Learn what an ECG can tell you, how the technology works, and which wearables offer the feature
With heart rate monitors now standard in smartwatches and fitness trackers, electrocardiograms (ECG/EKG) have rapidly become a common feature in health wearables.
The technology aims to assist individuals in monitoring their heart health more effectively, primarily by detecting atrial fibrillation (AFib), which is a major cause of stroke.
ECG technology gained prominence through the Apple Watch Series 4 in 2018, but it is commonplace within smartwatches in 2026. Devices from all major brands have this feature.
But what can an ECG smartwatch really do, and why is it a feature worth considering? We discuss all the key details in this extensive guide below.
At a glance: Best ECG wearables
You can click through to our full, in-depth reviews of each smartwatch and read what we thought of the ECG functionality. We’ve also grouped them and discussed how each brand handles ECG readings in the section below.
- Hume Band – Best discreet wearable for 24/7 heart-rate tracking
- WHOOP MG – Best discreet medical-grade ECG wearable
- Withings ScanWatch 2 – Best hybrid smartwatch for proactive ECG checks
- Withings ScanWatch Nova – Best luxury hybrid smartwatch with ECG
- Huawei Watch 5 / Watch D2 | Watch GT 6 Pro – Best Huawei ECG watches for health monitoring
📢 Limited Time Offer: Buy 1 Hume Band and Get 1 for free!
Other notable options:
- Fitbit Sense 2 | Charge 6 (and Charge 5) – Best Fitbit options with ECG and passive rhythm alerts
- Apple Watch Series 11 (and 4-10) | Apple Watch Ultra 3 (and 1-2) – Best Apple Watch models for ECG tracking
- Samsung Galaxy Watch 8 series (and 4-7) | Galaxy Watch Ultra – Best Samsung smartwatches with ECG
- Google Pixel Watch 4 (and 1-3) – Best Pixel Watch models for ECG readings
- Garmin Fenix 8 | Venu 4 | Forerunner 970 – Best Garmin watches with ECG support
- Coros Pace Pro | Vertix 2 | Apex 2 – Best ECG-style HRV tracking for recovery insights
ECG smartwatches: FAQ
Most wearables use optical heart rate monitors that use flashing LEDs to penetrate the skin and detect blood flow. When light reflects off the flow of blood, the sensors capture this.
The algorithm processes the data to estimate your heart rate. However, due to arm movement, accuracy may be limited—and that can be particularly problematic if the data is being used to inform medical scenarios.
This is where the electrocardiogram (ECG or EKG) comes in. Instead of measuring blood flow passively, the ECG assesses the heart’s performance in an on-the-spot test under more controlled conditions.
This term is more commonly used in the medical industry to refer to an electrocardiograph, which is also used to detect cardiac abnormalities.
An ECG smartwatch may detect atrial fibrillation, a condition that leads to an irregular heart rate and is a significant cause of strokes. Taking an ECG reading on your watch might help determine if you have a healthy heart rhythm.
However, many people only use this feature once and then forget about it. For a substantial number of individuals, having ECG capabilities can be extremely beneficial. Smartwatches from brands like Withings, Apple, and Fitbit can export an ECG graph of your heart rate, which can be very helpful when discussing your health with your doctor.
“ECG on wearables is super high value for a small segment. It is probably going to be more advantageous to our users over 50 than 20-year-olds, but we’re trying to build something for everybody,” Dr. Conor Heneghan, Director of Research Algorithms at Fitbit, told Wareable.
“AFib can come and go, as can conditions that affect the rhythm of your heart. That means having a device that can take spot readings at any time makes it a hugely powerful health tool to have at your disposal,” he said.
Most watches have a built-in ECG sensor that can take a spot reading of your heart rate rhythm. You start the app and then place your finger on a specific part of the watch (usually the case or crown) for the duration of the test.
Provided your heart gets a normal sinus rhythm, you’re likely to only need to periodically take an ECG test, just to check everything is in order.
