Apple Watch ECG and recorded Heart Rate data

Posted by jacqincalifornia @jacqincalifornia, Dec 25, 2025

When I'm having runs of PVCs and/or PACs the ECG app on my Apple Watch will say "Inconclusive." Have others had this experience? I'm not sure how much credence the cardiologists give to data from Apple Watch and other fitness devices.

Also, when I look at my heart rate range for each day I almost always see a very high heart rate number at the top of the range. It occurs when I go from a mostly low level of activity to, say, walking out the door and over to the mailboxes, or getting up from sitting and picking up a basket of laundry. Those high rates only last a second or two at most but they are extreme (139, 119, 121, 142, and even a 159). I don't' even achieve these highs when I'm on the elliptical at the gym.

I don't know if these high numbers reflect a rate hyper-reactivity to the change in activity level, or if it's just something funky in the Apple Watch's algorithm. I should add: I'm a new poster here, I have LBBB.

I guess I'm just curious about others' experiences with cardiac data from their Apple Watch.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

Profile picture for gloaming @gloaming

@jacqincalifornia https://www.ncbi.nlm.nih.gov/books/NBK2214/ This might be a decent start. Just do a google search like, 'how to read abnormal ECG with arrhythmia', or go to YouTube and do a similar syntax search.

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@gloaming Thanks!

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I have a lot of PACs and if I do the Apple Watch ecg on my wrist it almost always says afib. If I put the watch on my left leg and my right finger on the crown it reads sinus. Lead I, the standard Apple Watch lead, doesn’t detect my p waves. Lead II, the left thigh right finger lead does see my p waves.

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I know this is a pretty old thread, but I'll post here anyway.

I've found the Apple Watch ECG app invaluable in tracking PVC burden. (Yes, it flags as `inconclusive any 30-sec recording with 4 or more PVCs.) Of course the palpitations I feel are the giveaway, but they are very clearly evident in the ECG (my `personal best' is 11 in 30 seconds.) I also strongly recommend the iPhone app ECG+ for more careful monitoring--I wish I could post screen grabs. (I actually upgraded to the Premium version, so useful did I find it.) Some of the more useful: labeling important features in the ECG, explicit highlighting of PVCs, a value of the PVC burden for each ECG and averaged over a week or a month, histograms of PVCs by hour of day, even a chatGPT analysis. You can export everything to spreadsheets.

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It is interesting when I'm having a run of PVCs to watch the ECG recording in real time. I get those Inconclusive readouts fairly often, though I don't think I've ever had eleven in a 30-second reading! I'll try to attach a typical (for me) Inconclusive printout here. You should be able to click on the image to enlarge it..

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Aortic valve replacement and three stents I coron@ ray arteries

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