Apple watch series 4: now also with ekg in the usa

More screen, more battery, more for health: the Apple Watch Series 4 opens up new dimensions. With the update to watchOS 5.12. the watch can – for the time being in the USA – create ECGs.

Apple Watches

Not quite three months after its unveiling, the Apple Watch Series 4 is finally getting an essential feature with a software update, becoming the first consumer product to provide a reliable electrocardiogram (ECG). To do this, you start the update to watch OS 5.1.2, which is available from today, included ECG app and places the index finger of the other hand on the digital crown. A circuit closes, the measurement begins. The system update also includes software that uses regular pulse measurement to detect arrhythmias and thus the risk of atrial fibrillation. If the watch detects a corresponding deviation in the heartbeat, it notifies the wearer to take an ECG and, if in doubt, to consult a doctor. The new features are only available in the US for the time being, since the Apple Watch needs an official approval as a medical device. This has been granted by the FDA (Food and Drug Administration). In the EU, Apple has long since applied for such a release, but it is uncertain when this will take place. This is unlikely to happen this year.

Test from 24. September 2018: every year a new watch, with only incremental improvements – but this year is different with the Apple Watch Series 4 and the watchOS 5 that accompanies it, the new watch makes a significant leap forward in development and points in the direction it will continue to move in. However, it's not just the hardware that matters, but also the software.

Conclusion on the Apple Watch Series 4

The Apple Watch Series 4 means a significant leap forward, even if some of the new features are not yet usable, such as the creation of the ECG – and other innovations already come with watchOS 5 also on older devices. The entry-level prices of 429 euros (40 mm) and 459 euros (44 mm) for the GPS version (the LTE watches cost 100 euros more each) may seem daunting, but like the iPhone 5 in its day, the Apple Watch Series 4 primarily brings more information to the larger screen – app developers still have to do their homework for it. But even the upgrade from the year-old Apple Watch Series 3 seems justified if you get an ECG device for your wrist in early 2019. Apple is likely to have even more health features in the works, but it is highly uncertain when these will appear in a product.

Order Apple Watch Series 4 at MediaMarkt

Order Apple Watch Series 4 at Otto

Order Apple Watch Series 4 at Gravis

Special models

Apple sells the Apple Watch Nike+ in both versions as Series 3 and Series 4, each at the prices of the standard aluminum models. Only in stainless steel version and only as Series 4 are the fashionable Apple Watch Hermes to have, at prices at 1299 euros in the 40-mm edition and 1349 euros for the 44-mm variant.

Larger screen

That a lot has changed becomes clear as soon as you unpack it. A cardboard sleeve (unfortunately still shrink-wrapped) frames the cardboard box containing the watch – the wristband is included separately this time, also wrapped in cardboard. The watch (our test unit is a black aluminum model with a 44-millimeter screen) is packaged in a felt case, with the charger and cable lying next to it as usual – but not in a plastic shell, but in one made of cardboard. Apple has promised more sustainability and packaging made from renewable raw materials – this has already been met with the Apple Watch Series 4.

However, technical innovations are essential. This also starts on the surface: The case of the smart watch is only slightly taller and wider, but a bit thinner compared to the two previous models – the visible area on the screen, however, is much larger. Apple speaks of thirty percent, although the diagonals have only increased from 42 mm to 44 mm and from 38 mm to 40 mm respectively.

