{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:33:51Z","timestamp":1787124831788,"version":"build-2736575974"},"reference-count":87,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Atrial fibrillation (AF) is the most common sustained arrhythmia and a growing global health burden, yet conventional monitoring with Holter devices, event recorders and implantable loop recorders often fails to adequately capture recurrence. Rapid advances in digital health, wearable biosensors and artificial intelligence (AI) have transformed consumer smartwatches and wearables into potential clinical tools capable of continuous, real-world rhythm surveillance. This narrative review synthesizes contemporary evidence on smartwatch-based AF monitoring, spanning core technologies\u2014photoplethysmography, single-lead electrocardiography and AI fusion algorithms\u2014and validation studies across post-ablation follow-up. Compared with traditional modalities, smartwatch-based AF monitoring demonstrates improved detection of AF recurrence, enhanced characterization of AF burden, symptom\u2013rhythm correlation, and greater patient engagement. At the same time, key limitations are critically examined, including motion artifacts, false-positive alerts, short recording windows, adherence dependence, digital literacy and access gaps, as well as unresolved issues around regulation, interoperability and data privacy. By integrating engineering advances with guideline-directed care pathways, smartwatch-based AF monitoring holds promise to complement, rather than immediately replace, established diagnostic tools and to enable more proactive, individualized AF management. Future work must focus on robust clinical validation, equitable implementation and clear regulatory frameworks to safely scale these technologies.<\/jats:p>","DOI":"10.3390\/jcm15010014","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:59:57Z","timestamp":1766149197000},"page":"14","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Monitoring Atrial Fibrillation Using Wearable Digital Technologies: The Emerging Role of Smartwatches"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1657-4696","authenticated-orcid":false,"given":"Panagiotis","family":"Stachteas","sequence":"first","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9409-388X","authenticated-orcid":false,"given":"Marios G.","family":"Bantidos","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6222-812X","authenticated-orcid":false,"given":"Nikolaos","family":"Papoutsidakis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-5297","authenticated-orcid":false,"given":"Athina","family":"Nasoufidou","sequence":"additional","affiliation":[{"name":"Second Department of 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Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2685-3143","authenticated-orcid":false,"given":"Dimitrios","family":"Tsalikakis","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, University of Western Macedonia, 50100 Kozani, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9772-4595","authenticated-orcid":false,"given":"Emmanouil","family":"Smyrnakis","sequence":"additional","affiliation":[{"name":"Laboratory of Primary Health Care, General Practice and Health Services Research-Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kassimis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 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Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation Developed in Collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. 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