In only a few years, smartwatches have evolved from quirky devices and status symbols to robust health and fitness trackers. Since around early 2021, the market has been saturated with devices that use various sensors to monitor everyday life, exercise, sleep, and general health. They can also alert wearers of possible heart attacks and summon assistance if they fall and cannot get up.
Because of the Apple Watch Series 5, electrocardiograms (ECGs) have become a hot topic in the wearable technology world. There are a number of smartwatches that have it, including the Samsung Galaxy Watch 4, Fitbit Sense 2, and the new Apple Watches: Series 8 and Ultra. So, ECG capability is one of the most important health capabilities of today’s health watches.
Essentially, ECG is a medical process for monitoring heart activity and testing for any anomalies. It stands for electrocardiogram and is abbreviated as ECG. When taken in a hospital, it provides a more accurate reading. But the benefit of inserting a basic version of this hardware into a smartwatch is that you can obtain an ECG reading anytime you want. Plus, you can then send the data to your doctor rather than having to wait until they’re in the hospital.
Who needs ECG smartwatches?
The key question for many folks is ‘who needs an ECG smartwatch?’ Well, for many (likely, most) the functionality is something you might use once and then completely forget about it. However, an ECG is absolutely necessary for a significant portion of the population.
ECG on wearables is valuable for a tiny segment. Users over the age of 50 are more likely to benefit from this than those in their 20s and 30s.
Conditions that disrupt your heart’s rhythm, like afib, might come and go. This means that having a gadget on hand that can capture readings on-the-fly is a really useful health tool.
How does an ECG work?
By conducting an electrical circuit through the wearer’s body, smartwatches obtain an ECG. The heart rate sensor on the back of the device is pressed against the wrist. And, when the wearer places a finger on either the display or crown, it begins to take the reading. The ECG takes about 30 seconds to complete. The data is sent to a mobile app where it can be accessed, saved, and submitted to a doctor.
The Apple Watch Series 4 was the first smartwatch to have an ECG app released in 2018. Apple’s ECG app wasn’t accessible in every country at the same time because a clinical feature like this needs approval from government health departments. Instead, it arrived in the United States after the FDA approved the software. Still, it didn’t function in the United Kingdom or Europe until months later, when the European Union’s version of the FDA authorized its use.
Any manufacturer of ECG-enabled products must follow these measures. As a consequence, the ECG software is often delivered in stages. The FDA has yet to approve Withings’ ECG app in the United States (though it is available across Europe), and Samsung also faces delays.
Smartwatches have brought new innovations to many areas of modern life, however, the ability to conduct an ECG from your wrist is incredible. In most hospitals, a 12-lead ECG machine is usually used to conduct an ECG. This lets doctors check patients for heart blocks, atrial fibrillation, irregular heart rates, ventricular fibrillation, and heart attacks too.
It wasn’t possible to get ECG results from home until the invention of wireless ECG devices. Though smartwatches can’t diagnose a heart attack, they can alert you if you have an abnormal rhythm. This lets users know if medical attention is needed before any complications occur.
How accurate is a smartwatch ECG?
If you’re buying a smartwatch for an ECG scanner, make sure you opt for a model that is approved by the FDA. This means it’s clinically approved and has good accuracy too. Getting FDA-approved isn’t easy, so you can trust all smartwatches with this label are accurate. Some watches on the market don’t have an official FDA approval mark, so look out for this when shopping.
Smartwatches with ECG capabilities are often used to monitor for symptoms of atrial fibrillation. This disorder may cause an abnormal or unusually quick heartbeat. It’s common, but it can be fatal. And it often goes undiagnosed because ECG testing isn’t available outside of a medical setting. Smartwatches, including ECG hardware, emphasize that they cannot monitor other heart problems, such as possible cardiac arrest. But the data and alerts they provide will provide owners with the knowledge they have to seek help.