However, apps now take advantage of more of the available space the screen now goes all the way to the corners and edges, so you simply see more in each app. However, at launch, this is mainly relevant only for Apple's own apps and those of a few third-party developers. Because developers still have to do their homework, almost all of the apps on our iPhone that offer an extension for the Apple Watch Series 4 do not yet cope with the new screen defaults and therefore can not be installed on the watch. Simply scaling up doesn't work, the Series 4 finally claims the areas of the geometry not used at all so far. Update, 24.9. Numerous developers have apparently used the weekend and Monday and adapted their apps. Specifically, we can now install apps like DB Navigator, Runkeeper, Carrot 5 or kicker on the watch, which was not yet the case on Friday. Update end

Watch faces with much more information

How to make use of the space is already shown by the two new watch faces, one of which Apple has set up ex-factory: Infograph in round form (In addition, there is also the Infograph in modular form). Both "watch faces" have in common that up to eight complications can be put on the dial, previously there was a maximum of four. Some complications are also optimized for these views, the one for activity not only shows the filling level of the rings, but also gives concrete figures for training and calorie consumption, the one for temperature shows the current (calculated) value as well as daily minimum and maximum. Also only possible here: Putting favorite contacts on the watch face, which you can reach with a tap. A similar function had watchOS 1 already offered, the pressure on the side button brought a view on the screen, on which up to twelve contacts were placed. With the update to watchOS 2, this feature had given way to a multitasking view with the most important apps, which is still part of the system today. The infographics are exclusive to the new Series 4, but other innovations are coming to older watches with watchOS 5.

Apps like Photos, Mail or Messages benefit the most from the larger screen of the Apple Watch Series 4, you now get a much better impression of your own pictures and text messages can now be read somewhat reasonably.

Automatism when exercising, better views

You don't need an Apple Watch Series 4 for this, the update to watchOS 5 already does it: Automatic workout recording. How many times hadn't we realized after we started our sporting activity that we hadn't even activated recording at the beginning. The new operating system now remedies this by letting the watch ask after a while if you don't want to record the workout you just started, using the data the Apple Watch has collected from the start. Unfortunately this is only valid for a very limited selection, running as well as walking indoor and outdoor, swimming, cross trainer and rowing machine. For our preferred sporting mode of locomotion, cycling in the fresh air, this is not offered. And still the watch doesn't stop at traffic lights either. No special hardware would be necessary for this, algorithms should be able to recognize what we are doing quite easily on the basis of the GPS data and the pulse. An automatic stop after training is also only available for runners. There are also two new favorites in the workout app that were previously hidden under "other" – yoga and hiking.

For the latter, the altitude measurement is especially interesting, which we also have on the screen of the watch when cycling. For running, there is a new feature on the larger screen: The rolling kilometer. It shows the time needed for the last kilometer, i.e. not for the meters 2001 to 3000, but at meter 3076 the time needed from meters 2076 to 3075. Runners can thus control their speed even a bit better. Outdoor training should now be possible for an hour longer, up to six hours at a time. We have not been so diligent to verify this yet. Optimizations to many components are responsible for the extension, such as the more efficient S4 CPU, the GPS and the heart rate sensor. We can't say much about the battery life in the shortness of our test so far. We put the watch on at 71 percent charge on Friday afternoon, then trained on the bike for an hour, ran for half an hour the next morning and only plugged it into the charger in the early afternoon with ten percent charge left. We could also expect such things from a fresh battery, but whether it will now last longer than the previous maximum of two days (with little training) remains to be seen. We will update the test accordingly.

Caution, cases!

A technical update is given to the accelerometers in the Apple Watch Series 4. These are now able to detect values up to 32 g, until now it stopped at 16 g. This brings a new, useful function, only for the Series 4 (and its future successors). For so the watch is able to recognize falls as such. This can save lives, because if you fall and don't move any further, the phone connected to the watch (or the watch alone in its LTE variant) calls 911 – and knows the right phone number for each country right away. The watch also sends the coordinates and alerts the emergency contacts stored in the emergency passport. We have better not tried this, the misuse of the emergency numbers is finally punishable and in itself we did not want to lie on the face at all.

In the case of a less serious fall, however, you still have the opportunity to cancel the emergency call scenario after the fall. However, some sports or exercises can still be misinterpreted by the sensors as a fall, so when the fall sensor is activated, an appropriate warning appears. And if the wearer of the watch is older than 65 years, the function activates itself, a very useful feature.

