- 1 Fitness smartwatches with ECG: Overview
- 2 The best fitness smartwatches with ECG: comparison
- 3 Fitness smartwatch with ECG: With FDA approval
- 4 Fitness smartwatches with ECG not on the market
- 5 How does ECG technology work?
- 6 What fitness watches cannot do with ECG
- 7 Caution with pacemakers
- 8 Fitness smartwatch with ECG function: Outlook
Fitness smartwatches with ECG (electrocardiogram) are very trendy. The technology, which is still quite simple, is mobile and takes a back seat to the previous top seller among wearables sensors, the heart rate sensor. By means of simple hand movements, the function is intended to help detect atrial fibrillation, for example, which is an indicator of a possible stroke.
Among the best fitness watches with ECG recording are models from Apple, Fitbit or Withings, some of which come with GPS, pulse measurement, oxygen measurement, fitness tracker and Smartwatch functions. Caution is advised with the still clearly arranged but good selection. We show which models we had in a review and are officially approved and are therefore allowed to provide information on certain heart conditions.
But which is the right model for you? Which ECG fitness watch suits you best? Here comes the overview including comparison!
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Fitness smartwatches with ECG: Overview
The following fitness smartwatches with ECG are currently approved by FDA and available. FDA It allows them to record an ECG and provide users with medical health information regarding their heart rhythm:
- Apple Watch from the 4th generation
- Fitbit Sense
- Withings Move ECG
- Withings Scanwatch
- Samsung Galaxy Watch 3 / Galaxy Watch Active 2
The following model lack certification or is still not on the market:
The best fitness smartwatches with ECG: comparison
We consider the following models to be among the best fitness smartwatches with ECG. All models shown here convince us with rock-solid equipment like a 24/7 activity and fitness tracker (steps, sleep, calories, …) and serve as heart rate monitors by means of an integrated heart rate monitor. Furthermore, they are waterproof, offer good readability of the display, very good analysis functions in the app, and much more. Some also have a GPS receiver or a sensor for oxygen measurement (SpO2). Furthermore, they analyze general fitness, support various sports like running, cycling, swimming, and keep you up to date with Smartwatch functions. Unfortunately, Garmin is not yet included, because the manufacturer does not yet have a corresponding model in the shops.
|Apple Watch ab Verson 4||Fitbit Sense||Withings ScanWatch|
|Display||Color-Touch-Display||Color-Touch-Display||Analogue + small PMOLED-Display|
|Battery life Watch mode | GPS|
|1d - 3d | N/A||6d | 12h||30d | -|
|Weight||starting at 47.8 gram||starting at 46,3 gram||starting at 58 gram|
|Heart rate sensor||Yes||Yes||Yes|
|ECG FDA Approval||Yes||Yes||Yes|
|ECG-Measuring Principle||Fingercontact on watch crown||Hand lay on housing frame||Hand lay on bezel|
|Indications of Atrial fibrillation (AFib)||Yes||Yes||Yes|
|Warning at atypical heart rate (too high, too low, irregular heart rate)||Yes||Yes||Yes|
|Share ECG results with doctor||Yes||Yes||Yes|
|Heart Rate Oximeter||Yes||Yes||Yes|
|Indications of Respiratory Disorders/Sleep Apnoea||Yes||Yes||Yes|
|GPS||Yes||Yes||Connected GPS via Smartphone|
(running, swimming, cycling,...)
|Animated training courses on display||N/A||Yes||No|
|Integrated music -|
|Our individual test||Apple Watch 3 Test||Fitbit Sense||Withings ScanWatch|
Fitness smartwatch with ECG: With FDA approval
The following fitness smartwatches with ECG are currently approved and available and are allowed to indicate cardiac arrhythmia to the user.
Apple Watch Generation 4
Apple offers since the beginning of 2019 from Generation Watch 4 officially 1-channel fitness smartwatches with ECG. These can help to detect atrial fibrillation or warn in case of atypical heart rate (too high, too low, irregular heart rate). Until recently, subsequent models also contained corresponding functions.
This function is made possible by electrodes built into the Digital Crown and a new electrical heart rate sensor on the back of the housing. The user only needs to start the ECG app and press his finger on the Digital Crown. The ECG app then records the heart currents.
