Abstract
Smartwatches with pulse-plethysmography sensors capable of detecting irregular rhythms, potentially atrial fibrillation (AF), are increasingly common. Their sensitivity for AF detection in different populations is unknown. If ambulatory ECG monitoring were to be offered to all individuals with notifications this would generate vast amounts of ECG data to analyse. This perspective discusses smartwatch sensitivity for actionable AF, resource utilization to optimize stroke prevention, and suggests alternate ways to manage notifications.