Heart rate monitoring is something everyone wants to have on their smartwatches, and with the latest advancement in the health tracking features on wearable devices, some smartwatches now feature Electrocardiogram (ECG or EKG) sensors for more accurate heart rate monitoring.
There are few smartwatches with this technology on board, but not all of them are accurate and approved by the Food & Drug Administration (FDA), so in this article, I will be sharing a list of the best ECG smartwatches of 2021.
All smartwatches and wearable devices on this list have been tested and approved by the FDA for personal and clinical use. Although they might not be able to replace your doctor’s advice, these watches could help you greatly in monitoring your heart rate and detecting abnormalities in your heartbeat.
Can’t read the whole article? The list below contains my top picks on the best FDA-approved ECG watches right now.
- Apple Watch Series 5 – Best Overall
- Samsung Galaxy Watch 3 – Best For Android
- Withings Move ECG – Best Hybrid (only available in Europe)
- Apple Watch Series 4 – Best Series 5 Alternative
- Samsung Galaxy Watch Active 2 – Best Stylish
What Is An ECG & How Does It Work?
Everybody praises the watches that can detect heart conditions like AFib with ECG, but not everyone knows what this feature is or how it works in theory. If you don’t understand what ECG means and maybe you’ve heard it somewhere before, then I will try my best to explain it in detail below.
An Electrocardiogram (often called an ECG or EKG) is a technology that is used to record the electrical signals in your heart. It is a painless way doctors use to diagnose many common heart problems and some heart-related issues which a simple ECG procedure can detect include abnormal heart rhythm (known as arrhythmia), blocked or narrowed arteries, previous or present heart attacks, and more.
The ECG procedure is done with ECG machines, and you can find these machines at hospitals, clinics, ambulances, and generally any place where medical procedures are administered.
So How Does This Relate To Smartwatches?
Most wearable devices like smartwatches and fitness trackers make use of optical sensors when measuring heart rate. These sensors measure your heart rate by using flashing LEDs to penetrate the skin and detect blood, and while this method works most of the time in determining your heart rate, it is not as accurate as it should be, especially where heart issues are involved.
To solve this problem, some brands decided to find a way to implement the ECG technology on wearables like smartwatches hence releasing ECG enabled smartwatches. Apple was the first to launch this in 2018 with the release of the Apple Watch Series 4, and other brands like Samsung and Withings have also followed suit.
How Does ECG Work On Smartwatches?
You might be wondering how brands were able to fit in all the features of large ECG machines into a wearable device, well, that isn’t the case here.
Like I mentioned before, an ECG records the electrical signals in your heart. It does this by recording electric signals from the heart as it contracts with the help of multiple electrodes placed on the skin situated close to the heart.
The thing is, there is no way to fit in multiple electrodes into a smartwatch like the Apple Watch, for example, so the way ECG works in hospitals and clinics is way different from the way it works on smartwatches.
ECG machines in hospitals and clinics use a 12 lead with placement around the chest region for measurement, while smartwatches (like the Apple watch) use only a single lead. The difference? Well, a 12 lead ECG which is found in hospitals and clinics takes a lot of readings while the single lead can only take one reading at a time.
Note: ECG on smartwatches shouldn’t be relied on to detect heart attacks (even though they can) or all heart rhythm abnormalities because smartwatches can only take one reading at a time as they use a single lead measurement. These watches shouldn’t also be seen as a replacement for a doctor or regular heart checkups. Still, they can be of great help in monitoring your heart rate and detecting some heart-related issues.
What Can ECG Watches Detect?
Below are some heart problems which smartwatches with ECG can detect.
- Atrial Fibrillation – This is a situation where the heart beats too slowly, too quickly, or irregularly. If you’re diagnosed with AFib by your ECG-enabled watch, then you’ll need to see your doctor as soon as possible.
- Heart Attack – A heart attack is when the supply of blood to the heart is suddenly blocked. Some watches like the Apple watch give you a notification when this happens and moves to call any emergency contact or contacts you set.
- Abnormal Heart Rhythms – This is simply a situation where one’s heart isn’t beating in the regular or normal rhythm.
What ECG Watches Can’t Detect
- Chronic Heart Diseases – This is where the blood supply to the heart is completely blocked or interrupted by the build-up of fatty substances. ECG watches cant detect these conditions, so if you feel you have heart failure, see your doctor as soon as possible.
