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Apple Watch ECG app: How it works and what it means for the future of health

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Apple has long been positioning the iPhone and the Apple Watch as wellness devices — hardware that can help you track markers of fitness including exercise, step count, and even sleep and ‘mindfulness minutes’.

ALSO: Apple Watch ECG app launches today with watchOS 5.1.2 update

But now it’s taking that a step further by adding the sort of heart-monitoring technology more usually of interest to doctors — making it available to anyone with a wrist and a few hundred dollars to spare.

While previous versions of the Apple Watch have been able to measure a wearer’s heart rate, the Apple Watch 4 takes a big step up with its electrocardiogram (ECG or EKG depending on where you are) functionality — which is now live.

Thanks to the new functionality, the Apple Watch will be able to keep an eye on your heart in two ways. First, the Watch’s optical heart sensor quietly measures the wearer’s heart rhythm in the background. If it detects an irregular heartbeat, the Watch flashes up a message warning that you might have a condition known as atrial fibrillation, and so might like to consider a trip to the doctor. Secondly, electrodes in the new model’s crown and back sapphire crystal allow the Watch wearer to take an ECG themselves; again, an alert is delivered if there are signs of atrial fibrillation.


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So what’s the big deal with atrial fibrillation?

Atrial fibrillation, also known as AF or AFib, is a condition where the electrical signals that control the heart go awry. In a normal heart, the signal that tells the heart to beat comes from an area known as the sinoatrial node, and spreads out around the heart from there. The signal should be steady and regular, but in atrial fibrillation the signal to beat is generated outside of the sinoatrial node, and at random, giving someone with the condition an irregular pulse.

While that might not sound worrying, the irregular heart rhythm means the atrium doesn’t pump out blood as it should. The blood hangs around in the upper part of the heart for too long, and clots may form — clots that may ultimately end up in the brain, causing a stroke.

Apart from the irregular heartbeat, someone with atrial fibrillation may have no other symptoms — they may only become aware they have the condition after ending up in hospital. A study published last year found that a stroke was the first symptom of atrial fibrillation in one in five people with the condition, and that around one third of people who were at higher risk of AF had the condition, but hadn’t been diagnosed.

According to the Heart Study (Apple-sponsored research by Stanford University) the Watch was able to identify people with atrial fibrillation 98 percent of the time, and those with normal heart rhythm 99 percent.

SEE OUR SPECIAL FEATURE: Can technology save the NHS?

Atrial fibrillation is a condition that mainly affects the over-65s — although it can affect younger people too, they’re far less likely to experience the condition. One side effect of Apple’s new ECG feature may be that — as Apple Watch users are typically younger – it could lead to a wave of younger people visiting their doctor after a bout of atrial fibrillation. As atrial fibrillation largely hasn’t largely been picked up in a younger population before, because they’re not screened for it in the same way as over 65s, there’s been very little research done on how best to treat them.

“Atrial fibrillation is an important health issue that affects a lot of people, so there’s a lot of sense in trying to recognise people with atrial fibrillation. But what I think is the challenge is that we don’t know enough about the early stage of the disease to really guide people on what treatment to have,” says cardiologist and researcher Rohin Francis.

“The majority of all our information on atrial fibrillation has been in people who have been diagnosed opportunistically or who have had a stroke or mini-stroke, and often it’s something that we’ll find after they’ve had another problem, so we don’t have any real evidence on well patients — particularly younger patients — who might have a bit of atrial fibrillation from time to time.

“If we detect a short run of atrial fibrillation in someone that is otherwise fit and well and doesn’t have major risk factors for stroke otherwise, we don’t know whether they would benefit from the same treatment as someone who’s, say, elderly and has other risk factors, or who has already had a stroke,” Francis says.

Nonetheless, by bringing this sub-population of patients to medical attention, Apple is likely to inspire significant research into how to treat early stage atrial fibrillation in younger patients, particularly as the sheer number of Apple Watch users and the data they bring is likely to be many times what a conventional medical trial could generate.

