watchOS 5.1.2 Brings ECG to the Apple Watch Series 4

(Julio Ojeda-Zapata) #1

Originally published at:

Apple announced in September that its new Apple Watch Series 4 is capable of taking electrocardiogram readings as part of its health-monitoring features. That feature didn’t ship with the watch, but it’s now available with the watchOS 5.1.2 update, along with irregular heart rhythm monitoring on all supported Apple Watch models.

Age and location of TidBITS Talkers?
(mike sanders) #2

You might have mentioned in the article that the ECG feature is only available in the US, I spent some time looking for the app.

(David Bogart) #3

The Irregular Rhythm Notification also does not work in Canada yet. I guess regulatory approval is required. According to
Apple has not yet applied for approval here.

(Adam Engst) #4

Ach, sorry about failing to mention the US-only nature of these features! I’ll tweak the article to make that note.

Ironically, when Julio was writing this article, I was in Canada for hernia surgery, so if I hadn’t been recuperating, I might have thought about the international issue while editing.

It’s easy to see why these features are limited to the US, since medical regulations undoubtedly differ in every country, but at the same time, I expect to see users in other countries clamoring for them.

(Felix) #5

A good friend was getting “inconclusive” results about a third of the time, even after following the Apple guidance of what to do when experiencing multiple cases of that result. Well, OK, everything Apple suggests except going to see his Doc.

So then he had the idea that licking his finger before placing it on the crown might allow for better connectivity. And that, in fact, helped considerably but still didn’t yield a consistent sinus rhythm result.

Lastly, he wondered what would happen if he didn’t breath for the 30 seconds it takes to run the test. Result, he hasn’t had anything but sinus rhythm results since.

So, if any TidBITS reader is getting inconclusive results, try the Apple suggestions first and if that doesn’t work, give my friend’s solutions a whirl.

(frederico) #6

I don’t generally post personal information of this nature, but I’m in hospital right now because my Apple Watch picked up irregular rhythms within a few hours of installing the update.

I was already under observation for random, transient elevated heart rate/SVT/PSVT; but though a Holter monitor and later a 30 day monitor picked up some oddities, we could never get an EKG attached during any such events.

Apple Watch is going to change the world (even if the Apple wearable devices in future don’t actually look or behave as a watch).

(Tommy Weir) #7

Frederico, best of luck with that. As someone home just two days after having additional stents put in, the rollout of the ECG app is my main stimulus for getting an Apple Watch.

Mind yourself, at least you’re in the right place.

(gastropod) #8

According to Apple, everything needs to be dry to get a good reading:

“Liquid-free contact is required for the ECG app to work properly. Use of the ECG app may be impacted if the Apple Watch and/or skin aren’t entirely dry. Make sure that your wrist and hands are thoroughly dry before attempting a reading. To ensure the best reading after swimming, showering, heavy perspiration, or washing your hands, clean and dry your Apple Watch. It may take up to one hour for your Apple Watch to completely dry.”

I tried it after licking my finger, and got my first inconclusive result. The baseline was amazingly wobbly, even worse than one I tried in bed with my watch arm unsupported.

(Diane D) #9

No experience with Apple Watch, but many years experience with heart rate monitors. One of the first things you do when an HRM is acting up is wet it slightly (and most do it by licking it)


(Horvath Adam) #10

Re: “available only in the US” Does this apply Only to the ECG, feature or also to the “…passive-monitoring feature to detect irregular heart rhythms and extended this capability to most older Apple Watch models.”?
I fine point: if an updated Apple Watch originally bought in Canada is used in the US, would the feature become available?
Also: where could one find info. on this passive monitoring feature?

(Doug Miller) #11

It’s my understanding that the a-fib monitoring using the heart rate sensor is US only for now and also required government approval, and probably will elsewhere.

And here is Apple’s support page with information about heart rate abnormal rhythm detection:

That page confirms that it is US and US territories only for now. And I do not know what happens if you arrive in the US from another country. Perhaps call apple care to find out?

(Fearghas McKay) #12

I have a US purchased watch, set to US region but I use the UK App Store primarily. I can download the app using my US App Store account but the health app doesn’t let me do the necessary configs.

(Adam Engst) #13

Hope the Apple Watch ECG continues to be helpful!

My father had heart valve repair surgery in July 2017, and in January 2018 we got him a KardiaBand ECG band for the Apple Watch for exactly your reason. He was having some issues, but they never happened when he was at the doctor’s office. Being able to take an ECG and show the doctor was helpful, mostly for peace of mind, since I don’t think they ever revealed anything troubling. But at least he knew that, and the doctor could confirm it.

And good luck to you too, Tommy!

Keep wearing your Apple Watches, both of you! We can’t have two of our most valuable community members having problems that Apple technology can help with. :slight_smile:

I only have an Apple Watch Series 2, but I just had an ECG experience. I had hernia surgery last week at Shouldice Hospital in Toronto (the world experts in hernias) and as part of my pre-op testing, I had to have an ECG at my doctor’s office. The extremely judgemental machine printed ABNORMAL in big letters at the top of my readout, and my doctor explained that it was because I have a slow heart rate and a slightly enlarged heart, both due to being a competitive runner. Shouldice wasn’t pleased about the fact that a cardiologist hadn’t reviewed my pre-op test, so they repeated it, but the doctor just looked at it and muttered, “You’re in shape.” and moved on. I did get bit by all this cardiology on the day after my surgery, when, every time I tried to stand up, I’d get dizzy and have to lie down again. I also have low blood pressure, and it was so low after the surgery (it climbed to 97 over 56 by the end of the day), that my brain wasn’t getting enough blood when I was sitting or standing. Luckily, the sedative had cleared from my system the next day and I’ve been OK since.