- Cardiomyopathy – This is a situation where the heart walls become enlarged or thickened. ECG-enabled smartwatches cant detect this condition.
The Best ECG Smartwatches & Devices To Buy In 2021
Below are my top picks on the best smartwatches with ECG monitor in 2021. I will also be giving a detailed review of these watches and some issues I found while using them.
Note: I will also be using ECG, EKG, and Electrocardiogram interchangeably here, just know they all mean the same thing.
1) Apple Watch Series 5 – Best Overall
The Apple Watch Series 5 is the latest smartwatch from Apple and the best ECG-enabled smartwatch in the market right now. Apple was the first brand to introduce ECG heart monitoring on smartwatches in 2018 with the Series 4. The Apple Watch Series 5 watch features improved ECG tracking from the last and also more robust health and fitness monitoring capabilities.
This watch is arguably the best health/fitness smartwatch you can purchase right now. The watch is also approved by the FDA and ECA for personal use, and you can get ECG readings similar to the ones we see at hospitals directly from an Apple Watch Series 5.. Quite impressive if you ask me.
To get your heart rate on the Apple Watch Series 5, all you need to do is fire up the ECG app, which comes preinstalled on the watch and place your finger directly on the side button or knob, which Apple calls the “Digital Crown”. Do this for 30 seconds straight to allow the electrodes installed on the crown read your heart’s electrical signals.
The ECG app on the Series 5 can detect whether your heart rhythm shows signs of atrial fibrillation which is a severe form of irregular heart rhythm or sinus rhythm, which means your heart is beating in a regular pattern.
A sinus rhythm ECG result indicates that your heart is beating uniformly between 50 and 100 BPM. In contrast, a result with atrial fibrillation (AFib) shows your heart is beating in an irregular pattern 50 and 120 BPM. Any result under 50BPM or over 120BPM is considered inconclusive, and this could be caused by some factors which include intense training, dehydration, stress, alcohol, infection, and others. You can learn more about ECG results from an Apple Watch here.
ECG aside, the Apple Watch Series 5 also comes with many exciting health and fitness tracking capabilities. Some of these include fall detection with emergency auto-dialing, menstrual cycle tracking (for females), noise detection + alerts, calories burned calculator, and more.
On its display, the Apple Watch Series 5 features a 1.78-inch bright touchscreen display, which gives you enough room to use most of its features directly on your wrist. The watch is also a standalone smartwatch, meaning that you don’t always need to have your smartphone connected all the time to use the watch.
Battery life on the Series 5 smartwatch is also pretty decent, and Apple says the watch should be able to last for up to 18 hours tops, but this could be significantly reduced when you have a ton of features enabled all the time. This is an area where the latest Apple watch lags, but it’s pretty much understandable due to tons of features that the watch comes with.
The Apple watch series 5 is also not compatible with Android smartphones, and I don’t see Apple dealing with this anytime soon. If you’re an Android, you might want to check out the Samsung Galaxy Watch 3 below. It’s not as good as the series 5 in the area of ECG heart monitoring but an impressive smartwatch with a ton of features and compatible with most Android (and iOS) devices.
Verdict: The Apple Watch Series 5 is undoubtedly the best ECG smartwatch out there but lags in the area of battery life. ECG results are almost as accurate as of the one you’ll get at hospitals and clinics, and aside from ECG, there are a ton of other health features and fitness apps included in the watch.
2) Samsung Galaxy Watch 3 – Best For Android Users
The Galaxy Watch 3 is Samsung’s latest smartwatch, and it features an ECG sensor too! It is also the best Apple Watch 5 alternative and comes with tons of other health fitness tracking capabilities.
Like the older Galaxy Watch Active 2, the Galaxy Watch 3 features most of the fitness tracking features you will find on most smartwatches these days, if not all. It comes with 40 sport modes, and these modes are focused on helping you get a more detailed fitness analysis for specific sports.
Some supported sports include running, swimming, climbing, and the likes. Thirty-three of the supported sports needs to be configured manually for tracking while seven are auto-tracked.
Now to the ECG monitoring. Samsung like Apple has also gone a step further to get FDA approval for the ECG functionality on the Galaxy watch 3 so if you choose to go for this smartwatch, know that the FDA approves the personal use of ECG feature for HR monitoring and it works just fine.
