Apple Watch Series 4 ECG heart monitoring feature could arrive in watchOS 5.1.2 update

Posted:
in Apple Watch edited November 28
Owners of the Apple Watch Series 4 may soon be able to use the long-awaited ECG feature, with internal Apple training documentation allegedly indicating support for the health-monitoring function will be provided in the final public release of watchOS 5.1.2.




A major new feature in the Series 4 models, the electrocardiogram (ECG) was touted at Apple's September event as being the first time a device has been made available over the counter to consumers. While the Apple Watch Series 4 shipped, the ECG function was notably absent at the time of release on September 21, but would be enabled at a later time by a software update.

While the current version of watchOS 5.1.1 does not currently include support for ECG, the in-beta watchOS 5.1.2 version may be the release that enables the functionality to users in the United States.

Internal training documents used in stores are claimed to state watchOS 5.1.2 will be required on the Apple Watch Series 4 in order to work. As the data is collected in the Health app on the iPhone, users are also required to update to iOS 12.1.1, another operating system currently undergoing beta testing.

The training document advises the ECG app for the Apple Watch is regulated and only available to use in the United States. Apple gained U.S. Food and Drug Administration approval less than 24 hours before the Series 4's on-stage reveal.

AppleInsider verified the existence of the document cited in the report by MacRumors, but could not confirm the contents, or which watchOS version was listed as containing the feature.

Store employees are also instructed to tell consumers the ECG app "is not intended to be a diagnostic device or to replace traditional methods of diagnosis." The app should also not be used to "monitor or track disease state or change medication" without first speaking to a doctor.

It is unclear exactly when watchOS 5.1.2 will be released for public use, as it is entirely possible that it could be pulled beforehand. Currently watchOS 5.1.2 is on its second developer beta in the testing cycle while others are on their third iteration, and with the relatively few additions made in each update, may indicate a public release could happen very soon.
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Comments

  • Reply 1 of 14
    This is good news! I can't wait to try it out!
    watto_cobra
  • Reply 2 of 14
    This is good news! I can't wait to try it out!
    As long as we are "not dying to try it"  :)
    StrangeDaysMustSeeUHDTVMacProforgot usernamewatto_cobrajony0
  • Reply 3 of 14
    I hope they release it soon and don't flutter it up.
    watto_cobra
  • Reply 4 of 14
    The next big question is how long is this going to take to get approval in other countries? Will it be a painfully slow roll out like ApplePay? If its not officially for diagnostic then surely the approval process should be quick in other countries - hopefully.
    caladanianwatto_cobra
  • Reply 5 of 14
    laytech said:
    The next big question is how long is this going to take to get approval in other countries? Will it be a painfully slow roll out like ApplePay? If its not officially for diagnostic then surely the approval process should be quick in other countries - hopefully.
    Painfully slow internal roll outs indeed: The carriers in Norway still do not support eSim for the watch for example. 
    watto_cobra
  • Reply 6 of 14
    When do you expect it to be available in the Philippines, where is no ApplePay, TV App and so on? Still we need to pay a premium price for iPhones, AppleTV and Apple Watch.
    We not have an official Apple Store in the country and online orders are coming mainly from Shanghai and arrive after 3 to 4 weeks.
    forgot username
  • Reply 7 of 14
    MacProMacPro Posts: 17,776member
    When do you expect it to be available in the Philippines, where is no ApplePay, TV App and so on? Still we need to pay a premium price for iPhones, AppleTV and Apple Watch.
    We not have an official Apple Store in the country and online orders are coming mainly from Shanghai and arrive after 3 to 4 weeks.
    I hear you.  People laugh and rarely believe me when I tell them that one of the reasons I moved to the USA 30 years ago from the UK was to be at the bleeding edge of technology. Along with the climate, it was an indeed the major factor.  The UK is not all that far behind either but way too far for my liking at the time.
    edited November 29 watto_cobra
  • Reply 8 of 14
    AmaniSofiaAmaniSofia Posts: 2unconfirmed, member
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
  • Reply 9 of 14
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
    No, it's totally just a fake EKG where Apple takes their unreliable heart rate monitor and put it on a pretty graph tricking people to think they are getting a real EKG. I'm throwing away my Series 4 and getting one of those Samsung phones you are talking about RIGHT NOW!
    watto_cobra
  • Reply 10 of 14
    GabyGaby Posts: 25member
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
    It’s is a 1 lead, two electrode ECG that while in comparison to a full 12 lead is not capable of tracking and detailing comprehensive signals, it is still an electrical heart sensor and works completely differently to photoplethysmography, which is used to measure a persons’ Sats, perfusion Index, pulse and HRV etc. So yes it is an ECG but in a more simplistic and user friendly form. Until activated we have no way of knowing for sure but it will likely measure R-R intervals, and possibly more depending on the sensitivity and algorithms used, however, all single leads have limitations as it currently stands. It would be interesting if Apple created Bluetooth connected electrodes for other areas of the body, as even 1 lead ECG can be used sequentially for full 12 lead recordings. However due to the learning curve I doubt they would opt for this, but they could potentially gather more data to be processed by the watch. In terms of the QRS I’m not certain. Nevertheless, coupling the ECG with the optical sensors and one already has useful information for at home monitoring and sharing with primary care providers.
    Hope this helps  :)

