In 2019, the American Heart Association published a striking and very worrying report in the Journal Circulation. About half of the American adults are suffering from heart disease.
Smartwatches are nowadays real health powerhouses. So, recording a single lead Electrocardiogram and letting the algorithm do the analysis and interpret the results may be a lifesaver in some cases.
Choosing the right Android watch with ECG is not an easy task, though.
In this article, we will present what we think are the best models to consider. Our goal is not to give you a long list of all models offering such features but to concentrate on only those cleared by the regulators.
Even though ECG smartwatches are not considered medical devices, an unreliable analysis can have severe health consequences. Hence, we advise you to select carefully and always check with your doctor if a heart rhythm anomaly is detected.
Best Overall: Samsung Galaxy Watch 4
The Samsung Galaxy Watch 4 is the latest addition to the excellent Sansing range of smartwatches.
The new models come as Watch 4 or Watch 4 Classic, including more prestigious built materials such as a stainless steel case and a leather strap. Apart from this and the choice of different bezel sizes (40mm/44mm for the Watch 4 and 42mm/46mm for the Watch 4 classic), the internal structure and components are the same.
Design
In a nutshell, the Samsung Galaxy 4 shows a less rugged look and could be seen as the next evolution of Galaxy Watch Active 2. At the same time, the Galaxy Watch 4 Classic with its signature rotating bezel is more the descendant of the Samsung Galaxy Watch 3.
Both devices are circular. In addition, the Galaxy Watch 4 is available in two case sizes, 40mm and 44mm, and four color options, with black and silver accessible in both case sizes, green unique to the 44mm size, and pink gold exclusive to the 40mm size.
Both 42mm and 46mm versions of the Galaxy Watch 4 Classic are only available in two color combinations: black and silver.
They are MIL-STD 810G durable and water-resistant to 5ATM.
As for the display, both models rely on Super AMOLED displays with a resolution that varies depending on the size of the case.
Features
The battery life has certainly progressed from the previous models, but with 40 hours maximum, it may quickly become frustrating to recharge it every other day. On the other hand, wireless charging is somehow very convenient, and just half of an hour may be able to give you back enough power to go through the day.
Both models make the most of the new Exynos W920 for lightning-fast reaction time.
We will not go through the fitness and other features to concentrate only on the health-related ones.
The Galaxy Watch 4 has a newly developed three-in-one health sensor that can measure heart rate (plethysmography), take electrocardiograms (ECG), and assess body composition (Bioipedendance analysis or BIA): a first for a smartwatch.
The list of health features is long and should satisfy even the more demanding users. ECG and Blood Pressure rely on the Samsung Health Monitor App for calibration, recording, more detailed analysis, and easy sharing with your doctor.
The ECG feature is not intended to be used by users under 22 years old. Contrary to the Samsung Galaxy Watch 3, only one finger contact with the top right side button is needed to close the circuit and offer the benefits of a single-lead electrocardiogram.
The Samsung Health App will be the control center for the other health-related features, including:
- Sleep tracking,
- Heart rate monitoring,
- Stress level detection,
- Blood oxygen level,
- Body Composition
- Fall Detection
Why you should consider the Samsung Galaxy Watch 4
The Samsung Galaxy 4 has improved how it records electrocardiograms and detects a potential arrhythmia, including Atrial Fibrillation.
The Bioimpedance analysis is also an excellent addition to the Samsung Galaxy Watch 3, which already was a very competent health smartwatch.
Considering all of the additional workout and fitness features available, the Galaxy Watch 4 is undoubtedly the current best available android watch offering FDA-cleared ECG function.
Galaxy Watch 4 by Samsung
Price when reviewed: From $249.99
Pros
- FDA cleared ECG
- Numerous health features
- New 3-in-1 health sensor
- Stylish
- Competitive price
Cons
- The battery could be better
Runner up: Samsung Galaxy Watch 3
Apart from the newly developed Bioindepance sensor, the Galaxy Watch 3 includes most of the health and ECG features included in the Galaxy Watch 4.