The blood pressure monitoring, however, is still pending FDA approval, and Samsung is currently working on that as of the time of writing this article and I’ll update it when Samsung finally gets FDA approval for the BP monitoring. Other fitness tracking features on the Galaxy Watch 3 include step counting, stress monitoring, breathing exercises, and more.
Like the Apple Watch, the Samsung Galaxy Watch 3 also comes with a Fall Detection feature that is able to detect when you fall and send an emergency SOS to any of the 4 emergency contacts you set. This is a handy feature for seniors and people with disabilities.
I find the fall detection on the Apple Watch Series 5 as a better option than the fall detection feature Samsung offers. Still, they work in the same way by taking continuous readings from the accelerometer while you have the watch on.
The Galaxy Watch 3 comes in two models/versions, which are the 45mm model (with a 1.4 inch AMOLED display) and the 41mm model (with a 1.2 inch AMOLED display). Both models have ECG heart monitoring capabilities, but the screen size and battery life differ. The 45mm model, due to its bigger size, offers a higher battery life of around two days while the 41mm model being the smaller model lasts for 18hours to 1day max.
Verdict: The Samsung Galaxy Active watch is currently the best all-round Apple Watch alternative for Android users (and iOS users too). The ECG feature on the watch works exceptionally well and can help in detecting various heart-related issues directly on your wrist.
3) Withings Move ECG – Best Hybrid
The Withings Move ECG is the only decent hybrid smartwatch I’ve seen with ECG heart rate monitoring in recent times. If you need a hybrid smartwatch with ECG, then this is the smartwatch for you. No doubt about that.
Withings tried to make this watch look as minimal (and traditional-looking) as possible without slacking on its features, so they won me over on this. The watch features a very stylish traditional looking design with lots of internal health and fitness tracking features to choose from.
They initially released the Withings Move, which came without the ECG feature and later released another model with ECG, which is the Withings Move ECG.
Getting an ECG reading on this smartwatch takes just 30 seconds, and you can do this by placing your finger on the metallic side button (just like the Apple watch) and allowing the watch to do its thing. It can detect irregular heart rhythms, and this is known as Atrial Fibrillation (or AFib) and also give you a detailed analysis of your heart rate via the “Health Mate” app when connected.
The Move ECG is quite thicker than the original Move smartwatch, and this is because of the built-in ECG but even at that, the Move ECG is still a very lightweight smartwatch when compared to other ECG-enabled smartwatches on this list.
It is a hybrid smartwatch that was built to look like regular traditional watches but with smart features so don’t expect things like smart notifications or touch screen on the Withings Move ECG.
The smartwatch, however, is not just an ECG smartwatch as it also features a lot of fitness tracking features too. Some of these fitness tracking features include calories burned calculator, steps counter, sleep tracker, and multiple sport modes for more fitness analysis.
On its downsides, the Move ECG smartwatch is currently pending FDA approval although it has already been approved by the ECA for use in countries in the EU. In summary, the Move ECG is only available for purchase in the EU and not the USA for now. Withings is currently working to get the watch approved by the FDA but till then, you cant purchase the watch if you live outside Europe.
Verdict: The Withings Move ECG is an excellent fitness-focused hybrid smartwatch, and one of the best ECG watches out there. Like I said earlier, if you need a hybrid smartwatch with ECG, then this smartwatch would be your best choice.
4) Apple Watch Series 4 – Good Series 5 Alternative
The Apple Watch Series 4, which was released back in 2018, is Apple’s first smartwatch to feature an ECG sensor for heart rate monitoring. It also comes with tons of fitness tracking features, and although there is a newer Apple Watch (series 5), the Apple Watch Series 4 still works great and well worth it in 2021.
There is not much to say on the ECG feature on the Apple Watch Series 4 as it works the same way the ECG on the Apple Watch Series 5 works. All you have to do is fire up the ECG app on the watch and hold the crown downwards for 30 seconds to get an ECG. The ECG app on the Series 4 & 5 smartwatches are the same, but the sensors are a bit different as the sensor on the Series 5 is newer and more advanced.
