The ECG app for Apple Watch was announced at the September event and will be available by the end of 2018 as a free software update. The ECG app requires Apple Watch Series 4 which features electrodes in the digital crown and the back plate of the device. Due to legal reasons, the ECG app is limited by region.

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All Apple Watch models record your heart rate, a number in beats per minute. You can use the Heart Rate app to get a heart reading, or Apple Watch takes a heart rate reading passively every few minutes.

The electrocardiogram (ECG/EKG) records the actual pattern of the electrical impulses of your heart. This chart can then be found in the Health app and exported as a PDF to send to your doctor.

To get the ECG app, your Apple Watch must be set to a specific region. As ECG functionality crosses into the realm of medical health, Apple must get regulatory approval for each country to offer the ECG app.

You can get the ECG app for Apple Watch Series 4 in the following countries:

Available countries for ECG app

  • United States
  • US Virgin Islands
  • Puerto Rico
  • Guam

When the app is available to use, it will appear on the home screen honeycomb grid of apps. You just tap on it and follow the onscreen instructions to get an ECG. Simply place one finger on the Digital Crown and wait 30 seconds whilst it reads the electrical impulses in your body.

Apple Watch can detect some cases of atrial fibrillation. As always, consult your doctor and do not take the Apple Watch recommendations at face value. Atrial fibrillation detection happens with an explicit ECG session and in the background, so you can get an atrial fibrillation notification just as you were walking around.

How to get the ECG app outside the US

Right now, the ECG app is not available anywhere. Apple has promised it will be released before the end of the year, so we are waiting for a software update first and foremost. After that, you need to tackle the country restrictions if you do not live in the United States.

The way the Watch geographically limits access to the feature relies on the Region settings. Region affects formatting of dates or numbers. It is not the same as changing language. To change system region, open the Watch app on the paired iPhone. Tap My Watch -> General -> Language & Region. Change the Region to United States and wait a few seconds for that setting to transfer to Apple Watch. You may also need to reboot your Watch. Then, the ECG app will appear.

In summary, ECG requires an Apple Watch Series 4, a  software update from Apple (coming soon), and have your system region set to one of the supported countries in the list. If you are outside of the US, you can use the above hack to unlock the ECG if you are anxious to try it, as it may take months or years for the ECG app to be available in every region that Apple sells the Apple Watch.

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