Advances in medical technology make it easier than ever before to monitor your cardiovascular health. A variety of heart health monitors measure a range of markers that can help diagnose and manage heart problems, both in a clinical setting and at home. Whether you have heart disease or a high risk for heart problems—or the desire to prevent them—well, there’s an app (or device) for that, and we’ve got all the dirt on them.
Why everyone should monitor their heart health
Heart health monitoring is important for people who have heart disease, a high risk for heart disease, or who are experiencing symptoms they can’t explain, such as a racing, slow, or irregular heartbeat or chest pain while exercising. Even if you’re in excellent shape, monitoring your heart can help you stay that way by providing information that helps you maximize your cardio workout and reduce your stress.
Monitoring your heart health at home may be something your doctor recommends in response to symptoms you’re experiencing, or it may be something you’re personally interested in doing as part of your wellness plan.
Here, we look at the heart health monitors most commonly used by healthcare professionals for diagnosing heart problems — and by people who want to monitor their heart health at home.
Ambulatory ECG monitors
Ambulatory heart monitors are devices provided by your healthcare team to wear outside of the doctor’s office for a period of time. These hospital-grade cardiac event monitors work by detecting the electrical activity of your heart through your skin and producing an electrocardiogram (ECG or EKG) that is stored in the device’s memory or transmitted to your doctor for evaluation.
Ambulatory ECG monitors are often recommended for people who experience palpitations, skipped beats, uneven heart rhythms (arrhythmias), a fast heart rate (tachycardia,) or a slow heart rate (bradycardia.) They help diagnose a number of heart problems, including atrial fibrillation (AFib) and arrhythmias—even those you can’t feel.
Holter monitor
A Holter monitor is a portable device that you wear continuously for one or two days. It has attached wires with patches on the end, which adhere to your skin and record every heartbeat during the wearing period. This provides your healthcare provider with enough data to detect irregularities in rate or rhythm.
Loop memory monitor
A loop memory monitor continuously records your heart activity but doesn’t save it. When you feel a symptom and push a button on the device, the monitor saves the data from just before, during, and after the event.
Non-looping monitor
Non-looping monitors only record after they’re activated. If you have a handheld device, you’ll place it on your chest when you have an event, and small metal disks act as electrodes. For a wrist-worn version, you simply press a button to start recording the event. Both looping and non-looping monitors allow you to send your ECG information by telephone to your physician, who will determine whether you need to go to the emergency room.
Real-time monitors
A mobile cardiac telemetry device is a wearable monitor that automatically detects, records, and transmits abnormal heart rhythms over a wireless network in real time to a monitoring provider. Professionally trained staff review the abnormalities and initiate an emergency response if necessary. You typically wear this device for up to 30 days, and it auto-triggers a transmission for bradycardia, tachycardia, pauses, and atrial fibrillation (AFib.)
Patch recorder
A patch recorder consists of a device that sticks to your skin like an adhesive patch, and it contains all of the hardware and power it needs to detect, record, and save data about abnormal heart activity for two weeks.
Implanted loop recorder
This small device is implanted just under the skin and can detect and record abnormal heart rhythms for up to three years. They can record automatically or when activated by the person wearing it, and your healthcare provider can download the data wirelessly in the office.
Personal heart rate monitors
Heart rate monitors are widely available for personal use, and while they aren’t as sensitive as hospital-grade versions, they provide a fairly accurate picture of your resting heart rate over time, which can tell you important information about your cardiovascular health. They can also help you reach your target heart rate during exercise.
Heart rate monitors for personal use range in price from around $50 to several hundred dollars, depending on the brand, model, and additional features. These are the most popular types of personal heart monitors in use today:
Fitness trackers
Fitness trackers like Fitbit and Apple Watch continually measure your heart rate using optical technology. The device sends light into your skin and reads the light that bounces back when your heart beats. Activity trackers are wearable devices that you wear on your wrist 24/7. They allow you to get an accurate picture of your heart rate over time, with data presented in easy-to-understand charts.
Chest strap heart monitors
Chest strap heart rate monitors are inexpensive and work by reading the electrical signals your body sends when your heart contracts. Although these monitors are more accurate than fitness trackers, they’re not as comfortable—they wrap tightly around your chest and can chafe or slip out of place when you’re active. In order to retrieve visual data, you need to wear a tracker device that’s connected to the chest strap monitor via Bluetooth.