But if you frequently experience heart racing, palpitations, or periods of feeling unwell, then you can use the ECG app as much as needed. And it becomes an incredibly important health tool, right on your wrist.
Fitbit’s Director of Research Algorithms, Conor Heneghan, says that means users can have a better-informed conversation with their doctor.
“The problem with cardiac issues with rhythm is they’re so intermittent,” said Heneghan.
“For people who have palpitations or other symptoms, ECG can be a reassurance. And if they feel like something’s a bit odd going on physiologically, they can capture that moment to speak with their doctor about it,” he continued.
Fitbit also recommends that the ECG feature should only be used by those aged 22 or above.
This is a key distinction. An ECG is an active test you perform manually. However, many modern devices also use their photoplethysmography (PPG) optical sensor to passively monitor your heart rhythm in the background while you are still or sleeping.
If they detect an irregular rhythm that appears to be AFib, they will send you a notification prompting you to take a medical-grade ECG to confirm.
ECG watches and wearables available today
While ECG was once a premium feature reserved for flagship wearables, it’s now present in multiple devices from each brand. Given that the feature almost always works identically across an ecosystem, we’ve grouped the current devices with ECG from different manufacturers and explained how it works.
Hume Band
Hume Band is not your classic smartwatch but a wearable device focused on fitness, health, and overall wellbeing tracking. Priced at $249, it stood out for us as a strong option for users who want something discreet and less distracting than a smartwatch.
The wearable focuses on metabolism and recovery, combining data with holistic insights, so you can understand what’s happening inside your body. Since Hume Band is completely screenless, all metrics, trends, and recommendations can be found on the free HumeHealth app.
The ECG feature in Hume Band is swapped with a simpler approach—a PPG optical sensor. While it may not match ECG in detecting conditions like AFib, it’s just as important for 24/7 monitoring.
PPG works by shining a light onto the skin and measuring how that light is absorbed or reflected by blood flow. Sensors inside the band can detect changes in blood volume with each heartbeat, that way estimating heart rate. So, if you’re not really into devices that use low-level electrical pulses, Hume Band might feel like a more comfortable choice.
Unlike with other devices in the lineup, Hume Band doesn’t call for a specific routine or manual checks to estimate heart rate and blood flow changes. Yet, we did notice that a snug fit is needed to maintain accurate tracking over time.
Whoop MG
Though WHOOP isn’t a smartwatch, just like Hume Band, we’re including it on this list as a wild card option for those who want ECG functionality in a more discreet form factor. That is, if you’re willing to shell out for the top-of-the-range WHOOP MG (Medical Grade) and WHOOP Life subscription available at $359 per year.
Similar to functions on other devices, users simply hold their thumb and index finger on the conductive elements on the clasp to initiate a medical-grade reading in seconds (after firing up the app, as shown above).
The feature has regulatory clearance and, like others, is designed to help detect signs of AFib. Readings are in the app’s Heart Screener section, and the MG will also passively look out for high, low, or irregular heart rates and rhythms.
One caveat, though, aside from the hardware and subscription requirements: you have to wear the MG on your wrist for the ECG feature to work accurately. This means the sensor won’t work if you wear it in WHOOP Body apparel like sleeves, shorts, T-shirts, or the Bicep Band, because the circuit can’t function in those positions.
Withings ScanWatch 2
The Withings ScanWatch 2 is the company’s current-gen hybrid priced at $369.95, alongside the more premium Nova and Nova Brilliant models. Together, they represent some of the top hybrid watches on the market, with a focus on health and wellness monitoring rather than traditional fitness tracking.
The ECG feature works similarly across the lineup, and it remains one of the most proactive we’ve tested in this regard. You can take quick ECG readings to check for AFib and easily share the results as a PDF for more convenient consultation with your doctor.
It will also look for irregular heart rhythms throughout the day. The optical heart rate sensor continuously checks your heart rate for irregular beats, and if it catches anything unusual, it will prompt you to take an ECG test.