    I think future revisions will become extremely useful; I dare say essential. The⌚️in its current form has shown life-saving potential, so I am so excited to see where Apple goes from here. Looking toward the next 3-5 years I can imagine them fabricating custom smart clothing with bio-electrodes woven in to provide truly comprehensive medical grade monitoring which would be a a gigantic leap forward and negate the problem of the layman learning about proper lead placement etc...                 When I think of the potential of smart clothing, and the types of sensors and monitoring that can be automated... That type of simplicity and seamless integration just screams Apple to me, and the possibilities are limitless. 

    edited November 29 forgot usernamewatto_cobra0luke10luke1jony0
  • Reply 11 of 14
    AmaniSofiaAmaniSofia Posts: 2unconfirmed, member
    Gaby said:
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
    It’s is a 1 lead, two electrode ECG that while in comparison to a full 12 lead is not capable of tracking and detailing comprehensive signals, it is still an electrical heart sensor and works completely differently to photoplethysmography which is used to measure a persons’ Sats, perfusion Index, pulse and HRV etc. So yes it is an ECG but in a more simplistic and user friendly form. It would be interesting if Apple created Bluetooth connected electrodes for other areas of the body as even 1 lead ecg can be used sequentially for full 12 lead recordings. However due to the learning curve I doubt they would go that far, but they could potentially gather more data to be processed by the watch. Couple the ECG with the optical sensors and one already has quite useful data for at home monitoring and sharing with primary care providers. I think future revisions will become extremely useful; I dare say essential. The⌚️in its current form has shown life-saving potential, so I’m extremely excited to see where Apple goes from here. 
    Hope this helps  :)

    Thanks for the reply Gaby and for not being salty like Gutengel.  I am a little skeptical as how it could measure that potential using your wrist and applying the opposite finger to the watch. Those would be just two very distal limb leads. It would have to be very sensitive to measure that electrical potential.  I look forward to it coming out and will be trying it out on patients who have a left bundle branch block and will see if the there is truly a difference in the QRS complex. As for wireless monitor there are some promising ones out there. Qardiocore has one that is not yet approved in the states, but is  wearable EKG monitor. Also several companies sell wireless EKG patches that Bluetooth to your phone. These work just like implantable loop recorders. The future potential of these things in the health care setting is huge. Imagine being able to wear a multi lead EKG monitor while your work out. The real hurdle with all these is the FDA which hopefully keep them consumer friendly and affordable.
  • Reply 12 of 14
    GabyGaby Posts: 25member
    Gaby said:
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
    It’s is a 1 lead, two electrode ECG that while in comparison to a full 12 lead is not capable of tracking and detailing comprehensive signals, it is still an electrical heart sensor and works completely differently to photoplethysmography which is used to measure a persons’ Sats, perfusion Index, pulse and HRV etc. So yes it is an ECG but in a more simplistic and user friendly form. It would be interesting if Apple created Bluetooth connected electrodes for other areas of the body as even 1 lead ecg can be used sequentially for full 12 lead recordings. However due to the learning curve I doubt they would go that far, but they could potentially gather more data to be processed by the watch. Couple the ECG with the optical sensors and one already has quite useful data for at home monitoring and sharing with primary care providers. I think future revisions will become extremely useful; I dare say essential. The⌚️in its current form has shown life-saving potential, so I’m extremely excited to see where Apple goes from here. 
    Hope this helps  :)