Better pulse measurement, soon with ECG

Recently, we had visited the cardiologist because of repeated warnings of our Apple Watch Series 3 against too high resting pulse (>100 bpm), who fortunately found no problems. However, he pointed out to us that heart rate monitors are sometimes quite inaccurate, since they do not recognize extrasystoles and then display a higher heart rate. In terms of heart health, the Apple Watch Series 4 will bring real improvements, but we'll have to wait to try them out in the long run. This starts with the optical pulse measurement. Four instead of only two laser diodes emit green light, the photocells are arranged on the back of the watch around its center in a circle. The two infrared diodes, which check the pulse every ten minutes outside of training, are still attached near the center. With the new geometry, Apple wants to increase the reliability of the measurement, but during our performance test in the doctor's office a few weeks ago, we had already noticed with the Series 3 that its determined values were very close to those of the professional ECG.

Soon, however, we'll have the pleasure of being able to take an electrocardiogram ourselves with the fancy device on our wrist, without having to hook ourselves up to big gadgets with their weird suction cups. One electrode is installed on the back of the watch, a second one is in the digital crown. If you touch it, the circuit closes and the watch is able to create an ECG from the changes in current and write the data to the Health app. We'll have to wait a while for this feature though, Apple still needs clearance from the FDA in the US, they've already applied for clearance in the EU. In the U.S., Apple should be able to release the ECG via a software update before the end of the year; the manufacturer has not yet given a time frame for the EU.

The ECG device on the wrist, however, will offer a real advance in heart health. Because if the watch now registers a pulse above an adjustable threshold (so about 100 bpm), or – new under watchOS 5 – a pulse below a minimum value (ex works 40 bpm), you get not only the corresponding alarm on his wrist, but also the request to create an ECG – the data you can then immediately send by mail to the doctor of confidence or put him a printout in the mailbox. Similarly, the watch alerts you when it detects atrial fibrillation, a symptom of potentially serious conditions that should be investigated further with an ECG.

What the Apple Watch Series 4 cannot yet do, despite speculation to the contrary: Measure blood pressure and blood sugar. Both would be possible with spectroscopy alone, and Apple also holds the corresponding patents. However, the hardware of the current edition is not able to do so, as the manufacturer assures us. A 24-hour blood pressure monitor or even one for measuring glucose levels would be a hit – but when Apple will build such technology into a product remains completely open.

Connection to the outside

The Apple Watch Edition has had its day. The gold model of the first generation probably only had symbolic value anyway and hardly found any buyers, the ceramic model of the Series 2 and 3, on the other hand, was still somewhat affordable, although significantly more expensive than the stainless steel variant. Ceramic remains as a material, however, together with sapphire glass on the underside of the aluminum and stainless steel models. Apple cites a technical background: because the antennas of the watch are now no longer behind the screen and radiate only upwards, but sit below directly under the lid. Now that it's permeable to electromagnetic waves, reception improves, especially with the LTE variant of the watch. The GPS version and its Bluetooth and WLAN antennas also benefit from the new design. In practice this is hardly noticeable so far.

Whereas in another hardware design change, we hear significant differences. Microphone (right) and speaker (left) of the watch are now on different sides, Apple wants to improve voice quality during phone calls with it. This has audibly worked, we note during our conversations, you no longer have to hold your arm in front of your face to make a call.

Wristbands still fit

But what fits right away from the old days are the wristbands . These are as expensive as ever at Apple, the sports wristband (silicone), the Nike wristband and the Sportloop made of woven nylon cost 59 euros each, the leather wristbands and the Milanaise 159 euros. The link bracelet is available for 499 euro. Hermes bracelets cost 369, 469, 519 and 569 euros in their different versions. Fall 2018 sees a return to more muted colors, with Apple introducing Cape Cod Blue, Indigo, Hibiscus and Nectarine tones for silicone, leather and nylon, respectively.