Smartphone apps
Lots of apps have been developed to check and track your heart rate using your smartphone’s camera and flash. Some apps are more accurate than others, so it’s worth the time and effort to do some research, read the reviews, and check for endorsements before settling on a heart rate monitoring app.
Headphone heart rate monitors
Sports headphones with a built-in optical heart rate tracker are a useful tool for monitoring your target heart rate during exercise or your resting heart rate while you’re relaxing to some sweet grooves. Headphones that monitor your heart rate are typically more expensive than other types of monitors, but they’re accurate—and they serve a dual purpose!
Blood oxygen level monitors
A pulse oximeter is a device that measures your heart rate and how much oxygen is in your blood. The device features a small clip that you attach to the end of your finger, and it estimates the percentage of your blood that’s carrying oxygen. A pulse oximeter is a helpful tool for people who have a heart or lung condition that affects blood oxygen levels, including heart failure, asthma, pneumonia, COPD, or COVID-19. A normal blood oxygen is between 97% and 100%. If your oxygen level dips down to 95%, visit your doctor. If it goes below 90%, an emergency department visit is in order.
Blood pressure monitors for home use
If you have high blood pressure or you’re at risk for developing it, monitoring your blood pressure at home is an important way to manage it and help reduce your risk of heart attack and stroke.
A blood pressure monitor involves an inflatable cuff that measures the force with which your heart pumps blood through your body. Blood pressure comprises two numbers: the top number is the “systolic” pressure, which indicates how much pressure your blood is exerting against the artery walls when your heart beats. The bottom number is the “diastolic” pressure, which measures the pressure your blood is exerting against the artery walls while your heart is at rest. Normal blood pressure is 120/80, pronounced “120 over 80.”
Numerous types of blood pressure monitors are available at your local drugstore, from very simple, inexpensive devices to those with all the bells and whistles, like USB charging, Bluetooth connectivity, multiple user capabilities, downloadable data, and abnormal rhythm detectors. The most accurate blood pressure monitors are those that utilize an arm cuff rather than a wrist or finger cuff. Monitors that automatically inflate the cuff are more accurate than those you inflate with a bulb, and digital readouts are more accurate and convenient for at-home use.
The best tech to measure heart rate variability at home
Heart rate variability, or HRV, is a measure of the time variation between each heartbeat. This marker is a recent addition to the family of heart monitoring, but it gives you clues about how resilient and flexible you are.
When you’re in fight-or-flight mode, or you’re experiencing intense emotions, the variation in time between heartbeats is low. When you’re in a relaxed state, the variation is high. People with high HRV may be more resilient to stress and have better cardiovascular health. Low HRV is associated with worsening anxiety or depression and an increased risk of cardiovascular disease and death.
Tracking your HRV can help you stay motivated to make behavioral and lifestyle changes by creating more awareness around how your behaviors and emotions increase or decrease your HRV. The most accurate measure of HRV comes from your doctor, who examines a long strip of an electrocardiogram. But to use HRV as a personal health marker, you need something you can do on a regular basis yourself.
How to measure HRV at home: A few apps and heart rate devices have been developed in the past few years to measure HRV, but since this is a rather new concept in personal heart monitoring, they aren’t yet regulated by any agency—and their accuracy is still being investigated and improved on. According to Harvard Medical School, the least expensive and most accurate way to measure your HRV is with an inexpensive chest strap heart monitor plus a free, downloadable app for heart rate variability.
What should you look for in a heart health monitor?
The best heart rate monitors for the elderly, the athlete, the budget-conscious, or someone with a serious heart condition depends on a range of factors, including doctor recommendations and personal preference. Consider these points when choosing any type of heart health monitor:
Your medical condition. Work with your doctor to choose the monitor that will be of most use to you, whether you have a heart condition like AFib or you want to improve your physical fitness.
Your lifestyle. Choose a heart health monitor that suits your lifestyle. If you’re very active and often on the go, a smaller, wearable wrist device is more practical than a larger portable device.
Your insurance coverage. If your insurance policy has coverage limitations for heart monitoring, take the time to find a covered monitor that does what you want it to do.
A comprehensive heart health program through Forward can help you monitor your heart health with a full range of testing, monitoring, and professional guidance and recommendations for making sustainable diet, exercise, and lifestyle changes.