Apple Watch Series 4’s electrocardiogram feature could do more harm than good

“One of the most surprising announcements at Apple’s annual hardware event on Wednesday wasn’t a new iPhone, or even the new, thinner, next-generation Apple Watch. It was a feature on the Apple Watch,” Robbie Gonzalez writes for Wired. “‘We’ve added electrodes into the back sapphire crystal and the digital crown, allowing you to take an electrocardiogram,’ said COO Jeff Williams, eliciting one of the day’s biggest rounds of applause. ‘This is the first ECG product offered over the counter, directly to consumers.'”

“It sounds like a great idea in theory,” Gonzalez writes. “People with atrial fibrillation, which the CDC estimates affects between 2.7 and 6.1 million Americans, could likely benefit from a wearable, on-demand ECG device like the new Apple Watch. (AFib is the most common arrhythmia, and the only kind Apple’s watch is approved to detect.) But for everyone else, evidence suggests the potential costs could actually outweigh the proposed benefits… there is such a thing as too much insight into one’s health.”

“‘Do you wind up catching a few undiagnosed cases? Sure. But for the vast majority of people it will have either no impact or possibly a negative impact by causing anxiety or unnecessary treatment,’ says cardiologist Theodore Abraham, director of the UCSF Echocardiography Laboratory. The more democratized you make something like ECG, he says, the more you increase the rate of false positives — especially among the hypochondriac set. ‘In the case of people who are very type-A, obsessed with their health, and fitness compulsive, you could see a lot of them overusing Apple’s tech to self-diagnose and have themselves checked out unnecessarily,'” Gonzalez writes. “The cases in which Apple’s new watch could be most helpful are obvious: People with atrial fibrillation, family histories of heart disease, heart palpitations, chest pain, shortness of breath, and so on.”

Read more in the full article here.

MacDailyNews Take: This is a stupid article that in itself states, “not many studies have looked at the effects of widespread ECG screening” yet spills a lot of ink ignoring that salient fact.

We bet that millions with undiagnosed AFib far outnumber hypochondriacs, but, even if they didn’t, the lives saved plus the research potential of having millions of people contributing ECG information to medical studies (with Apple, it’s always opt-in, of course) will far outweigh some unnecessary checkups.

How Apple Watch saved my life – September 10, 2018
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Apple Watch saves life of New York man – May 3, 2018
Apple Watch saves Florida teen’s life – May 1, 2018
Apple Watch saves a mother and her baby after a car crash – February 16, 2018
Apple Watch saves kitesurfer stranded a mile off the California coast in great white shark-infested waters – November 13, 2017
Apple Watch saves another person’s life: ‘It would have been fatal’ – October 16, 2017
How my Apple Watch saved my life – July 25, 2016
A real lifesaver: Apple Watch saves lives – March 28, 2016
Man credits Apple Watch with saving his life – March 15, 2016
Apple Watch saves teenager’s life; Tim Cook offers thankful teen an internship – October 2, 2015

[Thanks to MacDailyNews Readers “Fred Mertz” and “Ladd” for the heads up.]


  1. What a dumb article. So a device that can save lives is no good because a few crazy people may go to the doctor for what? A test or screening. And this guys think that means the AW4 does harm!! Go away you had your 2 mins and you blew it.

    1. If you were not so judgmental and understood the concept of cost/benefit, the article would make a lot of sense. Please read about prostate cancer. This is a very complicated subject and even though there’s a very non-specific test (PSA) not all men should be regularly tested – just a subset who are at high risk. The article states COULD do more harm than good. If everyone goes out and buys a watch and picks up an arrhythmia, yes, there could be a drain on the healthcare system. Unnecessary, visits to a cardiologist.

      If we lived in a world where unlimited resources existed,yes, this watch would be fantastic. It’s just like we don’t do full body scans on a population. If you look closely enough, you’ll always find something wrong with our bodies. Sometimes not knowing is better than knowing. That’s why the author mentions false positives. We will all die from something and sometimes it’s best to not know everything that’s wrong with us. That was the gist of this article.