(Horvath Adam) #14

Tx for reply. Availability in US only is confirmed by Canadian sources. However a US bought V#4 watch apparently functions in Canada.

(Tommy Weir) #15

Cheers Adam :slight_smile: We all have to watch ourselves at this point!

Interesting that strong athletes have issues they can present too, I hadn’t considered that a sedative could have that effect. I’m a million miles off facing those issues. Shouldice were right to have a cardiologist review it, surgery being the trauma to the body it is.

(frederico) #16

Thank You, and good luck with your recovery.

To begin with, I absolutely hate wearing watches; except for periods of employment or athletics when it was necessary, I have always preferred clocks or pocket watches.

I think I posted on this elsewhere on this forum, but I only got a Series 3 in the spring because I was noticing the random elevated heart rate, but by the time I could get a pulse/ox meter on my finger, it was over. The very first day I wore the Series 3, I got seven notifications of elevated heart rate over 140bpm at rest. Okay, that was worth $300 (refurb) to find that out and get myself to a cardiologist.

But what I didn’t expect is how useful the damn thing is in so many other ways, especially using Siri and reminders/tasks, home control, and other automations.

And I’m an absolute sucker for gamification; I ended up being far more serious than I thought I already was about daily exercise; closing rings became a priority; and increasing ring goals became another. Lost a bunch of weight.

But the truth is, if not for health issues, I’d not be wearing this all the time; certainly not 23 hours a day (off only for charging during showers).

My cardiologist also wanted me to get a Kardia or an AliveCor; but, one, I didn’t want yet another thing that had to be on my person at all times so I could access and use it within 60 seconds (my episodes are typically very brief); and, two, the rumor mill was rife with bits about additional heart health options coming in the Fall. Since my heart otherwise checked out as being perfectly healthy, we agreed I could wait for Series 4, and I ordered day one (trade-in value was excellent for my pristine Series 3).

But we didn’t know it would take so long for the ECG to be activated; the docs were pusing me again to get at least spend the $130 on the AliveCor (with case), and it was in my Amazon cart when I saw the early AM rumor ECG would deploy that day. Glad I waited, because it is the fact it is on and automatically looking without manual testing that allowed me to then do the intentional EKG during an event.

I don’t think I would have been able to get the AliveCor out of its carrier in time to even catch the event.

LOL. I, too, have a “runner’s heart”, and have to advise nurses and such that my resting rate goes into the mid-30s, and I’m fine. I also have a heck of a time coming up from anesthesia or sedatives; a number of times I’ve been kept overnight for what were supposed to have been outpatient procedures (mostly because I live alone and they don’t want the liability of releasing me loopy or lightheaded).

I also had to tell Apple Watch/ to stop alerting me just because I went under 50bpm.

My BP, however, which also used to be ~95/~55, has indeed increased dramatically along with this [whatever this is] condition; now I’m tracking around ~120/~80 at rest, but it will really shoot up with activity. Trouble is I’m already on so many meds with Parkinson’s syndrome, they could be causing it in the first place, and I’m never a fan of taking this med to deal with that med, which might mean another med to deal with this med or that med or the other med.

I’m really curious what the demographics is here on TidBits; are we all old enough we should all have Apple Watch? And how many of us have been reading TidBits since the early 90s? Pushing thirty years soon; crazy.

[@tommy started a new thread for this topic: Age and location of TidBITS Talkers? -Adam]

Cheers, All.

(Adam Engst) #17

A post was merged into an existing topic: Age and location of TidBITS Talkers?

(Diane D) #18

You guys are killing me. Also an athlete. I don’t wear watches because I tend to smash them. Nothing on my wrists or fingers. But I was having weird heart issues this fall, due to my thyroid being under-dosed. It was to the point where I’d wear my Garmin to bed and during the day to keep an eye on it.

$300? I think I have to wait for the $100 price point - way out of date by that time :-/


(frederico) #19

Yeah, I wasn’t intitially happy with the buy-in, either, but when the upgrade time came; I didn’t hesitate. As I said, not only did it help with cardiac issues, it has absolutely delivered that value and more by getting me working out more consistently again.

Beyond that, with my failing memory and failing dexterity, using it for speech-to-text and spoken automation commands, timers, alarms, reminders, creating all the aforementioned, messaging, phone calls, and much, much more, I’ve come to love what it does for my overall life now with failing and complicated health.

It is SOOOOO much more convenient than pulling my phone out of my pocket (especially when I’m wrangling my walker).

I just wish I didn’t still HATE wearing it.

I also destroyed numerous watches in a previous career; but we also wore our watches on the inside of the wrist (as does the military) to prevent both damage and unwanted reflections; and I’m still baffled and upset that it’s not an option. If you try to use it on the inside of the wrist, you have to turn off Raise to Wake and a couple other settings, and then you lose easily 50% of what it’s good for (for someone in my condition and use case).

I keep filing bug reports and feature requests; hopefully next Fall they will relent. I just don’t see how military and people who work with tools and machines could fully use one, otherwise.


It looks like Apple is continuing to go full speed ahead with upcoming Watch features:

I’m particularly impressed by this: “The number of doctors on staff is an indication that Apple is serious about helping customers manage disease, and not just wellness or fitness.”