Heart rate apps

Don’t rely on your smartphone to track your heart rate - many heart rate apps have not been tested and validated so their accuracy is questionable.

Increasingly there are a number of apps that measure your heart rate and rhythm. People often use these apps when exercising to assess their fitness and intensity of their exercise regimen. They are also sometimes used for people with a condition called atrial fibrillation. However, to date, no studies explicitly or directly recommend the use of heart rate apps.

  Be aware - use heart rate apps with caution

Use these apps with caution. The accuracy of many of these apps are questionable as they have not been tested and validated for accuracy. There is no law requiring validation of these apps and therefore no way for consumers to know if the results are accurate.    

On this page you will find information on:           

How do heart rate apps work?

Apps that measure your heart rate generally use one of three methods:

  • touching your fingertip to the phone's built-in camera (called contact photoplethysmography)
  • holding a camera in front of your face (non-contact photoplethysmography)
  • linking to a specific external device.

Are heart rate apps accurate — what is the evidence?

To date, no studies explicitly or directly recommend the use of heart rate apps. The following is a summary of recent studies assessing heart rate apps.

Summary of recent studies 

Li et al.(2019) conducted a review to explore the current state of mobile phone apps in assessing heart rate and rhythm.
Findings: The authors findings suggest that there is a role for mobile phone apps in the diagnosis, monitoring and screening for irregular heart beat (arrhythmias) and heart rate. The authors found the apps AliveCor, CardiioRhythm and FibriCheck to be high-performing for atrial fibrillation detection.
Read more The current state of mobile phone apps for monitoring heart rate, heart rate variability, and atrial fibrillation: narrative review. JMIR Mhealth Uhealth. 2019 Feb

Pipitprapat et al. (2018) compared 3 heart rate monitoring apps with simultaneous standard ECG monitoring in adult patients at a critical care unit. The apps assessed were Instant HR, Cardiio: HR Monitor and Runtastic HR Monitor.
Findings: The authors found that heart rate measurements from these mobile apps correlated well with standard ECG, but that the accuracy of the apps was worse in the presence of an irregular or fast heart rate.  
Read more: The validation of smartphone applications for heart rate measurement Ann Med. 2018 Dec;50(8):721-727.

JanBouts et al. (2018) compared iOS-based smartphone heart rate apps, Runtastic Heart Rate Monitor and Pulse Tracker PRO by Runtastic (Runtastic) and Instant Heart Rate+: Heart Rate and Pulse Monitor by Azumio (Instant Heart Rate), when compared to the standard ECG and a Polar® T31 uncoded heart rate monitor, at varying exercise intensities.
Findings: The authors concluded that the results were not consistent or significant enough to suggest that the apps are accurate or valid. They recommended that more studies be conducted to determine the effects of extra movement, incorrect finger positioning, phone case size, finger temperature, and wet or dry conditions on the apps’ ability to measure heart rate. This would determine if these co-factors account for the discrepancy, or if the technology behind these smartphone-based apps needs to be improved to have more external validity.
Read more: The accuracy and validity of iOS-based heart rate apps during moderate to high intensity exercise Int J Exerc Sci. 2018 Jan 2;11(7):533-540. 

Coppetti et al. (2017) tested the accuracy of four commercially available heart rate apps (randomly selected) using two phones, the iPhone 4 and iPhone 5 .
Findings: The authors found substantial differences in accuracy between the four apps. In some apps there were differences of more than 20 beats per minute compared to ECG in over 20% of the measurements. The non-contact apps performed less well than the contact apps, particularly at higher heart rates and lower body temperatures. The non-contact apps tended to overestimate higher heart rates. Read more:  Accuracy of smartphone apps for heart rate measurement. Eur J Prev Cardiol. 2017 Aug;24(12):1287-1293

Does it matter that heart rate apps are not accurate?

Many heart rate apps have not been tested and validated so their accuracy is questionable. For most people, inaccuracies in heart rate measurements are not a big deal, but for elite athletes and people with heart problems who need to keep their heart rate within a certain range, these apps should only be used with caution.

However, some of the apps can be useful and appropriate for patients with atrial fibrillation. If this is you, then please discuss this with your cardiologist or GP before using one of them. For most patients with atrial fibrillation, routine monitoring of the heart rhythm is not required once you have been stabilised on medication.

Tips when using a heart rate app

If you do decide to use a heart rate app, follow these tips:

Do (✔)

  • Talk with your doctor about whether it is necessary for you to measure your heart rate regularly. Heart rate is only one part of the puzzle of total heart health and fitness.    
  • If you have atrial fibrillation and your doctor is having difficulty stabilising you on medication, discuss with them whether an atrial fibrillation monitoring app might be appropriate.  
  • Talk to your doctor if you think you detect:
    • a very low pulse rate (under 60, or under 40-50 if you’re very active) at rest
    • a very high pulse rate (over 100) at rest
    • an irregular pulse.

Don’t (✘) 

  • Don't rely on apps that measure your heart rate as an indicator of your heart health.  
  • Don't make changes to your heart medication based on the  heart rate readings from the app.

Other ways to measure heart rate 

Ways to measure heart rate Description

Measuring your pulse

Your pulse is the impulse that is generated with each heartbeat. It can be felt at various locations on your body such as your wrist and neck. In most cases your heart rate (each actual beat of your heart) will correlate very well with your pulse rate (for example each beat felt at your wrist). Therefore, most of the time your pulse rate is used as a substitute to check your heart rate. Learn more about how to check your pulse.

Pulse oximeter

Health professionals often use a pulse oximeter to check your pulse quickly. These are fairly accurate devices that are placed over a fingertip, whereby a sensor detects pulsations. Most blood pressure machines also assess pulse rate automatically. These devices can be bought online and in many pharmacies. Please be aware that accuracy cannot be guaranteed unless verified by an independent auditor. (Your GP's device is required to be checked yearly.) One practical option could be to have your device checked for its accuracy by your nurse.

Electrocardiogram (ECG)

The most accurate method for assessing actual heart rate is by having an electrocardiogram (ECG). In this painless test, wires are placed on your chest and a machine measures the electrical activity of your heart. It is typically used to assess for and diagnose different sorts of heart problems.
An ECG is one of many tools available to assess heart health, so it does not give you the whole picture. GPs are often able to do an ECG in their surgery (at a cost, generally between $40-$70). Hospitals can do them for free if you’re eligible, but it must be medically required. Read more about ECGs.

Learn more

The following websites have more information on apps for atrial fibrillation
Atrial fibrillation app reviews Practical Apps, Canada

References

  1. Consumers warned about accuracy of heart rate apps European Society of Cardiology, 2017
  2. Coppetti T, Brauchlin A, Muggler S, et al. Accuracy of smartphone apps for heart rate measurement. Eur J Prev Cardiol. 2017 Aug;24(12):1287-1293. 
  3. Consumers warned about accuracy of heart rate apps Science Daily, 2017
  4. Vandenberk T, Stans J, Mortelmans C, et al. Clinical validation of heart rate apps: mixed-methods evaluation study. JMIR Mhealth Uhealth. 2017 Aug 25;5(8):e129.
  5. Parpinel M, Scherling L, Lazzer S, Della Mea V. Reliability of heart rate mobile apps in young healthy adults: exploratory study and research directions. J Innov Health Inform. 2017 Jun 30;24(2):921.

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Last reviewed: 23 May 2019