There are other potential benefits from the Apple’s ECG feature too. As well as finding previously-undiagnosed people with atrial fibrillation, it could help track those already on treatment for the condition. By checking in with the ECG feature, patients with AF could keep their doctors up to date on whether starting a new treatment or swapping to a different medication has decreased the frequency of their atrial fibrillation.


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There are already some caveats to the Watch’s ECG feature, however: it is not to be used by people under 22, for example. The FDA also stipulates that the ECG Watch shouldn’t be used as a replacement for normal medical workup. “The ECG data displayed by the ECG app is intended for informational use only. The user is not intended to interpret or take clinical action based on the device output without consultation of a qualified healthcare professional.. [it] not intended to replace traditional methods of diagnosis or treatment,” it said.

Also, in around 10 percent of cases, the Stanford research found the Watch was unable to read people’s rhythm at all — meaning some Watch wearers who have atrial fibrillation may still go undiagnosed.

What’s next for the Watch’s ECG?

Apple’s Watch is a one-lead ECG, making it a very blunt instrument — it’s only set up to measure the heart’s activity at one point. It can detect atrial fibrillation, but detecting atrial fibrillation isn’t actually that hard: any doctor (and even most medical students) will be able to detect it just by taking a patient’s pulse.

With just one lead, the Watch’s ECG means it won’t become a substitute for a full 12-lead workup that doctors use to diagnose cardiac problems. However, there are other conditions that it could potentially be used to diagnose in future, such as other types of supraventricular tachycardia. Thanks to Apple’s ECG functionality, we could be witnessing the beginning of an era of home diagnostics: a time when a diagnosis is handed down by a device on the wrist, not a doctor in a clinic.

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Facebook is expanding Spotify partnership with new ‘Boombox’ project – TechCrunch

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Facebook is deepening its relationship with music company Spotify and will allow users to listen to music hosted on Spotify while browsing through its apps as part of a new initiative called “Project Boombox,” Facebook CEO Mark Zuckerberg said Monday.

Facebook is building an in-line audio player that will allow users to listen to songs or playlists being shared on the platforms without being externally linked to Spotify’s app or website. Zuckerberg highlighted the feature as another product designed to improve the experience of creators on its platforms, specifically the ability of musicians to share their work, “basically making audio a first-class type of media,” he said.

We understand from sources familiar with the Spotify integration that this player will support both music and podcasts. It has already been tested in non-U.S. markets, including Mexico and Thailand, and it’s expected to arrive in about a week.

The news was revealed in a wide-ranging interview with reporter Casey Newton on the company’s future pursuits in the audio world as Facebook aims to keep pace with upstart efforts like Clubhouse and increased activity in the podcasting world. 

“We think that audio is going to be a first-class medium and that there are all these different products to be built across this whole spectrum,” said Zuckerberg. “Of course, it includes some areas that, that have been, you know, popular recently like podcasting and kind of live audio rooms like this, but I also think that there’s some interesting things that are under-explored in the area overall.”

Spotify has already supported a fairly productive relationship with the Facebook and Instagram platforms. In recent years the music and podcasts platform has been integrated more deeply into Instagram Stories where users can share content from the service, a feature that’s also been available in Facebook Stories.

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Clubhouse closes an undisclosed $4B valuation Series C round, as tech giants’ clones circle – TechCrunch

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Buzzy “social audio” app Clubhouse has raised a Series C funding round, reportedly valuing the company at $4 billion. Clubhouse said the new round of financing was led by Andrew Chen of Andreessen Horowitz, with participation from DST Global, Tiger Global and Elad Gil. This round means Clubhouse has tripled the valuation it attained in January when Andreessen Horowitz led its Series B funding round.

The funding comes as Twitter, Spotify, Facebook, Telegram, Discord and LinkedIn are all prepping similar features to Clubhouse’s live audio streaming rooms, which has attracted attention for hosting live chats with the likes of Elon Musk and Mark Zuckerberg. Indeed, Vox reported that Facebook will announce a series of “social audio” products only today.

