HRV vs. VO2 max vs. ECG: Which wearable metric ACTUALLY matters? | Prof. Malcolm Findlay

Is your smartwatch just a fun gadget, or a serious medical device?

In this episode, Jonathan Wolf is joined by Dr. Malcolm Findlay, a leading consultant cardiologist, to explore the powerful health data available on your wrist. They decode the most misunderstood metric, Heart Rate Variability (HRV), and reveal how your wearable can provide clinical-grade insights into your heart's health.

Dr. Findlay explains the counter-intuitive science behind HRV — why more ‘wobble’ in your heartbeat is a sign of good health — and breaks down the two opposing nervous systems that control it. He shares the latest on how these devices can accurately detect serious conditions like atrial fibrillation and why he, as a cardiologist, trusts the ECG function on a consumer smartwatch to make diagnoses.

For listeners who track their own data, this episode is a practical guide to what your numbers actually mean. Dr. Findlay explains how to interpret your personal HRV trends, what constitutes a significant change, and when you should use the ECG feature. He also debunks common myths about heart rate zones, revealing the level of exercise intensity that truly benefits your long-term health.

The episode concludes with an empowering look at how this technology is shifting control into our own hands. Can a simple alert from your watch really help prevent a catastrophic event like a stroke? Discover which metrics matter most and how to use them to guide your wellness journey.

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Timecodes

00:06 Quick-fire questions on heart health

01:45 What is heart rate variability (HRV)?

03:05 Is a steady heart rate a healthy sign?

05:15 Atrial fibrillation makes HRV an invalid measure

07:30 What controls our heart rate?

10:00 Your heart is much more than a pump

11:10 Your thoughts can directly affect your heart

13:45 What lifestyle factors influence your HRV score?

15:15 How does stress impact your HRV?

17:15 Your watch's ECG is a clinical-grade tool

20:20 Wearables can help diagnose serious heart conditions

23:45 Are expensive wearables more accurate?

26:20 Does diet impact your HRV score?

29:15 How to track your HRV score correctly

30:00 Don't panic about small HRV fluctuations

32:30 When to use your watch's ECG function

34:10 The truth about heart rate training zones

36:50 The minimum exercise for a healthy heart

37:40 Does sleep consistency matter?

39:50 What is VO2 max and does it matter?

41:10 Stop comparing your health data to others

41:50 Key takeaways from the episode

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Studies referenced for today's episode Heart rate variability: standards of measurement, physiological interpretation and clinical use, 1996, European Heart Journal Diagnostic Accuracy of a Smartwatch App for the Detection of Atrial Fibrillation, 2019, The New England Journal of Medicine The Effects of Alcohol on Heart Rate Variability and Heart Rate, 2017, The American Journal of Cardiology The relationship between mental stress and heart rate variability, 2007, Journal of Psychosomatic Research

Have feedback or a topic you'd like us to cover? Let us know here. Episode transcripts are available here.