For those willing to benefit from a good deal and who do not mind wearing a watch released one year ago, now is the perfect time to benefit from the discounts offered on one of the still best smartwatches available on the market.
Galaxy Watch 3 by Samsung
Price when reviewed: Variable
Best for Health Tracking: Fitbit Sense
When it comes to deciding between the Fitbit Sense and the Samsung Galaxy Watch 4, design is undoubtedly one of the main factors to consider.
Both watches are reasonably priced and come with plenty of health tracking features, including an FDA-cleared ECG. However, the Samsung Galaxy Watch 4 may be a better choice for those willing to get everything in a more classic form. On the other hand, the Fitbit Sense will be more devoted to those willing to go the extra health mile and benefit from the Electro Dermal Activity Stress Sensor and included thermometer.
In any case, there is no wrong choice.
Design
The Fitbit Sense relies on the same design codes as the Fitbit Versa 2, with which it shares a rounded square screen.
With dimensions 1.59 x 1.59 x 0.49 inches, the Fitbit Sense offers a lot of view space to navigate comfortably between the different menus and features.
The display is bright and crisp, even in bright daylight. Covered by gorilla glass, it is also scratch-resistant, even if we do not recommend letting it fall on the floor.
Features
The Battery life of up to 6 days is one of the strong points of the Fitbit Sense compared to the Samsung Galaxy.
The ECG works on the same principles as the Galaxy Watch 3 and requires holding the metal bezel surrounding the screen with two fingers to complete the circuit.
In thirty seconds, the Fitbit Sense will record a single-lead electrocardiogram and detect an irregular heart rhythm. In addition, the data will synchronize with the Fitbit App to allow a more precise analysis of the ECG reading and share the results in case heart problems have been detected.
More than a pure ECG watch, the Fitbit Sense comes with plenty of health-related metrics, including:
- Stress Analysis (Electrodermal Activity Sensor),
- Blood Oxygen Saturation (measured at night and potentially useful to identify sleep apneas even though this feature is not cleared by the regulators,)
- Skin Temperature (measured while you sleep,)
- Sleep Score (require a subscription to Fitbit Premium to make the most of it,)
- Resting Heart Rate used to dynamically compute the Active Heart Zones
- Breathing Rate,
- Heart Rate Variability
Why you should consider the Fitbit Sense smartwatch?
With an excellent display and plenty of health-related applications, including a single-lead electrocardiogram, the Fitbit Sense is an excellent choice for those looking for a competent watch to wear all day long without having to worry about bringing a charger.
The ECG does what we can expect from a single-lead analysis. But, unfortunately, this feature is somehow not available in every country, depending on the local regulators.
Overall, Fitbit defined what a Health watch, including an ECG device, should be with the Fitbit Sense. With plenty of watch faces and straps to choose from, a solid choice still makes a lot of sense, even if the device is already one year old.
Sense by Fitbit
Price when reviewed: 297.04
Pros
- FDA-Cleared ECG
- A lot of Health-related metrics
- A crisp display
- A long battery life
Cons
- GPS is not very responsive
- No possibility to respond to text messages
Best for style: Withings Scanwatch
The Withings Scanwatch falls into the category of hybrid smartwatches, meaning that except for a round PMOLED display, it looks like a very classic and classy watch that will fit any boardroom.
Withings recently released the Scanwatch Horizon that makes the most of the diving watches aesthetic codes. However, the internal electronics and features are identical to the standard Scanwatch.
Design
The Scanwatch carries a hint of timeless elegance that can only be found in mechanical watches. Built of Stainless steel and sapphire glass, the Scanwatch (available in 38mm and 42 mm) is a reminder of what classic Horlogerie was before the appearance of the touch screens and rotating bezels.
Features
The ScanWatch was the first hybrid wristwatch to be clinically certified to detect AFib and sleep apneas symptoms. In addition, it has gained CE medical certification in Europe for AFib detection and SpO2 monitoring.
According to Fitbit, the ScanWatch is the “most medically advanced wearable.” We are not convinced of that, but this is undoubtedly still a reality as far as hybrid watches are concerned.
