Changing Your Apple Watch or iPhone's Region Won't Enable ECG App Outside of United States

Apple today released watchOS 5.1.2, which enables the ECG app on Apple Watch Series 4 models. However, as Apple made clear, the ECG app is currently only available in the United States and its territories of Puerto Rico, Guam, and the U.S. Virgin Islands, preventing it from being used internationally at this time.

applewatchseries4ecgfeature
Many software features on Apple devices are initially limited to the United States, but international users have often been able to simply change their iPhone or Apple Watch region to the United States to gain access.

That's not the case with the the ECG app on the Apple Watch Series 4, though, as it only functions on models purchased in the United States. Those who live in and bought an Apple Watch in Canada, the UK, or elsewhere abroad can't use the region-switching trick to enable the ECG app — it doesn't work.

Note that the ECG app requires an Apple Watch Series 4 with watchOS 5.1.2, paired with an iPhone 5s or newer with iOS 12.1.1.

Both the ECG app and irregular heart rhythm notifications are regulated features on the Apple Watch. Both features have been granted De Novo classification by the FDA for users 22 years and older in the United States. Apple says people already diagnosed with atrial fibrillation should not use the app.

It's unclear when the ECG app will expand to additional countries, but Apple Watch Series 4 models sold internationally do have the necessary electrical heart sensor. Apple is likely in the process of gaining clearance for the ECG app in other countries, but it has yet to comment on wider availability.

Related Roundup: Apple Watch 11
Tag: ECG
Buyer's Guide: Apple Watch (Buy Now)

Popular Stories

m1 chip slide

Five Years of Apple Silicon: M1 to M5 Performance Comparison

Monday November 10, 2025 1:08 pm PST by
Today marks the fifth anniversary of the Apple silicon chip that replaced Intel chips in Apple's Mac lineup. The first Apple silicon chip, the M1, was unveiled on November 10, 2020. The M1 debuted in the MacBook Air, Mac mini, and 13-inch MacBook Pro. The M1 chip was impressive when it launched, featuring the "world's fastest CPU core" and industry-leading performance per watt, and it's only ...
All Screen iPhone 2027 Feature 1

Apple to Hide Selfie Camera Under Display of 20th Anniversary iPhone

Monday November 10, 2025 1:55 am PST by
Apple will conceal the front-facing camera under the screen of its 2027 iPhone, a Chinese leaker said today, corroborating reports that Apple's 20th anniversary iPhone will have no visible cutouts in the display. Weibo-based account Digital Chat Station said Apple's development of under-screen camera technology was progressing as planned for adoption in 2027, one year after it will...
iphone air thinness

iPhone Air Sales Are So Bad That Apple's Delaying the Next-Generation Version

Monday November 10, 2025 11:41 am PST by
The thin, light iPhone Air sold so poorly that Apple has decided to delay the launch of the next-generation iPhone Air that was scheduled to come out alongside the iPhone 18 Pro, reports The Information. Apple initially planned to release a new iPhone Air in fall 2026, but now that's not going to happen. Since the iPhone Air launched in September, there have been reports of poor sales...
iphone pocket%402x

Apple Debuts iPhone Pocket, a Limited Edition iPod Sock-Style Accessory

Tuesday November 11, 2025 1:23 am PST by
Apple has teamed up with Japanese fashion house ISSEY MIYAKE to launch iPhone Pocket, a 3D-knitted limited edition accessory designed to carry an iPhone, AirPods, and other everyday items. The accessory is like a stretchy pocket, not unlike an iPod Sock, but elongated to form a strap made of a ribbed, elastic textile that fully encloses an iPhone yet allows you to glimpse the display...
iOS 26

iOS 26.2 Available Next Month With These 8 New Features

Tuesday November 11, 2025 9:48 am PST by
Apple released the first iOS 26.2 beta last week. The upcoming update includes a handful of new features and changes on the iPhone, including a new Liquid Glass slider for the Lock Screen's clock, offline lyrics in Apple Music, and more. In a recent press release, Apple confirmed that iOS 26.2 will be released to all users in December, but it did not provide a specific release date....
Early Black Friday Deals 1

The Best Early Black Friday Apple Deals on AirPods, Apple Watch, iPad, and More

Saturday November 8, 2025 6:16 am PST by
We're officially in the month of Black Friday, which will take place on Friday, November 28 in 2025. As always, this will be the best time of the year to shop for great deals, including popular Apple products like AirPods, iPad, Apple Watch, and more. In this article, the majority of the discounts will be found on Amazon. Note: MacRumors is an affiliate partner with some of these vendors. When ...
homepod mini colors