After 30 seconds, if the measurement is successful, the information and classification of the heart rhythm are available. These tell you whether the heart is beating in a normal pattern or whether there are signs of atrial fibrillation. If required, all this data is stored in a PDF file that can be presented to a physician.
If you want to know more about mainly sportive possibilities: our Apple Watch 3 Test.
Also the manufacturer Fitbit now offers a certified fitness smartwatch with ECG recording. The Sense is their new TOP model. Numerous exclusive and novel features are intended to distinguish it not only from its own models but also from those of other manufacturers. The keyword Biosensor Core conceals a series of new sensors. These include the one for the 1-channel ECG function, which is limited to the detection of atrial fibrillation.
An ECG is performed manually, with the fingers of the hand on which the watch is not worn touching the watch’s case frame. After the measurement, successfully acquired data can be exported as a PDF file and sent to a physician. The new heart rate sensor also detects an unusually high or low heart rate. These can be indications of heart disease that should be examined by a doctor, such as bradycardia (heart rate too slow) or tachycardia (heart rate too fast).
A GPS receiver and built-in fitness tracker are included. With up to 6 days it also offers a decent battery life. In terms of price, the manufacturer is now venturing into higher priced regions with this product, as the RRP price starts at $329.95.
Withings Move ECG
One of the first fitness smartwatches with ECG is the Withings Move ECG. Compared to the other watches presented here, it has only an analog dial, so it also offers a very good battery life. The 1-channel ECG function is used to detect atrial fibrillation. In the event of tachycardia or other irregularities in the heartbeat, for example, the user simply presses the watch button on the side and places a finger on the bezel. The result of the ECG measurement is available after 30 seconds.
In addition, the model is waterproof up to 50 meters, can be connected to GPS via smartphone and serves as a general activity tracker.
The ScanWatch ECG fitness smartwatch from Withings is one of the newest and most exciting models on the market. The 1-channel ECG, is easily performed within 30 seconds via 3 electrodes (on the bezel, among others). The user is informed whether the measurement indicates a normal heart rhythm or atrial fibrillation. After an ECG recording, the data is automatically available in the Health Mate App. The data can also be forwarded to medical specialists as a PDF file:
Like all other models presented in this paper, this model is unable to detect other heart diseases such as heart attack. The heart rate sensor should be able to detect an atypical heartbeat, i.e. one that is too high, too low, or irregular, and alert users to it.
But the ECG watch can do even more: by pressing and turning the digital crown, data on date, heart rate, steps, distance, calorie consumption and altitude are available. There is no need to do without GPS because it can be connected to GPS via the smartphone. Furthermore, the oxygen saturation (SpO2) can be measured and a training mode can be started in the fitness tracker. Smartwatch functions are also available and of course it also notifies the smartphone of any notifications.
Samsung Galaxy Watch 3
After the Galaxy Watch Active 2, the Galaxy Watch 3 is Samsung’s second ECG fitness smartwatch with ECG. Here too, the fingers of the free hand are placed on the existing button to obtain a result after 30 seconds.
According to the manufacturer, approvals are only available for South Korea and now also for the USA.
Fitness smartwatches with ECG not on the market
The following fitness smartwatch with ECG do not yet have noFDA approval or are still in the approval process. For this reason, they are not yet officially allowed to inform the user of cardiac arrhythmia.
Amazfit Verge 2
Amazfit’s latest ECG fitness smartwatch Verge 2 (not to be confused with Fitbits Versa 2) is currently only available in China, with market launches in the USA and Europe planned. Amazfit’s trackers are usually to be found on the lower price shelves. We are therefore eager to see whether the model will actually be approved for the detection of cardiac arrhythmias and atrial fibrillation.
How does ECG technology work?
The 1-channel ECG
All fitness smartwatches with ECG known to us today have a 1-channel ECG in the sense of ECG derivation I. It is important to understand what distinguishes this ECG for home use from that of a specialist. This is because the 1-channel ECG offers only limited possibilities for detecting indications of heart disease. Furthermore, users should not rely on the technology always working successfully.