Some of the most common smartwatches and wearable devices with an ECG app are mentioned below. Although not all of them are yet available globally, and the likes of Garmin still don’t offer this feature.
We’ve tested some of the best ECG smartwatches available in 2022 and we’ll give you an honest review.
Table of Contents
- How does an ECG work?
- ECG Smartwatches
- ScanWatch by Withings
- Omron HeartGuide Wrist BP
- Take your blood pressure
- How do you know if you’re monitoring your HR correctly?
Fitbit Sense 2
Fitbit, now owned by Google, is renowned for fitness trackers and offers their latest smartwatch as the Sense 2 on the heels of their first, the Sense. We discuss one of their latest trackers with ECG, too, the Fitbit Charge 5.
The Fitbit Sense 2 is a health-focused smartwatch that offers many stress-management and mindfulness tools as well. This is Fitbit’s biggest competitor to other big smartwatches like Apple Series 7, 8, SE, or SE2, or the Galaxy Watch4.
When it comes to the Sense 2’s improvements from Fitbit’s first model, the company gave us a lighter design, an improved EDA sensor, and a physical button on the side to control the smartwatch a bit more easily during workouts or sweaty moments. And even more than being able to detect your most stressful moments in a day, the Sense 2 will offer insights on how to manage it.
The Sense 2 is a about $100 more than the original Sense, and can be worth the extra money for those who truly wish to see a full picture of their heart health.
The Sense is a full-featured smartwatch with the same health and fitness features you’d expect from an Apple Watch. Plus alerts, water resistance, call handling, music streaming, contactless payments, and more. In fact, it gives the Apple Watch SE a run for its money.
In testing, our reviewer Maygen was a die-hard Fitbit fan, upgrading from a Charge 3, then to a Versa 2 and, finally, the Sense. The notable leap from tracking fitness band to fitness smartwatch is noticeable. In fact, she found the addition of Alexa compatibility really opened up her use of the watch beyond monitoring her workouts.
Steps, calorie burn, heart rate and therefore ECG readings are naturally meant as an indication only, not official medical data. However, the accuracy is enough to be confident in.
The only issue Maygen noted with the Sense is a practical one. She found the introduction of the almost touchless side button to be more of a burden than a blessing. Her wrist accidentally made contact a lot during workouts, which would cause the workout to pause unknowingly. Outside of exercise mode, pressing the button would also wake Alexa up. This is a minor complaint from one user so we wouldn’t say it’s a deal-breaker.
Fitbit Charge 5
The Fitbit Charge 5 is a compact device packed full of fitness and health features and is the first device to come with Fitbit’s Daily Readiness Score.
Maygen’s also tried the Charge 5 for a time. Gravity and grace aren’t always her friends, particularly when running, so to be able to simply press a button whilst on the go was ideal. Because it was so easy to unintentionally double-tap and skip over the screen she needed, it forced her to go through everything all over again.
It’s not the best or the worst running interface she’s ever used, but it’s also not the best either. To keep track of your progress, you’ll see three different metrics at a time; two of them are constant (distance and time), while the larger one in the middle changes with each tap to cycle through your current pace, average pace, heart rate, calories, and steps.
Putting aside the fiddliness, Maygen’s initial impression is that the built-in GPS and heart rate monitor fall short of keeping up with a Garmin Forerunner 245 which is a typical go-to running buddy and typically accurate for 5K and more casual runs.
Is the Fitbit Charge 5 worth it?
However, the Fitbit Charge 5 is more than the sum of its parts in several respects. For those who aren’t quite ready for Garmin Connect’s numbers bonanza but still want to get active, the new style and screen make the Fitbit app a strong contender.
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Both Fitbit devices include an HRM and the ability to perform an ECG. To complete the electrocardiogram reading, simply wear the device and put a finger on the aluminum case, as with others. The Fitbit Sense and Charge 5, like the Apple Watch, monitors unusually high and low heart rates.
