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I think they all use algorithms to smooth the data. I don't think any at the moment are accurate enough to give that data (unless you want to spend a lot of time panicking).
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Most watches sample heart rate at regular intervals rather than being on constantly, as the latter drains the battery faster than is acceptable to most users. They are indicative too, meaning that they are not accurate to the level that would be considered a health device, which is much more tightly regulated.
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Empatica do a couple of devices that may do that. I think the wristband will measure heart rate accurately but it's megabucks
https://www.empatica.com/e4-wristband
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@hoefla
All this chat about wearable tech... Do any of them track heartrate where it could give you the data beat by beat? I'm wondering if it would be useful to keep an eye on regularity or otherwise. So not just beats per minute. (Context: hereditary heart wonkiness, I've already had surgery once but it commonly comes back after a while, would be useful for me to be able to take data every so often and look over a 24h graph. Assume I know nothing about gadgets.)