Apple prompted many oohs and ahhs when it unveiled its electrocardiogram (ECG) feature for Apple Watch Series 4 in September. At the time, the impressive technical feat was bolstered by the FDA approval Apple had received for this new health feature. But Apple fans outside of the U.S. may have to wait a bit longer for the ECG feature, which hasn't rolled out yet. And when it does, 9to5Mac reports that availability will reportedly be limited to the U.S., based on code spotted in iOS. The limitation makes sense: an ECG is a medical feature, and therefore would need approval from any particular country's health body. It appears this isn't a case of "Ask for forgiveness, not permission." But 9to5Mac says the limitation is governed by software, not hardware. No matter where you are, the Apple Watch Series 4 will come with the sensors that enable the ECG. What's more, if you're outside of the U.S., there should theoretically be an easy way to get access to the ECG. All you have to do is go to your Apple Watch's Settings and change your region to the U.S.A. However, that will also probably mess with the date, time, and weather alerts as well. But if you're abroad with your new Watch and just need a quick heart reading, you may be able to deliver your own, uh, bypass. Of course, none of this is to say how accurate or effective the ECG feature is. We'll only be able to gauge that when it's available, and so far Apple hasn't given a date.<doc-sep>Apple Watch Series 4’s best feature isn’t available yet, and when it finally arrives later this year, it will officially be exclusive to users in the U.S. But with a simple trick, you should be able to take electrocardiograms anywhere around the world. Although the Series 4 hardware is the same in every country, Apple cannot offer the ECG feature to everyone yet because it requires approval from the relevant regulators. In the U.S., that’s the FDA, which has already given Apple Watch 4 the thumbs-up. We don’t know how far Apple has gotten in obtaining approval in other markets, but a recent report suggested users in the U.K. could be waiting up to two years to get their hands on the ECG feature. That’s if they wait for Apple to enable it. But you shouldn’t have to. Enabling Apple Watch 4’s ECG After examining code in iOS, 9to5Mac has confirmed that the ECG feature is enabled by the software region of your devices (Apple Watch and iPhone). If the region is set to the U.S., the ECG feature will be active. If it’s not, it won’t work. To enable the ECG anywhere, then, all you have to do is go into the Settings app and change the region. You’ll find this under General, then Language & Region, then Region. Your language settings aren’t determined by region, so by selecting “United States” in this menu, you won’t be forced to use U.S. English. If another language is your native tongue, you can continue to use that. But there are some things you may need to adapt to. Changing the region does adjust things like the date and time format and default units. You can either live with that, or change your region to the U.S. only when you want to use the ECG feature. We should also point out that this confirmation is based on pre-release software, so Apple could change things before the ECG feature is rolled out.<doc-sep>The Apple Watch Series 4 will include a more advanced heart-monitoring technology called electrocardiogram. This feature has received clearance from the US Food and Drug Administration, meaning it can be used as a medical device — a move that is part of Apple’s increasing push to brand the Watch as more than a fitness device. The Apple Watch Series 4 is the first major design overhaul of the Watch since its debut more than three years ago. The existing Apple Watch already had a way to measure heart rate, of course. Like most wearables, it monitors heart rate using green LED lights embedded in the device. The lights reflect on the skin to detect the pulse and changes in blood volume; this is turned into the heart rate number. This method is convenient but indirect. Watches are convenient, but the wrist isn’t always the best place for taking accurate measurements this way because there are so many layers of tissue, and studies suggest this method isn’t very accurate. ekg is far more accurate than guessing based on pulse The electrocardiogram, or EKG (or ECG as Apple calls it), is much better, and there have long been rumors about Apple developing this feature. Though this is a new feature in the Watch itself, last year the FDA approved the AliveCor KardiaBand, a watch accessory that essentially does the same thing. On the Series 4, users put their finger on the digital crown. The Watch passes a current across the chest to track electrical signals in the heart, directly, and it’s far more accurate than interpreting based on pulse. The process is meant to take about 30 seconds and the user will receive a heart rhythm classification. Normal rhythms will be classified as “sinus” rhythm, and the Watch will also classify irregular rhythms, such as atrial fibrillation. The information will be stored in the Apple Health app. EKG is a serious feature and the next step for Apple as a health company. It can be used to more accurately diagnose or monitor heart disease. Heart disease is the most common cause of death around the world, according to the World Health Organization, so of course companies want to work on a problem that could have a huge impact and be a real moneymaker. Apple is no exception. Last November, Apple announced that it would partner with researchers from Stanford University to run the Apple Heart Study to investigate atrial fibrillation (AFib). (Stanford will collect data from Apple until January 2019.) Third-party apps already work with Apple to see if their technology can detect common heart problems like irregular patterns. FDA clearance for the EKG feature on the Watch will pave the way for medical clearance of even more Apple features. The new Series 4 Apple Watch begins shipping on September 21st, but the EKG app and Irregular rhythm notifications won’t be available until later this year.<doc-sep>
Apple revealed the Apple Watch Series 4 during an event in September, highlighting a new electrocardiogram (ECG) app that will be coming to users in the United States through a watchOS software update later in the year. Regulatory clearance is required for the ECG feature, and because of this it will be limited to the U.S. at launch, although the company is working on approval for other countries. In a new post by 9to5Mac today, code found within iOS related to the ECG feature suggests that the ECG limitation is based on software, not hardware. This means that gaining access to the ECG app in a non-U.S. territory will be as simple as changing the region of the Apple Watch Series 4 and connected iPhone to the United States. iPhone region can be changed by going to the Settings app > General > Language and Region, and then selecting the Region of your choice. Those who switch regions should note that the time, date, currency formats, and more will be affected by the change. The ECG app on Apple Watch Series 4 works by placing a finger on the Digital Crown while wearing the watch. The electrodes in the Apple Watch detect the electrical impulses from your heartbeat and route the data to the S4, where it is converted into a signal for Apple's algorithms. This results in a heart rhythm classification that can vary between a normal rhythm to an atrial fibrillation. All of your ECG results are stored in the Health app in PDF format and can be easily shared with your doctor. While the FDA has granted de novo clearance for the ECG feature, that's not the same as FDA approval and the agency does not recommend that the ECG feature be used by those under 22 or those who have already been diagnosed with atrial fibrillation. The FDA warns that Apple's ECG app is not designed to replace traditional methods of diagnosis or treatment and is intended for informational use only. The Series 4 is the first ECG product being offered over the counter directly to consumers.