Fitbit Sense’s ECG app is also not available everywhere. However, it does operate in the US, UK. And Europe as of February 2021, with Canada, New Zealand, and Singapore on the way. Anybody under 22 does not use the ECG app, according to Fitbit. Reportedly, Fitbit will incorporate blood pressure monitoring with the Sense.
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Series 4, 5, 6, and 7, and the new 8/Ultra Apple Watches
The ECG app is available on the Apple Watch Series 4, 5, 6, 7, 8, and Ultra (but not the original SE Watch). Read a comprehensive overview and review of the Apple Series 8.
The first iteration (Series 4) was released in the autumn of 2018, and the most recent, Series 8 and Ultra, in fall of 2022.
The ECG app is available in most countries. It takes about 30 seconds to complete, then sends the data collected to the user’s iPhone’s Health app. It can then be sent off to a doctor if necessary.
An ECG is obtained by connecting the wearer’s body to an electrical circuit. Now, with the Apple Watch, you place the heart rate monitor on your wrist as expected, then tap the Digital Crown with your opposite hand’s index finger to conclude the circuit. The watch will then notify you if your heartbeat is regular or whether you have Afib.
While the Apple Watch SE also includes a heart rate monitor, it does not have the ability to take an ECG.
Apple Watch 8 – What we know from the recent release
The release of the Apple Watch Series 8 comes off the tail of the recent release of Watch OS9. Now as great as this update was, by way of offering scientific sleep insights, or better workout data, and especially for older models, OS9 won’t get you all the great features on Apple’s newest watch.
The Series 8 offers new features you can’t get on other Apple devices like Crash Detection, full resistance to dust, and a sensor for skin temperature. But as the Series 7 did, the Series 8 of course also features the ECG capabilities. You’ll need an extra $200 or so if you’d like the Series 8, its new features, and new colour options; but if you don’t have the cash, then the Series 7 with the OS9 update is still a great buy.
They didn’t release the Series 8 smartwatch alone, though: Apple also released a seriously upgraded version of the SE as well!
Apple Watch Ultra – What we know from the recent release
The most prominent upgrade between the Apple Watch SE and the Ultra is the fact that the Ultra boasts ECG monitoring. And if you’re concerned about heart health, then this new ECG smartwatch from Apple is a great choice, because Apple also added a blood oxygen app (not available on SE).
The Ultra is now, in fact, the most comprehensive smartwatch available from Apple (with the largest case, too!). It has the best underwater rating at up to 100m, plus the ECG app, and it features the most safety functions. Apple’s Ultra even has the added skin temperature sensor that you can also get in the new Series 8.
The Ultra comes with the most features, so the smartwatch does of course reflect that in its cost. An Ultra with GPS and LTE is double the price of a Series 8 with GPS and LTE.
Read a more in-depth review of the Ultra from superwatches.com here.
Apple Watch 7 – in-depth view:
The Apple Watch is a popular smartwatch and their 2021 release provides an accurate ECG feature too. The Apple Watch 7 offers an ECG app that can record electrocardiograms easily and quickly. This app checks your pulse to work out your heart rate and whether your upper and lower heart chambers are in rhythm.
Though this ECG app is popular, it’s not available in all regions. Before you purchase the Apple Watch 7 check their website to see if your region supports the ECG app. You can also find information on the Apple Website to learn how to download the ECG app and how to read your results.
To get the best results from your ECG app:
- Make sure the Apple Watch is clean and dry.
- Fasten the watch so it’s not loose.
- Rest your arm on a table while you’re recording.
On deciding to move further into the Apple ecosystem, Maygen bought an Apple Watch 6 and said goodbye to Fitbit. She was wildly impressed with the influx of data and found calorie burn and heart rate, in particular, to be less generous, which she assumes means more accurate.
The watch itself is comfortable. She uses the standard black silicone strap for the gym (which is very easy to clean), and a brown leather option for going out. That, or a stainless steel link bracelet totally changes the look of the watch.
