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

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.

applewatchseries4ecgfeature
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.

Related Roundup: Apple Watch 10
Buyer's Guide: Apple Watch (Neutral)

Popular Stories

iCloud General Feature Redux

iPhone Users Who Pay for iCloud Storage Receive an All-New Perk

Thursday February 6, 2025 11:21 am PST by
If you pay for iCloud storage on your iPhone, Apple has a new perk for you, at no additional cost. iCloud+ is the official name for Apple's paid iCloud storage plans, which range from 50GB for $0.99 per month to 12TB for $59.99 per month in the United States. iCloud+ plans already come with multiple perks for free, such as Hide My Email and HomeKit Secure Video, and now there is another one...
2007 iPhone

Apple Discontinuing This 18-Year-Old iPhone Feature

Saturday February 8, 2025 3:51 pm PST by
The end of an 18-year era is on the horizon for the iPhone. Apple reportedly plans to announce a new iPhone SE as soon as next week, and the device is expected to feature a full-screen design with Face ID, instead of a Touch ID home button. That means Apple will no longer sell any new iPhone models with a home button, for the first time since the original iPhone launched. The home button...
iOS 18

iOS 18.4 Will Include These New Features for Your iPhone

Wednesday February 5, 2025 7:15 am PST by
iOS 18.3 was released last month, so the first iOS 18.4 beta should be coming soon. iOS 18.4 is expected to be a more substantial update for the iPhone, with several new features and changes related to Apple Intelligence and beyond. Apple's website suggests that iOS 18.4 will be released in April, following beta testing. Below, we outline what to expect from the update so far. Apple...
iPhone SE 4 Single Camera Thumb

iPhone SE 4 Launching as Soon as Next Week

Thursday February 6, 2025 3:30 pm PST by
Apple's next-generation iPhone SE could debut as soon as next week with a launch to follow later in February, reports Bloomberg's Mark Gurman. Apple isn't expected to hold an event for the iPhone SE 4, and will instead unveil the device through a press release. The iPhone SE 4 is expected to have an iPhone 14-style design, with Apple eliminating the thick bezels and Touch ID Home button of...
iCloud General Feature Redux

Apple Ordered by UK to Create Global iCloud Encryption Backdoor

Friday February 7, 2025 2:37 am PST by
The British government has secretly demanded that Apple give it blanket access to all encrypted user content uploaded to the cloud, reports The Washington Post. The undisclosed order is said to have been issued last month, and requires that Apple creates a back door that allows UK security officials unencumbered access to encrypted user data worldwide – an unprecedented demand not before...
iOS 18

iOS 18.3.1 Update Coming Soon for iPhones

Thursday February 6, 2025 7:31 am PST by
Apple is internally testing iOS 18.3.1 for iPhones, according to our website's analytics logs, which have been a consistently reliable indicator of upcoming iOS versions. The software update should be released within the next few weeks. iOS 18.3.1 should be a minor update that addresses software bugs and/or security vulnerabilities. Apple Intelligence notification summaries for news and...
Apple Leak Feature

Apple Leaker Issues Apology: 'Profound and Expensive Mistake'

Friday February 7, 2025 9:21 am PST by
Last year, we reported that Apple sued its former software engineer Andrew Aude for providing journalists with confidential information about the company's future plans, including details about the Journal app, Vision Pro headset, and more. As reported by 9to5Mac, the Superior Court of Santa Clara County on Thursday dismissed the lawsuit after Apple and Aude reached an agreement to resolve...
imac video apple feature

Apple to Announce New Products Next Week

Saturday February 8, 2025 10:55 am PST by
Apple has yet to release any new devices in 2025, but at least two new products are expected to be announced next week, according to rumors. Below, we outline the new Apple products that are likely to be unveiled next week. iPhone SE 4 Apple plans to announce the long-rumored iPhone SE 4 as soon as next week, according to Bloomberg's Mark Gurman. The new iPhone SE is rumored to...

Top Rated Comments

tehStickMan Avatar
82 months ago
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.
Score: 5 Votes (Like | Disagree)
kdagher Avatar
82 months ago
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..
Score: 4 Votes (Like | Disagree)
srshaw Avatar
82 months ago
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:
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.
Score: 3 Votes (Like | Disagree)
Defender2010 Avatar
82 months ago
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:
Score: 3 Votes (Like | Disagree)
centauratlas Avatar
82 months ago
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....
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.
Score: 2 Votes (Like | Disagree)
tromboneaholic Avatar
82 months ago
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.
No one outside of Apple has been able to test it at all.
Score: 2 Votes (Like | Disagree)