Beyond ECG, Withings ScanWatch 2 stands out as one of the best designs. It’s an analog-style smartwatch that conceals its advanced features, making it look more like a classic timepiece suited for any social setting.
With a variety of bezel colors and band materials ranging from colored leather to metal, we believe it’s a strong contender for those who care about their well-being but prefer a classic look.
Withings ScanWatch Nova
Withings Scanwatch Nova takes the same health-first approach as the ScanWatch 2 model but elevates it with an even more luxurious design. It’s a refined alternative for those who want advanced technology and a statement piece.
The core features remain the same, including on-demand ECG readings that check for signs of AFib in just a few seconds. The Nova model also lets you export your ECG results as a PDF and utilizes PPG for around-the-clock monitoring.
What really stood out to us is how Withings ScanWatch Nova distinguishes itself through expert-level craftsmanship. It has this true luxury watch appeal, with a stainless steel case, ceramic bezel, and durable build designed for long-term use.
It’s less colorful than the ScanWatch 2 model, coming in black, dark blue, and dark green bezels, along with 4 additional band options: leather, recycled P.E.T., #tide® ocean material, and premium sport fluoroelastomer.
Starting at $599.95, Withings ScanWatch Nova is a premium smartwatch, and we understand it’s not for everyone. Still, it’s worth considering if you’re looking for more than just a health tracking device but appreciate craftsmanship and like collecting luxurious watches.
Huawei Watch 5 | Watch GT 6 Pro
Huawei has received regulatory clearance for its ECG feature in Europe, allowing users to perform heart rate rhythm spot checks on its newer smartwatches.
It’s a staple feature of the current flagship, the Huawei Watch 5, and is also available on the newer upper mid-range Huawei Watch GT 6 Pro.
Taking a heart rate measurement will show you whether your heart rhythm is normal or AFib on the watch and save the result to the Huawei Health app.
In the app, you can also log any accompanying symptoms and see an ECG graph, which can be shown to your doctor. Keep in mind that ECG readings shouldn’t replace actual evaluations by a licensed doctor, but they can help to explain your concerns.
Huawei Watch D2
We’ve split off the Huawei Watch D2 because it functions differently from the other Huawei devices featuring ECG. This is the brand’s dedicated health watch, which offers blood pressure monitoring and ECG detection.
It’s certainly not a comfortable or sleek smartwatch for casual wear, but as we discovered in our review, it’s a practical, health-focused smartwatch. This device offers medical-grade surveillance of your vital signs and is best suited to people with pre-existing condition monitoring.
However, as with all things Huawei, we are unlikely to see a release for this one in the US.
Fitbit Sense 2 | Charge 6 (and previous generations)
The Fitbit Sense 2 stands as the sole health watch from the company, equipped with various sensors, such as ECG. However, the ECG feature is also available on the Fitbit Charge 6 fitness tracker.
It’s the only fitness tracker form factor capable of taking an ECG reading, making it a great option for people who prefer this type of design. To take the reading, you pinch the sides of the case, and the data is sent to the Fitbit app.
With the Fitbit Sense 2, users can perform ECG spot checks by opening the app, touching their fingers to the aluminum case, and holding as instructed on the watch for an ECG to be taken. Again, this can be exported as a PDF.
The PPG sensor also continuously scans for abnormal rhythms, including high and low heart rates. That means it can alert you to possible issues without taking manual scans, allowing a better understanding of potential triggers of your specific condition.
Another point worth mentioning is that the Fitbit ECG sensor holds FDA and CE safety certifications for use in the US and Europe.
Apple Watch Series 4-11 | Ultra 1-3
The latest Apple Watch Series 11 and Ultra 3—plus older models—boast ECG functionality, with sensors built into the ceramic heart rate monitor under the watch and the Digital Crown.
Fire up the ECG app, pop your finger on the crown, and you’ll be guided through the reading.
You’ll be notified whether the reading is regular or shows signs of atrial fibrillation, and an EKG graph of your heart rate will be logged in the Apple Health smartwatch app, which can be downloaded and shared with your doctor for smoother consultation.
