Garmin ECG Function Is Now Dwell: Right here’s the way it works!

As of immediately, Garmin has launched ECG performance for the Venu 2 Plus watch, for customers in the US. That is Garmin’s first watch to have ECG, following each scientific trials, and subsequent FDA approval which they had been granted final week (extra on all that down beneath). The on-watch ECG performance will detect and classify atrial fibrillation (aka AFib), and a standard sinus rhythm.

In your Venu 2 Plus you may open the ECG app at any time, contact the bezel along with your different wrists’ fingers, after which wait about 30 seconds for the ECG to finish. After which you’ll get your outcomes in addition to the flexibility to avoid wasting/export the report by way of the app, equivalent to to ship the PDF to a health care provider.

Garmin is basically the final main smartwatch maker to hitch the ECG fray. This follows Apple, Samsung, Fitbit, and others who’ve acquired FDA approval for his or her ECG app implementations. For essentially the most half although, what you see on these units is all very comparable, largely owing to the method by which these units are licensed. Nonetheless, there are some variations, equivalent to Apple have irregular rhythm notifications (albeit non-continual), whereas Garmin doesn’t. Nonetheless, for these needing to do fast spot checks for ECG, it is a enormous step ahead.

Watch & Consumer Necessities:

With the intention to get the ECG app working, you’ll must have a Garmin Venu 2 Plus watch. Garmin has confirmed that that’s at the moment the one in-market watch they’ve which has the {hardware} inside to carry out ECG’s. That {hardware} has primarily two main parts: A wire linked to the bezel (contained in the watch), and a small steel ring across the exterior of the optical HR sensor. These two parts enable the watch to ‘full the circuit’ when measuring an ECG, and at the moment solely the Venu 2 Plus {hardware} has this.

When you can not see the wire linked to the antenna internally, you may truly see the skinny steel strip across the exterior of the sensor on the Venu 2 Plus:

Now in comparison with that not being current on a Epix seen beneath (or every other watch, merely flip yours over):

The following bit is that you just have to be within the US, bodily, when first activating the ECG app. This is because of regulatory necessities, and the onboarding course of occurs by way of your telephone with Garmin Join Cellular (Garmin’s smartphone companion app). Throughout that it makes use of each GPS+WiFi to validate you’re bodily within the US. You possibly can nonetheless do subsequent ECG’s exterior the US after finishing your preliminary activation (extra on this in a second).

Lastly, you could have the most recent model of Garmin Join Cellular and the Venu 2 Plus firmware. These variations are:

Garmin Join Cellular (iOS/Android): Not less than model 4.62
Garmin Venu 2 Plus Firmware: Not less than model 11.21

This Garmin Join Cellular model went stay this previous weekend, as did the Garmin Venu 2 Plus firmware model. So in case you haven’t upgraded but, do this now. Lastly, in case you’re studying this within the seconds after I hit publish (at 7:00AM US Jap Time), then Garmin additionally says there could also be a really slight delay of an hour or so until the function exhibits up as stay for everybody.

Received it? Good, let’s get rolling.

The way it works:


First up is activating the ECG performance in your (appropriate) watch. That requires Garmin Join Cellular (the smartphone app), to do preliminary activation. That’s as a result of Garmin verifies you’re bodily within the US utilizing your telephone’s GPS+WiFi alerts. This activation is simply required the primary time, and any subsequent utilization can happen exterior the US.

If it’s a part of setup of a brand new watch, it’ll be one of many duties you full (akin to WiFi setup). Whereas if it’s for present watch you’ll get prodded to think about setting it up. From there, it’ll provide you with a fast overview of what an ECG is, and what it isn’t. For instance, it doesn’t detect coronary heart assaults. That is a part of the FDA approval phrases, as a result of it’s thought of an over-the-counter medical system. As such, the person should have the ability to work out all the things purely from the step-by-step system directions. Which means, it assumes a health care provider/pharmacist didn’t discuss to you in any respect. It additionally validates you’re 22 years of age or older.

You can too entry this by way of the Units menu, and make sure the present setup steps which might be current:

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As soon as that’s carried out, it’s activated in your watch.

Now you can go onto your watch into the ‘Apps’ checklist. This is similar place you’d go to start out a Run/Bike/and many others. Scroll far sufficient and also you’ll ultimately see ECG within the checklist:

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Then, relaxation your arm and wrist on a desk, and place your thumb and index finger on the steel ring/bezel. Do guarantee no matter wrist you arrange in Garmin Join Cellular is similar wrist you’re sporting it for right here.


Lastly, the ECG begins and also you’ll wait 30 seconds. As you wait you’ll see the waveform displayed in real-time, in addition to your coronary heart price and a count-down. If you happen to transfer an excessive amount of or in any other case do one thing unexplainable, it’ll immediate a failure message.


As soon as it’s carried out, you’ll instantly get your end result. This occurs fully domestically to the watch, and there’s no connectivity required presently. Throughout the outcomes you may scroll left/proper alongside the waveform, in addition to choose any signs you might need had.