    Thanks for the reply Gaby and for not being salty like Gutengel.  I am a little skeptical as how it could measure that potential using your wrist and applying the opposite finger to the watch. Those would be just two very distal limb leads. It would have to be very sensitive to measure that electrical potential.  I look forward to it coming out and will be trying it out on patients who have a left bundle branch block and will see if the there is truly a difference in the QRS complex. As for wireless monitor there are some promising ones out there. Qardiocore has one that is not yet approved in the states, but is  wearable EKG monitor. Also several companies sell wireless EKG patches that Bluetooth to your phone. These work just like implantable loop recorders. The future potential of these things in the health care setting is huge. Imagine being able to wear a multi lead EKG monitor while your work out. The real hurdle with all these is the FDA which hopefully keep them consumer friendly and affordable.
    No worries, I don’t understand people who are snarky, rude or condescending, doesn’t help the one asking the question and really says a lot about a person.  I actually updated my post, as I missed out some points. But the algorithms used have just as much to do with accuracy as the hardware itself in many cases.  I’m In the UK so it’s a different system than the USA, even more stringent regulations in many cases, but in my opinion unless or until that you wish to make claims as to something being intended as a life saving device for example, I think there should be more leeway. I actually remember Tim Cook saying in 2014 or 15 that due to regulations Apple may well release devices alongside the watch but not as part of the device itself as it would slow innovation.  so I was a little surprised. Hopefully, as with regs for automated vehicles they relax or change the rules somewhat allowing for public testing and then if sufficient data is gathered that proves efficacy then they can make whatever health related claims. Regards. 
    watto_cobra
  • Reply 13 of 14
    Gaby said:
    Gaby said:
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
    It’s is a 1 lead, two electrode ECG that while in comparison to a full 12 lead is not capable of tracking and detailing comprehensive signals, it is still an electrical heart sensor and works completely differently to photoplethysmography which is used to measure a persons’ Sats, perfusion Index, pulse and HRV etc. So yes it is an ECG but in a more simplistic and user friendly form. It would be interesting if Apple created Bluetooth connected electrodes for other areas of the body as even 1 lead ecg can be used sequentially for full 12 lead recordings. However due to the learning curve I doubt they would go that far, but they could potentially gather more data to be processed by the watch. Couple the ECG with the optical sensors and one already has quite useful data for at home monitoring and sharing with primary care providers. I think future revisions will become extremely useful; I dare say essential. The⌚️in its current form has shown life-saving potential, so I’m extremely excited to see where Apple goes from here. 
    Hope this helps  :)

    Thanks for the reply Gaby and for not being salty like Gutengel.  I am a little skeptical as how it could measure that potential using your wrist and applying the opposite finger to the watch. Those would be just two very distal limb leads. It would have to be very sensitive to measure that electrical potential.  I look forward to it coming out and will be trying it out on patients who have a left bundle branch block and will see if the there is truly a difference in the QRS complex. As for wireless monitor there are some promising ones out there. Qardiocore has one that is not yet approved in the states, but is  wearable EKG monitor. Also several companies sell wireless EKG patches that Bluetooth to your phone. These work just like implantable loop recorders. The future potential of these things in the health care setting is huge. Imagine being able to wear a multi lead EKG monitor while your work out. The real hurdle with all these is the FDA which hopefully keep them consumer friendly and affordable.
    No worries, I don’t understand people who are snarky, rude or condescending, doesn’t help the one asking the question and really says a lot about a person.  I actually updated my post, as I missed out some points. But the algorithms used have just as much to do with accuracy as the hardware itself in many cases.  I’m In the UK so it’s a different system than the USA, even more stringent regulations in many cases, but in my opinion unless or until that you wish to make claims as to something being intended as a life saving device for example, I think there should be more leeway. I actually remember Tim Cook saying in 2014 or 15 that due to regulations Apple may well release devices alongside the watch but not as part of the device itself as it would slow innovation.  so I was a little surprised. Hopefully, as with regs for automated vehicles they relax or change the rules somewhat allowing for public testing and then if sufficient data is gathered that proves efficacy then they can make whatever health related claims. Regards. 
    I can kind of understand the snark when "Is this truly EKG monitoring?" has been answered by the primary source (Apple) several times and by secondary sources (newspapers) literally hundreds of times already. It really is a single-lead ECG. Not as good as a 12-lead, but enough to diagnose some conditions and to suggest further tests for others.

    At a technical level, Apple has switched to a new photoplethysmographic sensor with one emitter and a ring of eight detectors. Outside the PPG, they have two electrodes in contact with the wrist where the watch is worn. There is a third electrode in the center of the crown. Not sure what the wrist electrodes are made of, but the crown electrode is simple titanium.

