Garmin's ECG Rollout: Frustration and Feature Limitations Compared to Apple Watch

Garmin's ECG Expansion: A Limited Rollout

Garmin has recently expanded the availability of its electrocardiogram (ECG) feature to several countries in Europe and Australia for select devices. This rollout, however, has been met with some confusion and frustration among users, particularly those with devices that have the hardware to support the feature but are not included in the update. This article will explore the details of this rollout and the differences between the ECG functionality offered by Garmin and the Apple Watch, including the crucial distinction of how each device handles the detection of atrial fibrillation (AFib).

Supported Countries

After a lengthy regulatory approval process, Garmin's ECG feature is now available in the EU and Australia for the Fenix 8, Enduro 3, and Venu 3 smartwatches. This expansion follows the initial release of the ECG feature in the United States and some Asian countries, including Taiwan, Singapore, and Indonesia. The list of countries that now support the ECG feature on select Garmin devices includes:

It’s important to note that this expansion is not uniform across all Garmin devices. Specifically, the Fenix 7 Pro and Epix Pro, which share the same sensor as the Fenix 8 and already have ECG capability in the US, are notably excluded from this EU and Australia update. This decision has been puzzling to many users, especially since Garmin certifies devices as medical devices based on a combination of the sensor and the ECG app, not the hardware name. The exclusion of these devices suggests a possible strategic move to encourage upgrades to newer models.

How to Get Started with Garmin's ECG

For users with compatible devices, the ECG feature can be activated through the Garmin Connect app. After updating the watch and the app, users can find the ECG option on their watch. The process takes about 90 seconds. It is worth noting that the ECG function is not available on public beta firmware builds until the final build is released. Once activated in a supported country, the ECG function can be used in any country.

To take an ECG reading, users must place their thumb and forefinger on the watch's bezel or designated sensor points for about 30 seconds. This active participation is required to complete the electrical circuit and generate the single-lead ECG reading. The data is then stored in the Garmin Connect app, where users can review it.

Garmin ECG vs. Apple Watch ECG: Key Differences

Medical vs. Fitness Focus

• Apple Watch: FDA-cleared for detecting atrial fibrillation (AFib) and generating a single-lead ECG that can be shared with doctors. It is designed for proactive heart health monitoring and is more medically oriented.
• Garmin: Primarily aimed at fitness users, offering insights into heart health and detecting irregular heart rhythms. While it can detect AFib symptoms, it is not as medically oriented as the Apple Watch and may not have the same level of FDA clearance.

Device Interaction

• Apple Watch: Users place a finger on the Digital Crown to complete the circuit for an ECG reading.
• Garmin: Users touch the watch bezel or designated sensor points to complete the circuit.

Ecosystem & Reporting

• Apple Watch: ECG data is stored in the Apple Health app and can be exported as a PDF for doctors.
• Garmin: ECG data is stored in the Garmin Connect app. While the data can be reviewed, there may not be as direct of a medical reporting feature as Apple’s implementation. Some users note that the downloadable PDF generated by the Garmin device is a nice feature.

Availability & Regulations

• Apple Watch: Widely available in many regions, with FDA and other regulatory approvals.
• Garmin: The availability of the Garmin ECG feature is limited to specific models and markets due to ongoing regulatory approvals.

The Crucial Difference: Continuous AFib Monitoring

One of the most significant differences between the two devices is how they handle the detection of atrial fibrillation (AFib). The Apple Watch can provide passive, continuous monitoring for AFib. It will periodically check for irregular heart rhythms in the background and alert the user if something is detected. On the other hand, Garmin's ECG feature is not designed for continuous, passive monitoring. The user must manually start the ECG test to generate a reading and check for potential AFib symptoms.

This distinction is critical for users who are particularly concerned about their heart health and potential AFib issues. The Apple Watch's continuous monitoring can provide early detection of AFib, potentially leading to earlier medical intervention. Garmin’s approach, while useful for detecting AFib symptoms, relies on the user actively initiating the test and is not designed to catch intermittent AFib events that may occur without user awareness.

Conclusion

Garmin’s rollout of the ECG feature in Europe and Australia is a significant step, but it has been marred by the exclusion of some devices, particularly the Fenix 7 Pro and Epix Pro. This decision has led to disappointment and frustration, further highlighting the differences between Garmin and Apple's approaches to ECG functionality. While both offer ECG capabilities, the Apple Watch's continuous AFib monitoring is a key differentiator. The Garmin ECG feature is intended to offer more of a spot check to determine sinus rhythm, while the Apple Watch will look for AFib all the time and offer notifications. The Garmin ECG is more fitness-oriented than medically oriented compared to the Apple Watch.

Ultimately, both devices offer helpful ECG features, but the choice between them depends on individual needs and priorities. If continuous AFib monitoring is a priority, then the Apple Watch is the clear choice. If a user is interested in the more general fitness features of Garmin and is only interested in intermittent checks of the heart, then Garmin may still be a good choice. If Garmin wishes to retain its market position and loyal customers, it should consider that the current frustration around the limited rollout of features should be addressed.