Samsung Galaxy Watch 3, 4 and Samsung Galaxy Watch Active 2
ECG functionality is now available on several Samsung smartwatches including the 3, the new Galaxy Watch 4 and the Active 2. These have been licensed in the United States, Europe, and Samsung’s home country of South Korea.
When the wearer puts a finger from the opposite hand on the case, these watches can conduct an ECG using the heart rate sensor. You must rest your forearm on a flat surface and stay as calm as possible without shifting during the 30-second ECG, as with other ECG wearables.
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ScanWatch by Withings
The Move ECG and the ScanWatch are smartwatches with ECG functionality from Withings, a French technology company. The former is less expensive and a little dated now, whereas the latter is the latest and greatest. Both monitor exercise, heart rate, and sleep, but the ScanWatch has a basic display for displaying alerts and other data.
Unfortunately, despite being clinically validated and commercially available in Europe, Withings is still waiting for FDA approval. It can’t sell its ECG devices in the US before that happens. The organization had planned to clear this roadblock in 2020 as it was causing delays, but as of early 2021, it has still yet to do so.
On testing, we found the watch to be a little heavy on the wrist, but this is subjective. We like that it looks like a classic timepiece, rather than a smartwatch. As such, we feel the 50-60 age range will appreciate this. Looking over the reviews from other users, the design and ergonomics seem to be a standout feature. As well as the detail in the data provides for health monitoring, including the addition of ECG capabilities.
Omron HeartGuide Wrist BP
Some wearables go even further, emphasizing heart health as a selling point. One such gadget is the Omron HeartGuide. It’s being marketed as the world’s first scientifically tested wearable blood pressure monitor, and it’s been approved by the FDA (Food and Drug Administration of the United States).
It will check your blood pressure, track steps, distance, calories, and sleep, as well as show some (limited) smartphone alerts. When you ask HeartGuide to calculate your blood pressure, it will also calculate your heart rate.
Blood pressure and heart rate provide two different measures of heart health, as you probably already know if you monitor your blood pressure regularly.
Heart rate is the number of beats per minute, whereas blood pressure is the intensity of your blood flowing through the vessels. As a result, the Omron is unable to determine the heart rate during a workout.
If you check your blood pressure often, don’t need advanced smart features, and aren’t especially fashion-conscious, this may seem like a reasonable (if pricey) investment.
On testing, we found the readings to be very accurate in comparison to medical BP readings. Though, you should follow the guidance when it comes to taking a blood pressure reading. We detail the tips for this in our article here.
Take your blood pressure
It might also be appealing if you want to see how your blood pressure is at home. You’ll need fast fingers to put it on and take it off, which you’ll have to do any time you want to shower. If you’re patient, it may withstand being sprayed with water when washing your face, but it won’t survive being immersed in water. Even on a strong male wrist, it feels bulky and cumbersome.
It’s only available in a medium, and we can’t imagine how a large would feel. If you’ve had a mastectomy, you shouldn’t use the Heart Guide. Different alarms can be seen on traditional blood pressure monitors. Often, talk to your doctor about how much you can monitor your blood pressure during the day. In order to avoid bruising, Omron recommends not doing it more often than required. If you’re just going to do it once or twice a day, there’s no need to wear anything so heavy all the time.
How do you know if you’re monitoring your HR correctly?
There are some things you could do to ensure that your watch reliably tracks your heart rate.
- Make sure your smartwatch or fitness tracker is snug but not too tight around your wrist, with the sensors flush against your skin just above the wrist bone.
- Maintain the cleanliness of your smartwatch or fitness tracker. Sweat can also obstruct readings.
- Warm up before obtaining a reading if you have low circulation or are simply cold.
- Your heart rate can vary from your usual readings if you smoke or drink alcohol before taking a measurement. Try taking another one later as a comparison.
Last Updated on September 30, 2022
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