On its display, the Apple Watch Series 4 features a bright 1.78-inch bright touch screen display with always on. Battery life is also quite decent but will need to be charged almost every day if you use most of its features all the time.
The watch comes with most of the fitness tracking features as we see on the newer Apple Watch and Apple’s new fall detection, which is capable of detecting when you fall via the watch’s accelerometer and gyroscope.
Verdict: Although a slightly older model of the Apple Watch, the Apple Watch Serie 4 is still one of the best ECG-enabled smartwatches you can get right now. Like other Apple Watches, this isn’t compatible with Android devices, so if you’re on Android, you might want to take a look at the Galaxy Watch 3 or the Withings Move for ECG.
5) Samsung Galaxy Watch Active 2 – Stylish ECG Watch
The Galaxy watch Active 2 is an exciting premium smartwatch from Samsung, and like the Galaxy 3 I mentioned above, this watch also includes an ECG sensor for taking ECG readings and blood pressure monitoring.
Like the newer Samsung Galaxy 3 smartwatch, the Galaxy Watch also ships with an ECG sensor for taking ECG readings and it was just cleared recently for use in the USA by the FDA. The ECG feature on this watch was originally unavailable in most countries except South Korea but the latest update pushed by Samsung just recently saw them enable this for users in the USA and Canada.
The Galaxy Active 2 also comes with other fitness tracking features like blood pressure monitoring, steps counting, running coach, daily fitness reminders, and 39 sport modes designed to track your fitness when doing specific sports. Some supported sports include running, climbing, yoga, swimming e.t.c, and you can get recorded fitness data directly on your smartphone via the Samsung Health app.
On its display, the Galaxy Watch Active 2 features a bright [1.2-inch (40mm) & 1.4-inch (44mm)] round touchscreen display with always-on which can be enabled or disabled in the watch settings. Battery life is not the best in my opinion and this is a problem with feature-packed watches like this. The watch comes in 2 versions, the 40mm version, and the 44mm version. The 40mm version of the Active 2 gives you around 18 hours – 1 day of battery life while the 44mm version gives around two days of battery juice.
Verdict: The Samsung Galaxy Active 2 is an overall smartwatch without being the boss in any specific aspect. The ECG works just fine now and it is fully available in the United States.
6) Alivecor KardiaMobile 6L – Best Battery Life
The Alivecor KardiaMobile 6L is not a smartwatch like other devices mentioned above; instead, it is a six-lead ECG device you can have in your pocket. How cool is that?
It is an FDA approved personal clinical-grade EKG monitor which is capable of capturing medical-grade 6-lead EKG in seconds. The device can also detect heart conditions like Atrial Fibrillation, Bradycardia, and even tell if your heart is beating in a regular rhythm.
To get an ECG reading on the Alivecor KardiaMobile 6L, all you have to do is to fire up the Kardia Mobile app (which can be gotten on the Apple or Google Play Store) on your smartphone and tap on “Record Your EKG.” You will now be asked to put your fingers on the EKG monitor for 30 seconds (or slightly more) to get an ECG. It’s as easy as that!
Another impressive feature available on the Alivecor KardiaMobile 6L EKG monitor is the fact that you can share your ECG readings with a doctor via email directly from the app itself. You can also share your EKG data with a board-certified Cardiologist for regular reviews when you subscribe to KardiCare, which costs $9.99 monthly or $99 if you choose to pay yearly.
In addition to automatically sharing your EKG readings to certified Cardiologists for regular reviews, KardiCare members in the US also get discounted replacements at $19.99 if the device gets stolen or damaged.
The major downside to this device is that you have to pay a monthly fee to become a KardiCare member, which in turn allows you to use all its features. Don’t get me wrong; some of its features are free, and you can get an EKG without paying a dime after buying, but you have to pay a monthly fee to use specific features like sharing EKG with family and friends, regular EKG reviews by certified Cardiologists and more.
Another is the fact that it isn’t a smartwatch. Yeah, I know it isn’t meant to be a smartwatch and have all the fancy features we see on smartwatches, but I would have really loved it if AliveCor built this as a smartwatch and not an EKG-only device.
Verdict: The AliveCor is a 6-lead ECG monitor and one of the best personal clinical-grade EKG monitors, if not the best. If you need a lightweight standalone EKG monitor, then this is the device for you—no doubt about that.
