Abstract
This pilot study evaluated the feasibility of using an Apple Watch and a custom app to collect physiologic and activity data from pediatric patients with heart failure. Five patients aged 12-17 with significant heart failure, including two with LVAD, participated. Data such as heart rate, activity levels, and clinical status were collected to explore the potential of wearable technology for improving pediatric heart failure management. The study aims to generate hypotheses for further research on wearable technology in pediatric heart failure care.
Background
Pediatric heart failure is a complex and life-threatening condition, with high morbidity and mortality rates. There is limited pediatric-specific data to guide management, and current assessments rely on subjective recall and infrequent testing. Wearable technologies, such as the Apple Watch, offer the potential to provide continuous, high-fidelity data on pediatric heart failure patients, which could improve monitoring and interventions. However, little is known about the applicability of these devices in pediatric populations, especially for conditions like heart failure.
Methods
This feasibility study was conducted within the ACTION (Advanced Cardiac Therapies Improving Outcomes Network) registry, which focuses on improving pediatric heart failure outcomes. Patients aged 12-19 with severe heart failure were enrolled, and consent was obtained. They wore an Apple Watch for at least three months to collect daily step counts, resting heart rates, and heart rate variability through a custom app, “My ACTION Tracker.” Data were transmitted to the ACTION data center for analysis. The accuracy of the collected data was compared with clinical records.
Results
Five patients successfully participated in the study. The data showed correlations between activity levels, heart rate, and clinical status, with higher step counts and improved heart rate variability indicating better clinical outcomes. The Apple Watch’s heart rate data closely matched clinical records in most cases, except for patients with LVAD, where discrepancies were noted due to the lack of pulsatility. Despite some technical issues, such as inconsistent device wear and connectivity problems, the study demonstrated that wearables can offer valuable insights into pediatric heart failure.
Conclusion
This pilot study provides proof of concept for the use of wearable technology in pediatric heart failure. The data suggest that wearable devices like the Apple Watch can help monitor key health indicators such as activity levels and heart rate, offering a promising tool for continuous patient monitoring. However, challenges such as inconsistent data collection and technical issues must be addressed in future studies. Larger trials with improved technology and more participants are needed to validate the clinical utility of wearables in pediatric heart failure management.
This ACTION study was available online March 31, 2025 ahead of print in The Canadian Journal of Cardiology (CJC) Pediatric and Congenital Heart Disease. Congratulations to the authors:
- David M. Peng
- Jonathan B. Edelson
- Harishwara R. Gureddygari
- Toni Duganiero
- Aine Lynch
- Melissa McQueen
- Joseph Hillenburg
- E. Kevin Hall
- Lauren Smyth
- David N. Rosenthal
- Angela Lorts
CITATION
David M. Peng, et al. Capturing Physiologic Data in Children with Heart Failure Using Wearable Digital Technology: Lessons From Pilot Project. CJC Pediatric and Congenital Heart Disease. 2025. ISSN 2772-8129. https://doi.org/10.1016/j.cjcpc.2025.03.007.