These logged signs and full outcomes are then saved with that particular ECG end result to each the watch in addition to Garmin Join (cell and platform):

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In the meantime, again on Garmin Join Cellular you may see the total outcomes of your ECG (and historic ones), in addition to export out a PDF of the ECG to offer to a health care provider (or, , social media). Right here’s an instance of a PDF export:


And it’s a easy as that. The truth is, by design, it’s presupposed to be easy. That’s considerably the whole objective of this being a regulated over-the-counter medical system, it’s presupposed to be laborious (if not not possible) to screw up. Talking of which, let’s rapidly dive into some FDA bits.

Scientific Trials, FDA Approval, Different Areas:

It’s worthwhile to take a quick detour to the touch on the scientific trials and FDA approval for the ECG App. It’s possible you’ll keep in mind a couple of yr in the past I detailed out the place Garmin stood on scientific trials for his or her ECG app. The cool half about that is that every one of it’s public. The checks, the services concerned, person counts, and even take a look at protocol. In fact, that assumes mentioned firm information all of this below their precise firm identify. Garmin being Garmin, they did. Apple? Much less so – utilizing shell corporations to cover that Apple was truly engaged on it. In fact, Apple was first available on the market within the watch kind issue, so hiding their work was essential from a aggressive aspect.

With out getting too into the weeds, Garmin had initially filed the trials to incorporate 460 individuals, nonetheless, by the tip, that they had included 568 individuals. In speaking to varied trade of us, that’s fairly regular, as individuals that had been initially included are sometimes faraway from the research in a while. That may be as a result of the person may not have met the factors (extra on that in a second) upon additional inspection, or maybe there have been protocol errors of their pattern. You’d count on to see some improve between the projected quantity and the ultimate quantity. Subsequent month, the FDA will publish Garmin’s full abstract, which is able to give us much more particulars in a ultimate report kind.

The important thing factor to grasp although is that Garmin isn’t certifying the Venu 2 Plus as a medical system. Fairly, they’re certifying the “ECG App” working atop the Venu 2 Plus, and particularly, their proving to the FDA that it was “considerably equal” to an present FDA-cleared system. On this particular case, Garmin was proving substantial equivalence to Apple’s implementation.

Inside that, Garmin is simply targeted on ECG efficiency. So issues like PulseOx (SpO2 sensing), or coronary heart price throughout sport, or sleep detection, or every other Garmin well being function – these aren’t being vetted right here. It’s purely the ECG function and particularly inside that the detection and classification of atrial fibrillation and a standard sinus rhythm. That’s it.

To try this, Garmin needed to mainly go three separate bars/chunks:

1) Scientific Efficiency: their scientific trial knowledge, did it meet the FDA’s threshold?
2) Human Elements: Can a standard on a regular basis human with no preexisting information use the system correctly utilizing simply the directions proven within the app and on-device. Given it’s an over-the-counter system, that is essential.
3) Technical Efficiency: Does the algorithm meet varied necessities for thermal security, electromagnetic interference, arrythmia efficiency, and extra.

This whole course of, from an official scientific trials standpoint, began all the way in which again in April 2021 (almost two years in the past). In fact, that’s simply once they submitted their first formal paperwork that’s public, not when the engineering and preparations began. All of this concluded about 10 days in the past when Garmin acquired their ultimate FDA approval:


As you may see, given Garmin solely acquired this approval 10 days in the past, they’ve been prepared for fairly a while to hit the ‘Go’ button on toggling this to stay for customers. That is akin to what we truly noticed from each Fitbit and Apple, who acquired approval after which lit it up for customers inside days of that approval taking place.

Going Ahead:


Which after all brings us to the subsequent logical query – what do the timelines seem like for different international locations? Properly, that’s messier. Garmin’s official assertion is as follows:

“Garmin intends to proceed to increase its portfolio of merchandise supporting the ECG App and launch it in new areas in-line with mandatory regulatory approval.”

Now, the place it goes from right here is considerably extra complicated. Some international locations will take the FDA clearance roughly as-is, permitting for comparatively fast switch and approval. Nonetheless, others require beginning a lot of that paperwork course of once more.

For instance, I requested whether or not or not there have been plans for Europe/EU and Garmin would solely verify that there “is a plan”, however couldn’t say something extra particular. They did nonetheless famous that new EU regulation that got here into impact in 2021 marked a fairly vital shift within the certification method, making it extra thorough than earlier, and in addition extending the timelines too. Right here’s a fast article which explains the variations and impacts. Clearly, I’d count on Garmin is already fairly a methods into that course of, however it’s nonetheless…effectively…a course of (simply because it was for Apple, Samsung, and others).

The excellent news although is that like Apple and others, this doesn’t cease Garmin from releasing new watches with ECG {hardware}, that’s merely turned on by area as approval occurs. And that’s additionally true of the Venu 2 Plus. Sometime down the street if/when Garmin will get EU (or every other nation) approval, toggling that area on is a comparatively trivial affair for watches which have the fitting {hardware} already.

As for future {hardware}, I’d count on there might be baseline level someday this yr when primarily all future Garmin watches from a given value stage have ECG. In any case, it’s on comparatively cheap competitor units from each Fitbit and Samsung. And even the Venu 2 Plus itself is simply on the decrease finish of the mid-range Garmin pricing today, with far costlier items above it that would definitely be logical candidates for ECG inclusion in new {hardware} variants.

With that, thanks for studying!

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