7) SonoHealth Portable EKG – Best Standalone Personal EKG
The SonoHealth EKG is a portable standalone personal clinical-grade EKG monitor for individuals and families. Unlike other smartwatches and ECG-only devices on this list, this device is entirely standalone, and you can use it without connecting to a smartphone. You can, however, connect it to your smartphone to sync heart rate data via Bluetooth and the Sonohealth app, which is available on the Apple & Google Play Stores.
To get an ECG on this device, all you have to do is to place your fingers on the ECG sensors on the top of the device and wait for 30 seconds to get an ECG reading.
When compared to other (non-smartwatch) ECG monitors on this list like the KardiaMobile 6L, the SonoHealth EKG device stands out. First off, you don’t have to pay any fees to use all of its features, plus it takes less than a second to send your ECG reports to anyone, which includes your doctor via email.
The device can detect Atrial Fibrillation, which is a form of Arrhythmia and other heart conditions related to irregular heart rhythms. It is equipped with multiple sensors (leads) for more accurate measurements and more precise readings. These leads include a hand-to-hand EKG (LEAD I), a chest lead (LEAD V), and a foot lead (LEAD II, III).
Verdict: The SonoHealth EKG is one of the best portable multi-lead EKG monitors out there and a good value for your money. It’s not a smartwatch or a wearable device, but it’s very portable and does its job just as well as you would expect.
The KardiaMobile was the first EKG device released by AliveCor back in 2017 and unlike the KardiaMobile 6L I mentioned above which uses a 6-lead EKG, the KardiaMobile only uses a single lead. In case you don’t know what this means, a 6-lead EKG is capable of up to 6 readings at a time while a single-lead EKG can only take one reading at a time. In summary, the higher the leads, the more accurate the results will be.
Taking an ECG on the AliveCor KardiaMobile works the same way it works on the KardiaMobile 6L. All you have to do is download the Kardia app from any of the app stores (Google or Apple) and connect with the device. After that, launch the app and tap the “Record Your EKG” button. The app will request you place two fingers on the device for 30 seconds or slightly more, and once that’s done, you’ll get an ECG result which you can view or send to a doctor or anyone via email.
On its accuracy, the device is pretty accurate, and it is one of the best ECG monitors out there. Many users have praised the accuracy of this device, and it can detect various heart conditions like atrial fibrillation, Bradycardia (slower heart rate), and also tell if your heart is beating in a regular rhythm. As a single-ECG, don’t expect it to outperform the KardiaMobile 6L, which uses a 6-lead ECG, but it works and is accurate.
Like I said while writing a short review of the newer AliveCor KardiaMobile 6L, I wished these devices (the KardiaMobile and the KardiaMobile 6L) were complete smartwatches with ECG heart rate monitoring and not ECG only devices, but they perform their jobs just as perfect ECG-enabled smartwatches like Apple Watch does + more.
Verdict: The KardiaMobile is a good ECG monitor and one of the best personal clinical-grade single-lead ECG devices out there. If you need a budget-friendly alternative to the KardiaMobile 6L, which costs under $150, then this is the one one to go for.
There you have it; my top picks on the best smartwatches, wearables, and standalone devices with ECG heart monitoring right now. To be honest, there is no single “best” device for ECG monitoring, as they all have their flaws and positives.
If you need an ECG-enabled watch that detects heart conditions like AFib not minding the budget, then I highly recommend the latest Apple Watch, the Apple Watch Series 5, but then again, it does not support Android smartphones. The Apple Watch Series 4 is also a great alternative to the Series 5 when it comes to ECG + it is offered at a lower price.
Android user? Then go for the new Samsung Galaxy Watch 3, which has FDA-approved ECG + LTE support. The Galaxy Watch Active 2 is also a stylish and lightweight Galaxy Watch 3 alternative by Samsung which is offered at a reasonable price and comes a working ECG sensor for taking ECG readings.
Need a standalone ECG monitor? Then take a look at the SonoHealth EKG or the KariaMobile 6L. They are both excellent devices, although the latter requires a monthly subscription to use some of its features like clinical EKG review and sharing your EKG readings with family and friends.
Made the right buying decision? Let me know the device you got in the comments below. If you have any questions, you can also let me know in the comments, and I will provide answers to your questions as soon as I can.