A Smart Bed Flagged a 42-Beat Heart Rate Overnight, and Doctors Found a Dangerous Electrical Block

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The warning turned out to be real. Doctors diagnosed complete heart block, a serious failure of the heart’s electrical wiring, and implanted a pacemaker. Cardiologist James Ip of Weill Cornell Medicine and NewYork-Presbyterian Hospital described the case in a December 2025 report in the New England Journal of Medicine titled “Complete Heart Block Detected by Consumer-Facing Digital Health Technologies.”

The bed used ballistocardiography, a technique that estimates heart rate from the subtle motion created each time the heart pumps blood. Sensors in the mattress pick up those vibrations while a person sleeps, so no wires or wearables are needed.

The man did not rely on the bed alone. He checked his pulse with a smartwatch and a home blood pressure monitor, and both showed a slow heart rate. When he became short of breath, he called his doctor, who sent him to an emergency department, according to Gizmodo’s account of the report.

There, an electrocardiogram confirmed complete heart block.

The heart’s upper chambers, the atria, normally send electrical signals that tell the lower chambers, the ventricles, when to squeeze. In complete heart block, also called third-degree heart block, none of those signals get through. The atria and ventricles beat independently, and the ventricles fall back on a slower backup rhythm.

That slower rhythm may not pump enough blood, which can lead to fatigue, dizziness, shortness of breath or fainting. The American Heart Association groups heart block with other conduction disorders, problems in the pathway that carries the heart’s electrical signals, and describes third-degree block as the complete form. It is commonly treated with a pacemaker.

For context, a normal resting heart rate for adults is between 60 and 100 beats per minute when a person is sitting or lying down, calm and feeling well, according to the American Heart Association. The man’s average of 42 was well below that range and barely more than half his usual rate.

Heart block can develop as the heart’s electrical system wears with age. It can also follow a heart attack or heart surgery, and some medications that slow the heart can contribute.

The man received a dual-chamber leadless pacemaker. Traditional pacemakers sit under the skin of the chest and connect to the heart through wires called leads. Leadless systems use small capsule-shaped devices placed directly inside the heart, usually through a vein in the leg. Dual-chamber versions put one device in an upper chamber and one in a lower chamber so the two can coordinate the heartbeat. The FDA approved the first dual-chamber leadless pacemaker system in July 2023. After the procedure, the man’s symptoms resolved.

Ip’s report did not argue that every low reading from a smart device signals an emergency. Slow heart rates during sleep are common and often harmless. In the report, Ip wrote that while symptom-free slow heart rates during sleep are common, “the sudden occurrence of unexpected, symptomatic bradycardia warrants evaluation, especially with confirmatory electrocardiography.”

The key elements were the sharp change from the man’s normal rate, the confirmation on other devices and the new shortness of breath. Together, they pointed to a real problem rather than a sensor glitch.

U.S. guidance on slow heart rhythms, the 2018 bradycardia guideline from the American College of Cardiology, American Heart Association and Heart Rhythm Society, emphasizes linking symptoms to the rhythm itself, usually with an electrocardiogram. A consumer reading can raise the question, but diagnosis still depends on medical testing.

Ip sees promise in the trend. “These direct-to-consumer devices have ushered in a new era of medicine when patients are now empowered to help diagnose their arrhythmias,” he told Gizmodo.

Smartwatches have drawn most of the attention in consumer heart monitoring, largely for detecting atrial fibrillation. This case stands out because the first warning came from a bed, a passive device that asks nothing of the user beyond sleeping on it.

That convenience has limits. The report describes a single patient, and it does not provide data on how accurate the bed’s readings are or how often such systems produce false alarms. Movement-based estimates may be thrown off by a restless sleeper, a partner in the bed or other sources of motion. A device that flags too many harmless dips could also cause needless worry and doctor visits.

The case also shows how much it depended on the man himself. He noticed the alert, double-checked it with other devices, recognized new symptoms, and called his doctor.

For people who use sleep trackers or smartwatches, the takeaway is not to treat every number as a diagnosis. A sudden, unexplained change from a person’s usual heart rate deserves attention, especially when it comes with symptoms. Anyone with a very slow pulse along with fainting, chest pain, confusion, or shortness of breath should seek emergency care.

It recorded an average overnight heart rate of 42 beats per minute, compared with the man’s usual 78, using sensors that estimate heart rate from body movement.

It is a condition in which electrical signals from the heart’s upper chambers cannot reach the lower chambers, so the two beat independently and the heart rate often slows.

A smartwatch and a home blood pressure monitor also showed a slow rate, and after he became short of breath, an electrocardiogram in the emergency department confirmed complete heart block.

He received a dual-chamber leadless pacemaker, and his symptoms resolved.

Should people trust smart bed heart readings?

They can serve as an early warning, but they are estimates. The report gave no data on accuracy or false alarms, and diagnosis requires medical testing.