Apple Watch Series 4's ECG Feature Will Work Internationally When Set to U.S. Region

Discussion in 'iOS Blog Discussion' started by MacRumors, Oct 29, 2018.

  1. MacRumors macrumors bot


    Apr 12, 2001

    Apple revealed the Apple Watch Series 4 during an event in September, highlighting a new electrocardiogram (ECG) app that will be coming to users in the United States through a watchOS software update later in the year. Regulatory clearance is required for the ECG feature, and because of this it will be limited to the U.S. at launch, although the company is working on approval for other countries.

    In a new post by 9to5Mac today, code found within iOS related to the ECG feature suggests that the ECG limitation is based on software, not hardware. This means that gaining access to the ECG app in a non-U.S. territory will be as simple as changing the region of the Apple Watch Series 4 and connected iPhone to the United States.


    iPhone region can be changed by going to the Settings app > General > Language and Region, and then selecting the Region of your choice. Those who switch regions should note that the time, date, currency formats, and more will be affected by the change.

    The ECG app on Apple Watch Series 4 works by placing a finger on the Digital Crown while wearing the watch. The electrodes in the Apple Watch detect the electrical impulses from your heartbeat and route the data to the S4, where it is converted into a signal for Apple's algorithms. This results in a heart rhythm classification that can vary between a normal rhythm to an atrial fibrillation. All of your ECG results are stored in the Health app in PDF format and can be easily shared with your doctor.

    While the FDA has granted de novo clearance for the ECG feature, that's not the same as FDA approval and the agency does not recommend that the ECG feature be used by those under 22 or those who have already been diagnosed with atrial fibrillation. The FDA warns that Apple's ECG app is not designed to replace traditional methods of diagnosis or treatment and is intended for informational use only. The Series 4 is the first ECG product being offered over the counter directly to consumers.

    Article Link: Apple Watch Series 4's ECG Feature Will Work Internationally When Set to U.S. Region
  2. kdagher, Oct 29, 2018
    Last edited: Oct 30, 2018

    kdagher macrumors newbie

    Nov 12, 2017
    FaceTime application is also software based and not hardware, yet it doesn't work for phones bought in countries where FaceTime is banned (even if US store or Location was selected).

    The FaceTime App searches for the Model number from the approved list in Apple Servers or within the iOS itself and if it is not there it will simply not install nor show up in the APP store.

    Therefore, i assume it will be the same thing for the ECG App, unless Apple makes an exception..
  3. tom.humphrey macrumors member

    Jun 22, 2011
    Should I be impressed with this? Either have it set to my country and have time/date/currency correct, or try to use the ECG (touted as one of the major features) and have basic functionality incorrect everywhere....
  4. tehStickMan macrumors regular


    Jul 19, 2018
    Sweet can't wait for it to tell me my heart PSI while Siri shows me that I'm 12 feet away from my next left-turn.
  5. Putzytart macrumors newbie

    Apr 27, 2014
    Apparently ECG device approval normally takes years in the UK. As in like 4-5 years. I’m sure Apple will be fast tracking the process but good to know there is a stop gap measure for people who want a portable ECG
  6. Jetfire macrumors 6502

    Jul 10, 2008
    Cincinnati, Ohio, USA
    I don’t know about that. Qardio has their’s (Qardiocore) approved for Europe but it’s still not approved by the FDA in the USA. I can buy it on Amazon UK
  7. H2SO4 macrumors 601

    Nov 4, 2008
    One thing I love in life is sarcasm, (no really). That I'm sure, has a beneficial effect on the heart.
  8. ejfontenot macrumors 6502


    Dec 6, 2008
    I am sure that Apple will not recommend this as functionality. This could be seen as promoting a device that is not cleared for use in that geography.

