclusion, the findings suggest that a wearable ECG device may provide meaningful support for patients awaiting ablation and could serve as a practical addition to existing AF follow-up pathways within the Icelandic healthcare system Keywords. Atrial Fibrillation, smartwatch, digital health, wearable devices, feasibility study, patient monitoring, clinical prioritization,