How to use the ECG app, set up irregular rhythm notifications on the Apple Watch

Got an Apple Watch Series 4? You can now use the electrocardiogram app to see your heartbeat in real time, and also get notifications for when the watch identifies atrial fibrillation and other irregular heart rhythms. These features are potentially lifesaving, which is why you’ll want to take a few minutes to set them up. Here’s how.

Download the latest version

apple watch
Joel Chokkattu/Digital Trends

The ECG app and irregular heart rate notifications are exclusively available for the Apple Watch Series 4, in WatchOS version 5.1.2. You’ll need to open the Watch app on your iPhone, scroll down, and tap on General > Software Update > Install if you haven’t installed the update yet.

Disclaimers

There are a few disclaimers you should keep in mind. First, the data provided by the ECG app is “intended for informational use only,” according to the U.S. Food and Drug Administration. You should always contact a qualified health care professional before interpreting or taking any clinical action based on this data. As the FDA said, it’s “not intended to replace traditional methods of diagnosis or treatment.”

The ECG app is also not meant to be used by people younger than 22 — in fact, you won’t be able to move past the setup process if you are younger than 22. Finally, Apple says the ECG app or Apple Watch cannot detect strokes or heart attacks. If you aren’t feeling well, you should contact a physician immediately.

The ECG app has FDA clearance, not FDA approval. Approval is given to Class III products that tend to have high risk, but Class I and II (the app is classified as the latter) are for lower-risk products. The app also only works in the U.S. right now. If you bought the Apple Watch in a different country, changing the watch’s region to the U.S. will not allow you to use the ECG app. You’ll have to wait until Apple gets approval from respective government agencies.

How to set up the ECG app

apple watch ecg setup
Joel Chokkattu/Digital Trends

Once your Apple Watch is up-to-date, open the Watch app and scroll down to Heart. Here, you will see an option to Set up the ECG App in Health. Tap on this, and you’ll be taken to the Health app. A brief description of the ECG app will appear, along with the option to Set up ECG app. Tap this option to start the process. You will need to provide your date of birth.

You’ll be greeted by more descriptions of how the ECG app works — you can press Continue after reading them all — and a further breakdown will show the different types of results you will see, ranging from sinus rhythm to atrial fibrillation (or AFib). You can read Apple’s descriptions for these results here.

Apple will then mention some of the disclaimers we’ve mentioned above, including how the Apple Watch cannot detect a heart attack, how it cannot detect blood clots or a stroke, and how it cannot detect heart-related conditions. Tap Continue, and you’ll finally be ready to take your first ECG.

Before you do that, make sure the Apple Watch is on the wrist you selected when you first set up the watch. To double-check, you can open the Watch app on your iPhone, tap General, and open Watch Orientation. Choose the wrist you want the Apple Watch to be on. Make sure the Apple Watch sits snugly around your wrist to ensure an accurate reading.

Now it’s time to find the ECG app. Tap the crown on the side of the Apple Watch to open the app switcher. You need to look for a white app with a red heartbeat on it. That’s the ECG app (you can see an example on the iPhone in the image above). Tap on the app to open it. Make sure your arm is flat on a table or on your lap, and now hold your finger on the crown on the side of the Apple Watch. Stay still for 30 seconds, and make sure your finger stays on the crown. You’ll be able to see your heartbeat on the watch, and it’s a little mesmerizing.

Once the 30 seconds are complete, you will get one of the results we mentioned above, such as sinus rhythm. Just open up the ECG app on the watch whenever you want to take the test again.

How to send ECG app data to your physician

While you should not take clinical action based on the data from your Apple Watch, the ECG reports can be beneficial as supplementary data for your physician. It’s easy to export the reports you get from the Apple Watch. Open the Health app and tap on the Health Data tab at the bottom. Tap on Heart, and find the Electrocardiogram you just took. Tap this, and you will be able to see the report. Open it, and there will be a button to Export a PDF for your doctor.

When you click on this, you’ll see a PDF version of your report, along with the Share button at the top right. Tap it to see the list of apps you can use to share the PDF. Choose the appropriate app, whether it’s the Mail app or Gmail, and you’ll be able to send the report to straight your doctor’s inbox.