  2. In 1900, it was believed going faster than 45 mph in “one of those new fangled automobiles” would cause suffocation.

    History is replete with dour pronouncements born of ignorance or threat to authority. If even 1% of Watch wearers thinks about lifestyle choices that give rise to aFib, that’s a victory.

    “Maybe I shouldn’t have that eighth beer…..”

    1. “going faster than 45 mph in “one of those new fangled automobiles” would cause suffocation.”

      They’ve been responsible for a very large number of cases of chronic loss of breath for pedestrians, cyclists and passengers.

  3. Well, that’s “glass half empty” perspective. Affecting a relatively few people with anxiety vs saving some from death because of undiagnosed heart defects. Hmm… good advice doc. Wonder how many doctors they had to interview before they found a doctor with this opinion?

  4. “possibly a negative impact by causing anxiety or unnecessary treatment,’ says cardiologist Theodore Abraham, director of the UCSF Echocardiography Laboratory”

    Knowledge is power. Saving a few lives far outweighs the slight inconvenience and anxiety that a few false alarms may trigger. The AppleWatch has already been notifying people of elevated heart rate, so this isn’t new, and we’ve yet to hear about any “negative impact”. Maybe UCSF is unhappy that Stanford Heart was involved in the development of this and not them. Both have world-famous heart programs, so maybe a little competitive fire is leading to misguided comments like this.

    What is new is being able to take a single-trace ECG, when something seems amiss. And that’s not exactly new either. My mom has been taking FDA-approved single-trace ECGs with her AliveCor mobile device attached to the back of her iPhone for several years now. The difference is that instead of having to use her iPhone with a device attached to the back, she can now just touch the crown of her AppleWatch and get the same result. Far more convenient.

    So, nothing about the new capability is actually new, as high heart rate while resting has been something the Stanford Heart Study has been following since last year, and the ECG is something that AliveCor has offered with a wrist strap on the AppleWatch. Where were Dr. Abraham’s comments about the negative effects in the past?

  5. One of my favorite pastimes is going through 5-year old Wired magazines and seeing how many “next big things” and “OMG this is terrible” predictions they made have been correct. They’ve been batting somewhere in the low single digits for going on decades.

  6. It is normal when looking at any new technology or treatment to do a cost benefit and complication analysis . The fact that it has been endorsed by the AHA and certified by the FDA implies that some estimates have at least already been done .
    Many patients with supraventicular tachyarhytmias do not have symptoms and most cases are intermittent which means one has to have have a mechanism for observing the event at the time of the event . Holter monitoring can be hit and miss .
    Also AF is not the only dysrhythmia that the watch is likely to document . I was quite impressed that the accelerometers can spot falls etc . Hopefully there will be a builtin software mechanism for automatically recording lead 1 during a fall or syncopal event . This could be a real game changer .

  7. I’m a psychiatrist, and this is why cardiologists should stick to ECG interpretation, not wildly ridiculous psychiatric epidemiology. By this reasoning, its time to ban all medical advice, applications, articles and searches on the Web.

  8. I’m not sure how it could result in unnecessary treatment. Surely the point of this is that if it flags up something you can go to a doctor, they can review the data and then have more insight as whether you need treatment. If they’re just treating someone based solely on the suggestion of a watch then I think the doctor is the problem. As the speaker they brought on stage said, the problem a lot of the time is that by the time someone with a problem gets to a doctor the problem may have subsided and they’ve got nothing to go on. At least with this, even if it’s not 100% accurate they can get a better idea of what they might be dealing with.

  9. Its stupid dumb easy for medical equipment producers to push through any untested piece of garbage through the FDA. which makes this feature incredibly suspect and hilarious at the same time. Apple touts that they got FDA approval.. so did hundreds of other junk pieces of equipment that barely do what they say they do.

    the FDA is very corrupt and messed up.

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