New HomePod Mini Coming Soon With These Features

Tuesday November 11, 2025 7:30 am PST by
Apple is expected to announce a new HomePod mini imminently, headlining with new chips. Here are all of the new features we're expecting. The second-generation HomePod mini is highly likely to contain a more up-to-date chip for more advanced computational audio and improved responsiveness. The current HomePod mini is equipped with the Apple Watch Series 5's S5 chip from 2019. Apple is likely ...
Apple fitness plus feature

Future of Apple Fitness+ 'Under Review'

Sunday November 9, 2025 5:30 am PST by
The future of Apple Fitness+ is "under review" amid a reorganization of the service, according to Bloomberg's Mark Gurman. In the latest edition of his "Power On" newsletter, Gurman said that Apple Fitness+ remains one of the company's "weakest digital offerings." The service apparently suffers from high churn and little revenue. Nevertheless, Fitness+ has a small, loyal fanbase that...
iphone black friday gold

The Best Early Black Friday iPhone Deals

Monday November 10, 2025 10:18 am PST by
Cellular carriers have always offered big savings on the newest iPhone models during the holidays, and Black Friday 2025 sales have kicked off at AT&T, Verizon, T-Mobile, and more. Right now we're tracking notable offers on the iPhone 17, iPhone 17 Pro, iPhone 17 Pro Max, and iPhone Air. For even more savings, keep an eye on older models during the holiday shopping season. Note: MacRumors is...
2024 iPhone Boxes Feature

Apple Adjusts Trade-In Values for iPhones, iPads, Macs, and More

Thursday November 6, 2025 11:12 am PST by
Apple today updated its trade-in values for select iPhone, iPad, Mac, and Apple Watch models. Trade-ins can be completed on Apple's website, or at an Apple Store. The charts below provide an overview of Apple's current and previous trade-in values in the U.S., according to its website. Maximum values for most devices either decreased or saw no change, but the iPad Air received a slight bump. ...

Top Rated Comments

konqerror Avatar
91 months ago
This is not the type of innovation we want Tim! :mad:
Nothing to do with Tim. Selling an unapproved medical device is a serious crime in nearly all countries. For example, an unlimited fine and 6 months jail in the UK.
Score: 34 Votes (Like | Disagree)
porkrind Avatar
91 months ago
WOW! **** you Apple!

I love how the ********s waited with releasing this information so people who bought on release day cannot return the watch.

I bet you'll need to buy a new shiny ECG enabled model if you want the feature after it's approved by your country too.
This is a bunch of *********. They said during the keynote that this functionality would be US-only until other approvals roll in. Once those approvals happen, there's no reason at all to think that they won't be able to enable the functionality just exactly as they did for the US today.
Score: 18 Votes (Like | Disagree)
rmoliv Avatar
91 months ago
Pay for something you cannot use even if you moved to the US because your watch was purchased elsewhere. Ridiculous. Doesn’t make sense.
Score: 15 Votes (Like | Disagree)
aldanger99 Avatar
91 months ago
"That's not the case with the the ECG app on the Apple Watch Series 4, though, as it only functions on models purchased in the United States"

So this begs the question: can I just buy a series 4 while in the U.S. (I'm Canada based), bring it home and enjoy the feature? We used to do this with the original iPhone before Canada got them and have done so with lots of tech stuff in the past. If the unit itself is a U.S. model and I set my region to the U.S., which I have already done to get the Apple News App, will I be able to use the ECG feature? Might have to investigate this one with a trip south!
Score: 14 Votes (Like | Disagree)
bbednarz Avatar
91 months ago
Pay for something you cannot use even if you moved to the US because your watch was purchased elsewhere. Ridiculous. Doesn’t make sense.
The advertising was pretty clear that this was only going to be available in the USA. They cannot change the health laws of other countries.
Score: 13 Votes (Like | Disagree)
mgollaher92 Avatar
91 months ago
That's really a pity, what's the point that I got an ECG built-in Apple Watch 4? I'm from UK.
They were pretty clear it would be US only for the time being when they announced it. You can't just willy nilly sell something that performs ECG functionality because you feel like it. Looks like they had to do a lot of work for this to even be advertised as such in the US. Plus it's the first over the counter device of its kind that can do an ECG.
Score: 12 Votes (Like | Disagree)