Heart rate apps

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.    

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(external link). 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(external link) 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(external link) 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(external link). Eur J Prev Cardiol. 2017 Aug;24(12):1287-1293

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 and heart rate.

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.