How to set up irregular rhythm notifications

how to use ecg app set up irregular rhythm notifications apple watch
Joel Chokkattu/Digital Trends

The Apple Watch can alert you to high or low heart rates, or even irregular heart rhythms. To do this, open the Watch app on your iPhone and tap on Set up irregular heart rhythm notifications in Health. This will open up the Health app again, and you’ll be greeted with a brief description of atrial fibrillation, a type of irregular heart rhythm. Tap Continue, and you’ll need to add your date of birth again. You will also need to indicate if you have been diagnosed with atrial fibrillation by a doctor.

Next will be a series of tips you should know, some of which we’ve already discussed. Apple wants to make it clear that the Apple Watch cannot detect heart attacks, and it’s not constantly looking for AFib. Tap Continue, and now Apple will describe what you need to know when you get a notification — essentially, you should contact your doctor and discuss it with them.

Tap on Turn on Notifications, and that’s it.

How to turn off irregular rhythm notifications

Now how do you turn it off? It’s simple. Open the Watch app, go to Heart, and toggle off the button next to Irregular Rhythm.

Emerging Tech

Awesome Tech You Can’t Buy Yet: Write music with your voice, make homemade cheese

Check out our roundup of the best new crowdfunding projects and product announcements that hit the web this week. You may not be able to buy this stuff yet, but it sure is fun to gawk!
Wearables

Tips and tricks to get you started with your new Fitbit Inspire HR

The Inspire HR may be an entry-level fitness tracker in Fitbit's lineup, but the device still has plenty of features to explore. These are our favorite tips and tricks to help you use the Inspire HR to its fullest potential.
Wearables

Fitbit Versa Lite tips and tricks to get started with your new smartwatch

Got your hands on a Fitbit Versa Lite? The smartwatch may be the pared down version of the more expensive Fitbit Versa, but there's still plenty for you to tweak in the settings. Here are our Fitbit Versa Lite tips and tricks.
Mobile

Even older Apple Watches could be effective at spotting heart conditions

The Apple Watch Series 4 is known for detecting heart conditions like atrial fibrillation thanks to having an electrocardiograph feature. It turns out that older Apple Watches could be effective at tracking AFib, too.
Deals

Stay fit and save cash with our top 10 affordable Fitbit alternatives

As much as we love Fitbits, they're rather expensive. If all you want is a simple activity tracker, however, then check out these great cheap Fitbit alternatives. With offerings from brands like Garmin, you don't need to pay full price.
Deals

It’s time to check out the best Apple Watch deals for March 2019

The Apple Watch has surged to prominence in recent years. If you're in the market for an iOS wearable, we've sniffed out the best Apple Watch deals available right now for all three models of this great smartwatch.
Wearables

Spring is here, and Apple’s beautiful new Watch bands will help you celebrate

Apple knows that seasons matter in the fashion world, and has refreshed its most popular Apple Watch bands to celebrate the arrival of spring. See them all, including our new favorite teal versions, here.
Home Theater

Here are some common AirPods problems, and how to fix them

Apple’s AirPods are among the best fully wireless earbuds we’ve seen, but they’re not perfect. If you’re having trouble, take a look at our guide to the most common problems and what you can do to fix them.
Wearables

Garmin adds a splash of spring color to its Instinct hiking smartwatches

Just in time for the spring season, Garmin is refreshing its Instinct GPS smartwatch with a fresh coat of paint that brings three new colors to this outdoors-focused watch that debuted last fall.
Mobile

Apple patent suggests Apple Watch bands could have built-in fitness indicators

Apple may be exploring ways to make Apple Watch bands a little more useful. A new patent has been filed by Apple that suggests Apple Watch bands could eventually have indicators for things like fitness goals.
Wearables

Fossil made a smartwatch in 2004, and it’s part of a new brand retrospective

Fossil has been making watches for 35 years, and to celebrate the anniversary, it has a new retrospective exhibit complete with the first smartwatch it made — the Wrist Net watch from 2004.
Deals

Make some time for the best smartwatch deals for March 2019

Smartwatches make your life easier by sending alerts right on your wrist. Many also provide fitness-tracking features. So if you're ready to take the plunge into wearables and want to save money, read on for the best smartwatch deals.
Wearables

Fossil is working on a smartwatch with BMW, and it’s coming next year

Fossil, the watch company that makes smartwatches under its own name and partners with other major brands too, intends to launch a smartwatch with car manufacturer BMW in the future.
Mobile

Diesel’s denim-inspired smartwatch straps are a casual, colorful must-own

Diesel will release two new versions of the On Full Guard 2.5 smartwatch later this year, with seriously cool, denim-inspired straps in classic Diesel colors. We tried them on at the Baselworld 2019 show.