The ECG app on Apple Watch Series 4, in combination with the smartwatch, allows you to perform an electrocardiogram directly from your wrist. And to record your heartbeat when you experience symptoms such as an accelerated heartbeat or irregular heartbeat. By doing so, helping users to collect important data to be shared with doctors.

This advanced feature has been available to users in the United States since the end of last year. It is now available in 19 European countries, including Italy, France, Germany, Spain and the United Kingdom.

These are weeks of intense activity for Apple, the latter. First the burst of new hardware that preceded the special event on services. With the arrival of the new iPad Air and iPad mini, the new iMac and the second generation AirPods.

Then, precisely, a special event entirely dedicated to new services. With the launch of Apple Card, Apple TV+ streaming platform and digital subscription services for magazines and gaming.

Now, for European users, the introduction of these features that greatly increase the potential of smartwatch.

Apps and hardware work in tune for health

The arrival in Europe is made possible by the fact that the ECG app and irregular heart rhythm notifications now have the CE marking. As well as the authorisation for the European Economic Area.

The notification function in case of irregular heart rate on Apple Watch will occasionally check the background heartbeat. And you’ll be sending a notification if you detect an irregular pulse index of atrial fibrillation (FA). In the United States, Apple has worked for several years with the Food and Drug Administration to obtain the De Novo classification for the ECG app and the notifications of irregular heart rhythms. And to make them available as services \over the counter \\.

These new features, ECG apps and irregular heart rate notification function are available as part of the free update to watchOS 5.2. They will help users identify possible symptoms of atrial fibrillation, the most common arrhythmia. If not treated, Cupertino points out, the FA is one of the main conditions that can cause a stroke, the second most common cause of death in the world.

According to the FAA, about 1.5 million people in the UK suffer from atrial fibrillation, the most widespread cardiac arrhythmia. But a third of these people may not be aware of having this problem.

How Apple Watch Series 4 makes the electrocardiogram

To make new features possible, the Apple Watch Series 4 hardware features and apps contribute. In the Digital Crown and back crystal on Apple Watch Series 4 there are new integrated electrodes. These interact with the ECG app to allow customers to perform an electrocardiogram similar to a single-derived ECG.

To make an electrocardiogram, at any time or following an irregular heart rate notification, users launch the new ECG app on Apple Watch Series 4 holding their index finger on the Digital Crown. When the user touches the Digital Crown, the circuit closes and the electrical signals that cross the heart are measured. After 30 seconds, the heart rhythm is classified as F.A., sinus or non-concluding rhythm.

All registrations, classifications and any symptoms found are securely stored in the Health app on iPhone. Users can then share a PDF of results with doctors.

Using the optical heart rate monitor integrated in Apple Watch Series 4 or later, the function of notification of irregular heart rhythm from time to time will monitor the user’s heart rhythm in the background. In order to verify the possible presence of irregular heart rhythm signals, the index of atrial fibrillation. It will then alert the user with a notification in case five rhythm checks over a minimum of 65 minutes detect an irregular pace.

Technology for the health of the heart

The fact that the ECG app is able to accurately classify the result of an electrocardiogram as AF and sinus rhythm, Apple reports, has been confirmed in a clinical trial with about 600 participants. The classification of a 12-derived ECG by a cardiologist, defined as a gold standard, was compared with the classification of the rhythm detected through an electrocardiogram simultaneously performed by the ECG app.

The study showed that the ECG app on Apple Watch had 98.3% sensitivity in classifying atrial fibrillation and 99.6% specificity in classifying sinus rhythm in the categorized recordings. Within the study, the ECG app was able to classify 87.8% of the readings made.

The notification function in case of irregular heart rate, still states Apple, has recently been examined in the Apple Heart Study. With over 400,000 participants, Apple Heart Study was the largest atrial fibrillation screening study ever conducted. And one of the main cardiovascular trials carried out so far.

A subset of data obtained from the Apple Heart Study was sent to the FDA to obtain authorisation for the notification function in case of irregular heart rate. In this substudy, consisting of participants who received an irregular warning of their beating on Apple Watch while wearing an ECG electrode, 80% showed signs of AF from the traditional ECG and 98% showed signs of AF or other arrhythmias of relevance

For these new functions related to heart health, customers will have to follow a specific configuration procedure on the device. This includes details about who can use them, what they can and cannot do these functions, what results can be obtained, how to interpret them. As well as clear instructions on what to do if you experience symptoms so it is advisable to consult a doctor immediately.


• Apple Watch has helped a lot of people around the world and it is an honor for us that it has become such a fundamental element in the lives of our customers. With these new heart rate detection features, Apple Watch plays an even more active role in the health of users, providing even more vital information. He said Jeff Williams, Chief Operating Officer of Apple.

With the ECG app and the function of reporting irregular heart rhythm, customers can now better understand and more consciously some aspects of their heart’s health. He said Sumbul Desai, MD, Vice President of Health for Apple.

Martin Cowie, Professor of Cardiology at the Royal Brompton Hospital, at Imperial College London, and President of the Digital Health Committee for the European Society of Cardiology, commented with these words. ♪ It’s exciting to see the potential of Apple Watch in providing a first indication of potential heart rhythm problems. Today, in Europe, about 11 million people suffer from atrial fibrillation, the most common problem of cardiac arrhythmia. An on-demand ECG and heart rate control could be a powerful tool for better managing heart health across Europe. The opportunity to innovate to optimize patient care is huge and this is a big step forward.

More information is available on the Apple website at this link.

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