With the 1-channel ECG, the left and right arm are used to generate an electrocardiogram (ECG). The wearables have several ECG electrodes for this purpose, which are located on the back of the housing and thus have contact with the skin. Another one is either in the bezel, case frame or crown of the watch and is touched during measurements with the hand of the arm on which the watch is not worn. This creates a closed circuit through which tiny electrical signals are conducted that are generated by our heartbeat. These can be measured under the skin by the electrodes mentioned above.
For comparison: in a medical specialist, electrodes are normally attached to the skin near the heart by means of a 12-channel ECG, which also measure the electrical activity. However, the 12-leads provide much more measurements of the heart with which more types of heart disease can be detected.
To successfully record an ECG, it is important to follow the manufacturer’s instructions. Usually, these instructions instruct you to sit calm and relaxed, place your arm on a table and call up the ECG function. Arm and hand muscles should also be relaxed. After the measurement has been started, the user places his finger or palm on the bezel, case, crown or similar for 30 seconds, depending on the manufacturer, to cover the corresponding electrode.
After about 30 seconds, the watch will signal via the display and vibration alarms when the measurement is complete. A short information about the results of the ECG is usually displayed by the watch itself. Detailed information as well as the ECG is available in the manufacturer’s app. From the app, it can be exported or sent to a physician by e-mail (usually as a PDF file).
Currently, the 1-channel electrocardiograms generated in this way can be helpful for the following health claims:
- The smartwatch classifies the measurement as a normal sinus rhythm, which indicates an even heart pattern during a 1-channel ECG
- Signs of atrial fibrillation – known as AFib (Atrial Fibrillation) – based on the analysis of the sinus rhythm of the heart In this case, the two upper chambers of the heart move irregularly instead of pumping regularly. Atrial fibrillation should be detected and treated as early as possible, as a side effect is an increased risk of stroke.
- Heart rate appears too low or too high. These signs are associated with bradycardia ➚ (heart rate too slow) or tachycardia ➚ (heart rate too fast).
The big advantage
It is often the case that during heart examinations by the doctor the symptoms do not occur at the moment so that they have to be repeated. The great advantage of approved fitness watches with ECG is that, unlike an ECG taken by a specialist, users usually always have the devices with them. Thus, they can generate one or more 1-channel ECGs at the moment when a complaint occurs. This can help a doctor analyze the complaint from the outset and save lives.
What fitness watches cannot do with ECG
ECG fitness smartwatches offer only limited possibilities due to the 1-channel ECG as mentioned above. In addition to what they can do, users should therefore also be aware of what they cannot do. The first thing to keep in mind, according to the manufacturers, is that measurements are not as accurate as those made by specialists. This means that users can suffer from cardiac arrhythmia despite an unremarkable ECG. In case of doubt, a physician should always be consulted, especially if the user feels unwell. This doctor can perform a more detailed examination.
If the measurement is successful, the watches only provide indications and signs of the diseases mentioned above. The watch itself cannot detect any heart disease that may actually be present. Nor are the devices able to detect other heart conditions such as heart attacks, strokes or other diseases.
If measurements are not carried out correctly, the ECG watches are hardly able to detect signs of heart disease. So it can happen that they cannot classify the recording. For example, if the arms are not lying still on a table during the recording, the watch is too loose around the wrist or the hand muscles are too tense. It is also important that the other hand makes proper contact with the watch’s bezel/crown. For a small circle of users, certain circumstances may cause the current signal to be too weak, making the measurement difficult. For example, with people with anatomical deviations.
Some ECG watches automatically measure the heart rhythm with their pulse sensor to look for indications of atypical heart rate. However, this only happens during certain resting phases of the body. Therefore, if you are very active and in motion, you will benefit little from measurements taken automatically by the pulse sensor.
It is also not possible to automatically generate electrocardiograms. This can only be initiated manually by the user in resting phases, because the free arm is always needed.
Caution with pacemakers
Manufacturers advise not to use fitness smartwatches with ECG when wearing a pacemaker or other internal medical device. This is because the watches emit a small electrical signal into the body to record the electrocardiogram (ECG). This can disturb a pacemaker.
Fitness smartwatch with ECG function: Outlook
We hope that this article on fitness smartwatches with ECG function has given you a good overview of current models. We are curious to see which other manufacturers will jump on this bandwagon. It will be exciting to see who combines their model with other features such as GPS, fitness tracker and other features in such a way that the result is a watch with the greatest possible health overview and early warning functions.