Apple has FDA clearance for its ECG in the European Economic Area, and more than 20 countries now have the ability to use the health feature.
Samsung Galaxy Watch (all post-2019 models)
The Galaxy Watch 8 is the latest Samsung smartwatch on the market, and ECG measurement remains a big part of its appeal. However, like with previous generations (listed just below), you will need a Samsung smartphone to use the feature.
The ECG app is available on the Galaxy Watch 8 series, Galaxy Watch Ultra, Galaxy Watch 7, Watch 6 Classic, Watch 5, Watch 5 Pro, Watch 4, and Watch 4 Classic.
When you place your finger on the sensor built into the top physical button, it takes a 30-second reading. You’ll also need to remain still with your forearm resting on a flat surface.
Samsung’s Health Monitor app is live in the US and South Korea, and it’s also received clearance in Europe. Moreover, Japan, Indonesia, the UAE, Chile, India, and China are all confirmed, too.
Google Pixel Watch 1-4
It’s not just Fitbit devices that Google enlists to take electrocardiograms; the Pixel Watch 4 (and the other Pixel Watches) also offer the skill.
Like with the Apple Watch, this is done via the crown on the outer edge of the watch during a 30-second scan. Results are then sent to the Fitbit app for your perusal, with a full history and timeline of your readings shown (as described above).
Garmin Fenix 8 | Venu 4 | Forerunner 970
After introducing the feature relatively late, Garmin now has many watches within its stable capable of running the ECG feature.
At the time of writing, this list includes Garmin devices with the Elevate 5 heart rate sensor, as it also supports the required architecture for ECG readings. This includes the Fenix 8 Pro, Fenix 8, Fenix 7 Pro, Forerunner 970, Epix Pro (Gen 2), Enduro 3, Venu 4, Venu 3, and Venu 2 Plus.
The feature works by having the user place their index finger and thumb on the metal edge of the device’s bezel or on the top-right button for 30 seconds to obtain a reading. The watch will display the heart rate rhythm and indicate whether it is sinus (normal) or AFib.
You’ll need to set it up in Garmin Connect first, which will also serve as a hub for historical data and a place where you can export individual readings as PDFs.
Coros Vertix 2 | Apex 2/2 Pro | Pace Pro
Coros is gradually expanding its ECG functionality to more watches. The Pace Pro, released in late 2024, is the first of the brand’s running watches to feature this technology. However, it has also been part of a few other models for some time now.
However, it’s not a health feature like those found on other smartwatches. Instead, the Coros sensor aims to provide a more accurate assessment of heart rate variability, which helps gauge your recovery after workouts. Poor HRV scores can also indicate stress, overtraining, or alcohol intake.
HRV scores are commonplace in fitness wearables but typically operate via the PPG sensor during sleep. We like that Coros has gone down a novel route that aligns with the brand’s specialty.
How does ECG smartwatch tech work?
An ECG captures the small electrical signals produced by your heart’s beats beneath the skin, displaying them as a trace. This enables trained professionals, devices, or wearables to gain insights into your heart’s function and identify any potential abnormalities.
“In the simplest sense, it can tell you the heart rate (how fast), the rhythm (how regular), the state of the conduction system and muscle tissue (heart attacks), and even the level of certain chemicals like potassium in the blood and the effect of medication,” says Dr. Keith Grimes, GP and Clinical Innovation Director at Babylon Health.
In a medical environment, an electrocardiograph typically involves attaching electrodes to the skin near the heart. This setup measures the electrical activity generated during heart contractions. The receiver collects the electrical signals and records the data, enabling analysis of the heart’s rhythm and the detection of irregularities.
What about ECG readings in consumer devices?
The technology in at-home ECG devices functions differently.
Instead of applying electrodes to your skin, the wearable or smartwatch usually requires you to put your finger on the digital crown, frame, or certain button. After waiting for 30 seconds, your heart’s electrical activity creates a red trace on the watch screen. When finished, the app will inform you if the trace shows a normal heartbeat, known as a sinus rhythm, or an irregular heartbeat.
