My New Apple Watch 4 Is Nice: But It Won’t Record ECGs or Work With KardiaBand!

The skeptical cardiologist picked up an Apple Watch 4  at the Galleria Apple Store in St. Louis today.  The Apple employee who retrieved it told me that ECG recording capabilities were expected in the fall. Of course fall began today and it is not at all clear when, if ever, Apple will provide the software update to its AW4 that will provide ECG capabilities.

Fortunately, consumers already have the capability of  recording a medical grade single lead ECG with any Apple Watch 2 or 3-using the KardiaBand from AliveCor.

Apple has hubristically proclaimed the AW4 as the  ultimate guardian of our health and while setting it up I was asked if I wanted the watch to notify me if my heart rate dropped below 40 bpm for 10 minutes. Sure! Let’s see how irritating this feature will be.



After setting up the new watch I immediately attached my KardiaBand and installed the Kardia Apple Watch app.

I was able to open the Kardia app and it performed its normal SmartRhythm monitoring but when I tried to record an ECG, alas, nothing happened.

It appears that the KardiaBand does not work with the new Apple Watch 4. Yet.

I was informed by Ira Bahr at AliveCor that their “testing on AW4 is not yet complete. So at present, the device is not supported.”

Now I face a difficult decision-Do I wear my new AW4 with a non KardiaBand wrist band (and no ECG capability) or wear my old Apple Watch with the KardiaBand (and outstanding ECG capability.)


21 thoughts on “My New Apple Watch 4 Is Nice: But It Won’t Record ECGs or Work With KardiaBand!”

  1. I believe you have already made up your mind. I enjoy your insights on the Apple Watch and health benefits. Thank. Also still waiting for part 2 of motion sickness meds (don’t think I missed it).

  2. Funny just last month I was at the Apple store and asked if they had a watch yet that kept track of blood pressure and heart rate. They said coming soon. Apple wanted to be absolutely sure this product would be reliable. It was a huge liability. The young man assured me, this would not be released for a while yet until testing made this watch accurate. Waiting patiently!

  3. What prompted you to “update” for a LESS capable watch ? – and pay money for the privilege ???
    I would not reward APPLE with my support if that’s how they support
    the loyal… sheeple.

  4. Another useless Boy’s Toy – Was the A3 watch ‘not’ working?
    Better you had invested the money on The Eternal Fiancee, who will freely give you the Health feedback you actually need,
    For the rest of your life !

    1. Ouch! Guilty as charged. In my defense I cite the following. 1) I believe I am addicted to Apple gadgets (see my posts on AirPods and the Watch). 2) I’m getting the latest AW4 to evaluate Apple’s claims for the benefit of readers and patients considering purchasing the watch for its “health” or cardiac benefits. (Right now I would stick with the Kardia mobile ECG device unless you already own or want an AW2 or 3). It’s hard getting unbiased evaluations of these things and I (even with my Apple product addiction) am unbiased. 3)It is a tax deduction. 4) The Eternal Fiancée does indeed provide marvelous Health feedback but seems incapable of detecting afib. By the way, the AW3 that works with my KardiaBand was initially purchased by her and she gave it to me after deciding it wasn’t stylish enough.

      1. Interesting. According to Forbes, It appears that the ecg feature will need to be approved in each country where the app is available, which may take more or less time. What I can not find out is whether Apple will be charging an annual fee, as Kardia does… IMHO, Kardia’s annual fee is outrageously expensive. So, I think I’ll wait out to see what Apple comes up with. Apple very rarely underwhelms…

        1. François
          Thanks for that info.
          For me and my patients the annual fee of 99$ is money well spent.
          The Kardia device and app can be used without a subscription but your tracings are not stored on the cloud and your physician can’t review them online.
          This feature (KardiaPro) I believe is 15$ per month andI now find to be essential in managing my afib patients.

  5. I just got my first Apple Watch and I noticed that it measures Heart Rate Variability but I’m not very familiar with that and don’t really know how to interpret my numbers (they seem pretty low — averaging below 50). I searched your website but didn’t find any mention of it. Might you be able to post an explanation and any takeaways from the numbers people might get using the Apple Watch?

    This article:

    “The SDNN is the “gold standard” for medical stratification of cardiac risk when recorded over a 24 h period”

    So it seems somewhat useful to be able to understand the numbers. Of course the Apple Watch is not measuring SDNN consistently over 24 hours but instead seems to pick a few random times to measure it (and when using the breathe app, which may skew the results (?) – my only reading above 100 came when using ‘breathe’).


    1. I have been evaluating and researching the heart rate variability feature on Apple Watch. I actually have published some research in this area.
      So far I am unimpressed.Your comment has motivated me to try to write something about it.

      1. That would be great – thanks a lot! And thank you for all the work you do to put together such a useful and informative website.

  6. And by the way…absolutely agree with the fiancee. The kardia band is ugly…have paired the black ugly half with a pink apple half band (as the connection is the same) and it is only half a ugly😊. I actually get compliments on my two two color band.

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