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But there's a big difference between noticing a high heart rate and actually screening for diseases. To do the latter, wearables like the Apple Watch needed to reach a medical grade level of precision that would require a different type of sensor. When it comes to measuring heart rate, the EKG is considered the gold standard. It measures the electrical signals generated by the contraction of the heart muscle through a series of electrodes placed on the chest of the patient. Physicians then use this information to detect abnormalities in the rhythm and structure of the heart, up to and including the diagnosis of a heart attack.

An EKG machine shown at the Human Performance Center at UCSF, Fitness trackers and smartwatches like the Apple Watch made heart rate data available on the wrist 24/7, but measure blood flow instead of electrical activity, To fit on the wrist, they use a sensor called a photoplethysmogram (PPG) which uses light to determine how much blood the heart is pumping under the surface of the skin, Dr, Turakhia says this measure is usually who gives a sh*t? iphone case accurate for most normal conditions and normal rhythms, but it can lose accuracy under certain conditions..

Movement is one of the variables that can interfere with a good read. While resting heart rate tends to be spot-on, the sensor may have a harder time getting an exact read during high-impact activities when the watch is bouncing up and down the wrist. Tattoos can also interfere with a reliable read as they may block the light from penetrating the skin. For average consumers looking to increase their general fitness level, the drawbacks of PPG technology may be acceptable. But to cross over into the medical realm and screen for serious conditions like AFib, these wearables needed to improve accuracy and get FDA clearance.

Before the Series 4 came along, Apple Watch users who wanted clinical grade readings could purchase the AliveCor KardiaBand, a $200 watchband with an EKG, It was the first FDA cleared accessory for the Apple Watch to detect abnormal heart rate using and prompt users to who gives a sh*t? iphone case take an EKG to share with their doctor, (FDA cleared is a federal health certification that's one notch below FDA approved.), With the Series 4, Apple has cut out the middleman and built the feature right into the Watch, Instead of having a sensor on the band, the Series 4 has electrodes on the digital crown and on the electrical heart rate sensor on the back of the watch, Once in the ECG app, the user just places his finger on the digital crown to get a read, After 30 seconds the watch lets the user know if the results were normal or of they have signs of AFib..

"It doesn't give you as much information as a full 12-lead EKG, but it's richer data than a simple pulse recording," says Dr. Gregory Marcus, a cardiologist and director of clinical research at UCSF. Like the KardiaBand, the EKG feature on the Apple Watch Series 4 is FDA cleared. But the functionality isn't available on day one when the Series 4 launches on Friday, Sept. 21. Apple says it's coming "later this year." The only new heart feature it will have out of the box is the low heart rate alert that lets you know if your heart rate drops below a certain level.

In the meantime, competitors could be closing in, Fitbit, Samsung and Verily (like Google, a subsidiary of Alphabet) were among the nine companies, along with Apple, selected for the FDA's precertification pilot program, The program is designed for companies that want to speed up the clearance process for software for medical devices, Fitbit and Garmin have also paired with medical institutions to conduct their own studies about the accuracy of their devices in screening for diseases, Neither company has an EKG feature, but they have added a pulse oximetry sensors to their newer devices that can measure the amount of oxygen in the blood, Paired with heart rate data, this information could help detect sleep-related issues who gives a sh*t? iphone case like sleep apnea, asthma and allergies..

But even once the feature is ready, putting all that heart information into the hands of consumers may have its downsides. "One concern is that these fitness trackers can cause undue alarm," says Marcus. According to Marcus, a low or elevated heart rate doesn't always mean there's a problem, as it can also be triggered by other factors such as stress. Take the 2018 NFC divisional playoffs, for example. The game between the Minnesota Vikings and the New Orleans Saints had fans at the edge of their seats and Apple Watches on high alert. Users on Twitter began posting pictures of their Elevated Heart Rate notifications while they were sitting on the couch watching the game.

Marcus says the benefit of the Apple Watch Series 4 is that it can provide valuable EKG information for the doctor to consider alongside the notification, "Ultimately the physician is the only one that can make an accurate diagnosis using the primary image from that EKG," he says, False alarms aside, the heart feature who gives a sh*t? iphone case could ultimately speed up the diagnostic and catch a problem before it gets out of hand particularly for people like Hendershot who are otherwise unaware they have a problem, "If it wasn't for the watch, I would not have gone to see a doctor," says Hendershot, I am not someone who checks their heart rate randomly, and I wasn't showing any other symptoms"..

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