The Apple Watch’s ECG Feature Is Finally Here. It’s Cool. Maybe Scary Too.

If I had told you 10 years ago that your watch could perform an ECG good enough to win clearance from the FDA would you have believed me?

The new heart-monitoring features of the Apple Watch, which roll out today in the United States, are in no way equivalent to a visit with a cardiologist. This is obvious, or should be, because Apple explains it in excruciating detail before you can even begin using them. These features arrive at market with the endorsement of the American Heart Association and after a big-ass study conducted with the help of Stanford University. They are slick, easy to use, and, in my limited experience with them, relatively accurate compared to a heart study I had done a few years ago.

And that’s really all you need to know. For people who care about their health and like the Apple Watch, the electrocardiogram app and AFib Notification are another good thing about the Apple Watch. They will inevitably save someone’s life by inspiring a medical workup that would not have otherwise occurred. If that life is yours, they will be best thing ever. If it isn’t, they’ll be more of a…novelty. And on the flip side, of course, someone may well get a false positive, get scared out of their Allbirds, and be really, really mad.

So here’s what we’re talking about. There’s a Food and Drug Administration–cleared single-lead ECG monitor (sorry, Apple Watch Series 4 only) and accompanying notification system for atrial fibrillation (AFib), the most common form of irregular heart rhythm. The watch intermittently analyzes heart rhythm in the background and sends a notification if it detects an irregular heart rhythm on five rhythm checks in a certain time.

Some will roll their eyes at this. They will note that Apple’s single lead ECG is not a true ECG, which uses 12 leads (leads are electrodes placed on the body surface). They will argue that it can’t detect heart attacks. They will make wisecracks about the app’s rigorous disclosure and consent onboarding process which very carefully, painstakingly frees Apple of any legal liability.

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