    Using electrodes in these positions, it is relatively simple to get a single-lead ECG, it's just the amplifying and filtering equipment was relatively large and expensive. Consumer gym equipment has had low-quality single-lead ECG sensors for heart rate monitoring for decades. Amplifier and fabrication technologies have come a long way since then, and Apple's signal processing team is extremely good. I am not at all surprised they can extract diagnostic-quality single-lead ECG data from that starting point.
    watto_cobra
  • Reply 14 of 14
    GabyGaby Posts: 25member
    zimmie said:
    Gaby said:
    Gaby said:
    Is this truly EKG monitoring? Is this actually measuring the electrical potential and creating a true QRS complex? I think this is just taking your pulse and converting it to a generic EKG waveform. That is not earth shattering technology. Samsung phones have been able to monitor your pulse and oxygenation level for  quite some time. The potential for true multiple lead EKG monitoring is huge. Many companies are working on it now. However most of these attempts will be thwarted by the FDA and if ever approved will have a hefty medical markup in the American market.
    It’s is a 1 lead, two electrode ECG that while in comparison to a full 12 lead is not capable of tracking and detailing comprehensive signals, it is still an electrical heart sensor and works completely differently to photoplethysmography which is used to measure a persons’ Sats, perfusion Index, pulse and HRV etc. So yes it is an ECG but in a more simplistic and user friendly form. It would be interesting if Apple created Bluetooth connected electrodes for other areas of the body as even 1 lead ecg can be used sequentially for full 12 lead recordings. However due to the learning curve I doubt they would go that far, but they could potentially gather more data to be processed by the watch. Couple the ECG with the optical sensors and one already has quite useful data for at home monitoring and sharing with primary care providers. I think future revisions will become extremely useful; I dare say essential. The⌚️in its current form has shown life-saving potential, so I’m extremely excited to see where Apple goes from here. 
    Hope this helps  :)

    Thanks for the reply Gaby and for not being salty like Gutengel.  I am a little skeptical as how it could measure that potential using your wrist and applying the opposite finger to the watch. Those would be just two very distal limb leads. It would have to be very sensitive to measure that electrical potential.  I look forward to it coming out and will be trying it out on patients who have a left bundle branch block and will see if the there is truly a difference in the QRS complex. As for wireless monitor there are some promising ones out there. Qardiocore has one that is not yet approved in the states, but is  wearable EKG monitor. Also several companies sell wireless EKG patches that Bluetooth to your phone. These work just like implantable loop recorders. The future potential of these things in the health care setting is huge. Imagine being able to wear a multi lead EKG monitor while your work out. The real hurdle with all these is the FDA which hopefully keep them consumer friendly and affordable.
    No worries, I don’t understand people who are snarky, rude or condescending, doesn’t help the one asking the question and really says a lot about a person.  I actually updated my post, as I missed out some points. But the algorithms used have just as much to do with accuracy as the hardware itself in many cases.  I’m In the UK so it’s a different system than the USA, even more stringent regulations in many cases, but in my opinion unless or until that you wish to make claims as to something being intended as a life saving device for example, I think there should be more leeway. I actually remember Tim Cook saying in 2014 or 15 that due to regulations Apple may well release devices alongside the watch but not as part of the device itself as it would slow innovation.  so I was a little surprised. Hopefully, as with regs for automated vehicles they relax or change the rules somewhat allowing for public testing and then if sufficient data is gathered that proves efficacy then they can make whatever health related claims. Regards. 
    I can kind of understand the snark when "Is this truly EKG monitoring?" has been answered by the primary source (Apple) several times and by secondary sources (newspapers) literally hundreds of times already. It really is a single-lead ECG. Not as good as a 12-lead, but enough to diagnose some conditions and to suggest further tests for others.

    At a technical level, Apple has switched to a new photoplethysmographic sensor with one emitter and a ring of eight detectors. Outside the PPG, they have two electrodes in contact with the wrist where the watch is worn. There is a third electrode in the center of the crown. Not sure what the wrist electrodes are made of, but the crown electrode is simple titanium.

    Using electrodes in these positions, it is relatively simple to get a single-lead ECG, it's just the amplifying and filtering equipment was relatively large and expensive. Consumer gym equipment has had low-quality single-lead ECG sensors for heart rate monitoring for decades. Amplifier and fabrication technologies have come a long way since then, and Apple's signal processing team is extremely good. I am not at all surprised they can extract diagnostic-quality single-lead ECG data from that starting point.
    No, in point of fact it has two contacts on the wrist. It has two electrodes total, and it makes use of 4 green diodes and two infrared in the central optical sensor, and an unknown number of sensors for detection. And you’re preaching to the choir...  I don’t think you read my original post. 
    I don’t know about you but when someone asks a question I do them the courtesy of not making any assumptions about what they already know, not making them feel stupid, and being polite. 
    edited December 4
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