Are Home ECG Monitors Reliable?

Heart palpitations, skips, and flips are very common symptoms that most of us will experience from time to time. In many cases, they are just your heart’s normal reaction to stress, fatigue, or even changes in hormones. But sometimes these symptoms are a warning of something more serious. 

If you are having heart symptoms, your provider may recommend an electrocardiogram (ECG, also called EKG). Or you might need to wear a heart monitor to make sure there isn’t a serious heart rhythm issue. But what if you can’t make it to the doctor’s office? New technology has made it possible to monitor your heart rhythm from your smart device. Personal ECG devices became especially useful during the COVID-19 pandemic, when it was more difficult for people to visit their doctor’s offices.

Here we’ll discuss why people use at-home monitors and how reliable they are. 

Promotional Disclosureinfo_outlined

SPECIAL OFFER

Prescription Savings Are Just the Beginning

See what other benefits you qualify for—from cashback cards to cheaper insurance.

Unlock Savings

What can a traditional ECG tell you?

An ECG is a noninvasive test that your provider performs in a clinical setting. It gives important information about the health of your heart. 

During a traditional, or 12-lead ECG, you lie on an exam table, and a provider attaches small sensors (electrodes) to your chest. These record the electrical pattern of the heart from 12 different angles. 

An ECG will tell your healthcare provider:

• Your heart rate and rhythm 

• If there’s evidence of a heart attack or damage to the heart 

• If your heart wall may be abnormally thick 

• Clues about other things that may put you at risk for heart problems

The ECG will help your provider know if a rhythm problem is causing your symptoms. But you may also need an ECG if you have had heart rhythm problems like atrial fibrillation in the past. Less commonly, you may have an ECG if you are at risk for heart rhythm issues due to a prior heart attack or your family history. 

But in many cases, an ECG can only tell you what’s going on at that specific moment. Because it just gives a snapshot of what your heart is doing, you might need an at-home monitor to get a better look. 

Are there other ECG options?

Since the ECG only records for a few seconds, it will only tell you what’s going on with the heart rhythm at that particular moment. That’s why other types of ECGs can be helpful. 

Read more like this

Explore these related articles, suggested for readers like you.

Does Insurance Cover Cardiac Monitoring Devices for Home Use?

What Can a Smartwatch Do for Your Heart Health?

A Guide to Heart Arrhythmias

When Should I See a Doctor for Heart Palpitations?

View more

Medical-grade at-home monitors

Holter monitors, or ambulatory heart monitors, are at-home monitors approved for medical use. You wear these on your chest continuously for up to 30 days. These devices record every heartbeat that you have and send your tracings directly to your physician’s office. This helps your medical provider find out what’s happening with your heart rhythm while you’re having symptoms. It can even help when a rhythm problem occurs without symptoms. 

The downsides of medical-grade monitors include:

• A healthcare professional must prescribe them, which means you will likely need a doctor’s visit.

• Some people are allergic or sensitive to the adhesive that keeps the monitor in place.

• If you don’t have any of your symptoms while wearing the monitor, then you may not get an answer. 

Personal at-home ECG monitors

“Smart,” wearable technologies can also detect heart rhythms that cause symptoms. But unlike doctor-prescribed ECG monitors, many of them don’t record all the time. So there’s a chance they could miss an irregular heart rhythm. Smart, wearable devices can also be expensive. And most insurance plans don’t cover them since many haven’t been approved or cleared by the FDA.

What are the most common personal ECG monitors?

Two common smart, home ECG monitors are the Apple Watch and the AliveCor Kardia devices. Fitbit, Wellue, Omron, and Emay also offer products for use at home. 

The Apple Watch is especially helpful because you can wear it on the wrist. That makes it easy to check your heart rhythm whenever a symptom occurs. The other devices require a few extra steps to get the device up and running. So there’s a chance the symptoms may be gone by the time you hit the “record” button.

What are the most accurate home ECG monitors?

Medical-grade Holter monitors and similar devices are highly accurate. They are placed directly on the chest, which eliminates a lot of the “noise” that you can get with personal at-home ECG monitors. 

Personal at-home ECG monitors use wrist or finger sensors to detect heart rhythms, so they may be less accurate. Medical-grade monitors record a continuous ECG, while many personal ECG devices require that you hit the record button to save a tracing. For these reasons, if your problem is potentially life-threatening, a medical-grade recording device is your best option.

There are no good studies that directly compare the newest versions of personal, at-home ECG monitors to each other or to medical-grade devices. That said, researchers from Northwestern University found the Apple Watch to be very reliable. The AliveCor system has also done well when tested in people at risk for serious heart rhythm problems. Less is known about the other products listed above.

Of course, accuracy depends on whether you use the product correctly, and if you use it when you’re having symptoms. It’s also important to get good skin contact for a clear recording — and to prevent faulty or incorrect interpretations. 

Do you need a more accurate home ECG monitor than a smartwatch or app?

It depends on your symptoms, how severe they are, and the particular device you’re using. In some cases, your healthcare provider may need a more accurate read of your heart rhythm than what’s possible with a personal at-home monitor. In those cases, a medical-grade heart monitoring device may be necessary. But if you already have one, it doesn’t hurt to ask if you can use your smartwatch or other device first.

How do you use a home ECG monitor?

Using a personal at-home ECG device is usually fairly simple. But it’s important to read up on it or watch an instructional video before you start to monitor your heart. That way, you’ll be ready to use it if you experience palpitations.

You wear the Apple Watch on your wrist, where sensors will track your heart rate and rhythm. Be sure you have the app installed on your smartphone so you can download your rhythm recording.

The AliveCor monitor uses a small finger pad that you can carry with you or stick to the back of your smartphone. You’ll need to use the app with this gadget as well. When you feel palpitations, you place your fingers on the pad while the product takes an ECG.

The other devices use sensors that you press to your fingers, palms, chest, or legs to record your heart rhythm.

What can affect the accuracy of a home ECG monitor?

The main drawback of personal ECG devices is that they aren’t as reliable as medical-grade monitors. Issues that may affect the accuracy of personal home monitors include:

• Movement 

• Poor contact with the sensors

• Poor fit

• Sweating

• Tattoos, if they’re directly underneath the sensor

Sometimes the monitor can misread heart rhythms that are regular — but abnormal — and flag them as normal. The opposite is also true: The monitor may flag your heart rhythm as abnormal when it’s not. It’s important to understand that the computer isn’t always right. Getting a professional read is necessary before a problem can be accurately diagnosed.

What should you do if a home ECG monitor detects an irregular heart rhythm?

If your home ECG monitor detects an unusual rhythm, don’t panic. It’s important to discuss your irregular rhythm with your healthcare provider, so they can discuss with you what to make of your reading. 

Your provider can also help you with next steps. They may want to see you for an in-person evaluation, or they may give you instructions on how to share your results. Most of the home ECG devices will allow you to create a PDF file of your recording, which you can download and/or print. But it’s important to check with your provider before sending any information, to be sure they can receive it. There should be safeguards in place to keep your information private. 

Keep in mind, these devices aren’t designed to detect a heart attack or stroke, and they don’t take the place of timely medical care.

Seek medical care if you have: 

• Chest pain 

• Shortness of breath 

• Palpitations that don’t stop 

• Prolonged dizziness or weakness 

Why trust our experts?

Written by:

Sarah A. Samaan, MD

Sarah Samaan, MD, FACC, FACP, FASE is a board-certified cardiologist who practiced clinical cardiology for nearly 30 years. She is a member of the American College of Cardiology, the American College of Physicians, and the American Society of Echocardiography.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Our editorial standards

Meet our experts