    I know it is semantic, but Class II devices are typically "cleared" for use by the FDA. Approvals are related to devices that require a Pre Market Approval (PMA) and have a different process for review by FDA.
  9. CmdrLaForge macrumors 601


    Feb 26, 2003
    around the world
    I assumed they connect it to the Apple Store ID. So lets see. If true I might even get one. I don't think this is a feature I would use all the time.
  10. Rogifan macrumors Core


    Nov 14, 2011
    Isn’t the reason it’s not available everywhere at launch due to regulatory requirements? Which I would imagine are different across countries. It’s only natural that Apple would start with the US.
  11. strategicthinke macrumors 6502


    Feb 6, 2014
    Rio de Janeiro
    Apple News can be turned on by selecting a different region. And Apple has no reason to take away the ECG app from the watch, especially as they hope it will be approved in other places as well. So, I wouldn’t worry about it.
  12. tromboneaholic Suspended


    Jun 9, 2004
    Clearwater, FL
    Agreed. There is difference between being "banned" and "awaiting approval."
  13. Defender2010 macrumors 68030


    Jun 6, 2010
    Who in their right mind would ever think it was hardware based? Clearly Apple have not made two different watches - one type for US consumers and another for the rest of the world. :rolleyes:
  14. zorinlynx macrumors 603


    May 31, 2007
    Florida, USA
    I don't get why they can't just enable it world-wide, and just say "This is not a medical device. This feature is for entertainment only." in the areas where it doesn't have approval.
  15. srshaw macrumors 6502

    Aug 13, 2011
    Actually that's what I thought they did given that the cellular bands are different across different regions. The model numbers are certainly different between us/uk.
  16. Mike MA macrumors 68000

    Mike MA

    Sep 21, 2012
  17. centauratlas macrumors 6502a


    Jan 29, 2003
    You should be talking to the control-freaks who are running your government then about why are not allowing you the freedom to use a device they way you want to. So, no, you shouldn't be impressed with it, as long as you are looking at the correct people to blame for the lack of functionality in your country.

    It definitely sucks for people who buy the watch and then have their government block them from using all the features.
  18. zuiram macrumors member

    Jan 14, 2017
    Has anyone actually tested switching region, doing an ECG and switching back to their original region? If that works, it would probably be a worthwhile update.
  19. tromboneaholic Suspended


    Jun 9, 2004
    Clearwater, FL
    No one outside of Apple has been able to test it at all.
  20. simply258 macrumors regular

    Oct 15, 2003
    Well they did that for the dual sim Chinese phones, so why not? Maybe someone should try to use a Dual sim tray in another regions iPhone and see if it works.
  21. Jarman74, Oct 29, 2018
    Last edited: Oct 29, 2018

    Jarman74 macrumors regular


    Mar 22, 2009
    Not sure it would be a smart move when you have already spent millions in R&D to create a medical device. I mean, the last thing Apple may want is temporarily selling it as a toy and then awkwardly backtrack after it finally gets approval.

    It would be much safer to enable the feature with a warning every time you use it - e.g. it is an approved medical device in the US awaiting for approval wherever it is sold. But I guess this would not be a great user experience according to Apple, so they just decided to delay the feature altogether.
  22. KPOM macrumors G5

    Oct 23, 2010
    Time and date will be correct (it will still detect you are in another time zone), though activating cellular may not work. And you can simply switch modes when you want to run the ECG app.
    --- Post Merged, Oct 29, 2018 ---
    Since modern chipsets support over 25 LTE bands the new iPhones work just about everywhere. China was different only because they ban eSIM.
  23. tromboneaholic Suspended


    Jun 9, 2004
    Clearwater, FL
    However, there are different Apple Watch models supporting different bands for different regions. That said, it was fairly clear this was a software restriction.
  24. CmdrLaForge macrumors 601


    Feb 26, 2003
    around the world
    Maybe we hear some news about it tomorrow, even so I doubt that.
  25. Nmeyrick macrumors member

    Apr 10, 2015
    Actually changing the region seems to do much less than you would imagine; as far as I can recall it basically determines defaults for things like units, date display format etc - but crucially you csn still override these defaults to your preferred values.

    When apple pay launched I tried setting my AW 0 region to usa and found I was able to use apple pay on it in London a couple of months before it launched in the uk. I was only able to link one of my wife's us credit cards since uk banks weren't supported, but other than that it worked great. As best I recall I was able to change pretty much all other settings to uk values so that the USA region didn't really bother me

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