The biggest difference between an electrocardiograph at a hospital and the ECG technology in your smartwatch is that the former uses 12 leads while the latter uses a single lead. In the simplest terms, the 12-lead device takes multiple readings of your heart, while the single-lead device takes just one. That is why a smartwatch can’t replace an actual procedure suggested by a doctor.
A single-lead ECG has limited capabilities and provides just one view of your heart. It cannot reliably detect all heart rhythm abnormalities or worsening heart problems. Additionally, it cannot identify the electrical changes that occur during a heart attack or reveal an abnormal heart structure.
How can ECG tech save your life?
An ECG performed by a medical professional can detect various heart issues. ECG devices for home use aren’t as developed or reliable but still have their uses.
Here are several ways the ECG technology in your smartwatch may help to save your life, including the issues it might identify.
Atrial fibrillation
Atrial fibrillation is a heart condition characterized by an irregular and rapid heartbeat. This common condition can be life-threatening if not treated in time. Its intermittent nature adds to the challenge of detection.
ZDNet writer Jason Perlow participated in the early testing of Apple’s Atrial fibrillation detection and, thanks to the data collected, identified a problem with his heart in 2018.
The reason personal devices are effective at recognizing this particular kind of arrhythmia (irregular heartbeat), and the reason Perlow cites for its effectiveness in his case, is that you can take them at any time.
Unlike getting an ECG at the hospital, you can monitor your heart throughout the day. “Irregularities in heart rate can be episodic and difficult to capture,” explains Dr. Grimes, “So a personal ECG that you carry with you can help clinicians record when palpitations happen and help with diagnosis.”
This means you can take a 30-second ECG whenever you feel symptoms and also better understand the context of what may have brought them on—for example, if you just got back from a run and you’re feeling a bit off.
Advice on harnessing the ECG feature
Dr. Tony Faranesh, a senior research scientist at Fitbit, says the optimal way to identify atrial fibrillation through heart rate tracking is to screen while at rest, making sleep ideal for detection.
Most smartwatches utilize an optical PPG heart rate sensor to measure heart rate. Meanwhile, the ECG sensor takes on-the-spot readings.
Dr. Julia Reynolds, Associate Director at Innovation Agency, tells us that the Kardia Mobile built by startup AliveCor is sometimes even prescribed to patients for this exact reason.
“Individuals may be given a mobile ECG device by their health professional if they are concerned they may have paroxysmal atrial fibrillation—that’s when it comes and goes. That way, if they are feeling signs and symptoms, they can take their ECG when they are experiencing symptoms.”
The problems with false positives (and negatives)
ECG devices available to consumers can detect a range of heart problems, whether cleared or not, but that doesn’t mean they should replace a trip to your doctor.
“Reading an ECG is tricky,” Dr. Grimes explains. “Current technology uses machine learning to detect common abnormalities, but personal ECG, like the kind you find on the Apple Watch, is not as accurate as medical devices.”
Personal ECG devices save lives, but they can also miss serious problems or lead to unnecessary worry about heart issues. Dr. Grimes calls these “false negatives” and “false positives.”
Although many in the medical profession are warning people to be wary of the results they get from their consumer ECG devices, having more control over our health at home will become more widespread over time.
That means instead of advising against ECG devices, people need to be informed that readings might not always be accurate. If you notice a reading that worries you, it’s best to see a medical professional to have it checked.
Final thoughts on ECG smartwatches and wearables
With the ECG feature appearing in more smartwatches and wearables, health monitoring has become quicker, easier to understand, and more accessible. Insights into heart rhythm are no longer just novelty—they can potentially detect more serious health issues like AFib.
While devices like Hume Band, WHOOP MG, Withings ScanWatch 2 and Nova, Huawei, Apple, and more can’t replace medical advice, they provide valuable data. Overall, the inclusion of ECG features in these smartwatches offers more informed ways to stay on top of your health, and that’s exactly what we love the most about them.