One of the drawbacks of the small display is that the information provided is limited. It is then necessary to check all the results on the Health Mate app, which can save the ECG as a PDF file and share it with your doctor or an online electrocardiogram analysis service such as Vericardia.
Why you should consider the Withings Scanwatch?
The Withings Scanwatch combines the best of the two worlds and combines elegance with technology. The ECG is approved in Europe and appears to have also finally been approved in the US. On October 12, the company announced that they finally received clearance from the FDA for the ECG and SpO2 monitoring. This is excellent news! Withings is planning to toll out the ScanWatch in the US from November at a price of $279. If you want to check on your heart health but do not want to compromise on style, the Withings Scanwatch is definitely the watch you should consider.
ScanWatch by Withings
Price when reviewed: tbc
Pros
- 30 days battery life
- Stylish and smart
- Ecg and Sleep apnea detection
- FDA Cleares for ECG and SpO2
Cons
- Limited information on the internal screen (but it is linked to the design)
Best yet to come: Fitbit Charge 5
The newly released Fitbit Charge 5 is currently our absolute favorite when it comes to fitness bands. It includes all of the health Sensors of the Fitbit Sense in a smaller and more discreet form factor. We love it.
The Fitbit Charge 5 ECG update has been released on November 10 as well as the Daily Readiness Score making this fitness tracker the ultimate best when it comes to fitness or health tracking.
Charge 5 by Fitbit
Price when reviewed: $179.95
To Know More
What are the benefits of an ECG watch?
An electrocardiogram (ECG/EKG) is NOT only related to the analysis of the heart rhythm. For example, many smart or not-so-smart watches or fitness bands will measure the heart rate based on the blood flow detected via their Photopletysmographic sensor.
They somehow do NOT qualify as ECG watches. Let us explain why.
Analyzing the Heart Rhythm and not only the Heart Rate is critical
The heart is not beating like a metronome. Instead, there are slight differences between two consecutive heartbeats. These differences will be the basis of the Heart Rate Variability (HRV.)
Measuring the Heart Rate is relatively simple. Just count the number of heartbeats during 30 seconds, and that is it! Any smartwatch can do that, and you certainly do not need to pay hundreds of dollars to get this metric right.
Measuring the Heart Rhythm is much more complex as there will be a need to detect the microcurrents emitted by the heart, hence the need for an ECG tracking feature.
The figure below shows that the same heart rate will somehow show different heart rhythms.
Atrial Fibrillation is the prototype of what a heart rhythm disorder is. It will often lead to what is known as palpitation and feeling your heart pounding very fast into your chest.
ECG smartwatch will detect the heart rhythm and rely on powerful FDA-cleared algorithms to tell you if you are potentially suffering from bradycardia (slow heartbeats), Tachycardia (fast heartbeats), or Atrial Fibrillations.
What you should look for in an ECG watch?
An ECG watch is a complex device because it often relies on multiple sensors to detect the heart’s electric activities.
An electrocardiogram is traditionally performed at the doctor’s office or the hospital and will allow looking at the different electric axes of the heart. By looking at how the electric currents propagate within the heart, cardiologists will have the ability to diagnose heart diseases and even glimpse at the overall morphology of the heart.
A watch will never replace a clinical ECG, but it may offer warning signs that warm the user and invite him to visit a doctor for a more thorough examination. This is precisely what we can hope from these devices: To make users aware that their heart rhythm may justify a more thorough medical exam.
In conclusion
Heart Health is a significant concern, and an FDA-approved ECG smartwatch is undoubtedly an easy way to make the difference between a normal sinus rhythm and atrial fibrillation.
A reliable ECG smartwatch is not reserved anymore to Apple Watch owners. Android users have many choices to go beyond a simple fitness tracker and add ECG monitoring to their health routine.
The Samsung Galaxy Watch 4 is our overall winner, but all smartwatches presented here offer reliable analysis of the heart rhythm. The choice is more in the design and additional features than in the ECG functionality.
