Recurrent nocturnal ST-T deviation and nonsustained ventricular tachycardias recorded with a smartwatch: A case report.

A 44-year-old male patient presented to our clinic with nocturnal palpitations. The smartwatch electrocardiogram (ECG) demonstrated ST-segment deviation and non-sustained ventricular tachycardias. The patient suffered from coronary one-vessel disease. The coronary angiography revealed de novo proximal left anterior descending stenosis and in-stent restenosis, which necessitated coronary stenting. However, the recurrent palpitations reappeared 2 weeks later. The smartwatch ECGs again demonstrated ST-segment deviation and wide QRS tachycardia, reassessments with coronary angiography and magnetic resonance imaging revealed no relevant ischemia. The patient was diagnosed with vasospastic angina. His symptoms disappeared after percutaneous administration of nitrates.This case highlights the utility of smartwatch ECGs to support clinical diagnosis, decisions, and follow-up in the case of ischemic attacks. Learning objective: This case report highlights the importance of an adequate anamnesis and the meaningful use of wearable devices. The smartwatch enables the patient to record electrocardiograms (ECGs) easily and immediately during symptoms. That is one of the major advantages of this new technology, because we can even detect events that are too subtle to be detected in the normal 24-h Holter ECG. This case highlights the utility of smartwatch ECGs to support clinical diagnosis and decisions by establishing a valid symptom-ECG correlation.