But, unusually for such a late stage of funding, the company has not revealed the amount raised. Industry sources say that this is probably because the Series C funding round is “multi-stage” and therefore not officially closed. Alternatively, the company is “hyping” itself ahead of a sale, as is often the case with “hot” startups. Twitter reportedly broke off talks to acquire the startup at a $4 billion valuation, according to Bloomberg.

And despite appearances that this funding round has been timed to coincide with the launch this week of Facebook’s Clubhouse clone, one well-placed source told me “this funding round has been in the works for the last 1.5 months” and that some offers have been “above 2x” the $4 billion valuation. In other words, there are some investors out there who think Clubhouse is worth more than $8 billion.

So far Clubhouse is demurring on all this, and declining to comment more directly to the media. The company disclosed the news about the funding during its weekly “town hall” chat last Sunday night and in a blog post, the company said the fundraising will support a fresh burst of growth for the app.

“While we’ve quadrupled the size of our team this year, stabilized our infrastructure, launched Payments in beta to help creators monetize, and readied Android for launch, there is so much more to do as we work to bring Clubhouse to more people around the world. It’s no secret that our servers have struggled a bit these past few months, and that our growth has outpaced the early discovery algorithms our small team originally built,” said the post.

Noting that “it’s important to us to be building all of this with people who are invested in the community and who represent a diverse set of backgrounds and voices,” Clubhouse has, however, been struck by a wave of problems in the last few days, when anti-Semitic audio rooms seemed to proliferate on the platform. Clubhouse has previously been criticized for its seeming inability to moderate extremism on the app.

The year-old platform, which has reported 10 million weekly active users, has thrived during the pandemic while people were locked down and therefore unable to chat easily in person.

Tech news site The Information first reported details on the Clubhouse funding on Friday.

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Facebook invests in audio with short-form Soundbites feature, podcast support, and a Clubhouse clone – TechCrunch

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Facebook today officially announced a suite of new audio products — an indication that it’s taking the threat from Clubhouse and other audio platforms more seriously. The company is doing more than just building its own take on Clubhouse, however, it’s also announcing tools that allow podcast creators to share long-form audio, a new Spotify integration for music, and a brand-new short-form experience called Sound Bites.

The Clubhouse clone was probably the most-discussed of the new products ahead of today’s announcement, given the increased interest in the audio networking market.

Like Clubhouse, the Facebook experience will also involve live audio rooms, where users can engage in topical discussions.

“I think the areas where is where I’m most excited about it on Facebook are basically in the large number of communities and groups that exist. I think that you already have these communities that are organized around interests, and allowing people to come together and have rooms where they can talk is — I think it’d be a very useful thing,” said Zuckerberg, in a friendly interview with Platformer, timed alongside the official announcement. “When we launched video rooms earlier last year, groups and communities were one of the bigger areas where that took off. So, I think around audio, just given how much more accessible it is, that’ll be a pretty exciting area as well.”

Image Credits: Facebook

The Live Audio Rooms will be available across both Facebook and Messenger, Facebook says in an official blog post.

The company will first test Live Audio Rooms in Groups, reaching Groups’ 1.8 billion monthly users. They’ll also be made available to public figures and experts. Early adopters of the feature will include American football quarterback Russell Wilson, Grammy-nominated electronic music artist TOKiMONSTA, artist and director Elle Moxley, and five-time Olympic medalist and entrepreneur Nastia Liukin, Facebook says.

Live Audio Rooms will be available to everyone on Facebook this summer. Also this summer, Live Audio Rooms will be made available on Messenger, for an experience that allows friends to hang out, too.

In addition to products that rehash audio functionality available in tech products from other companies, Zuckerberg also revealed that the company was working on an audio-only version of its TikTok competitor Instagram Reels that allows users to quickly move through algorithmically-sorted short audio clips, a project being called Soundbites. In its blog post, Facebook detailed that they will be testing Soundbites over the next few months with a small group of creators before making it widely available.

Image Credits: Facebook

“The idea here is it’s short form audio clips, whether it’s people sharing things that they find funny… or kind of pithy things that people want to share that cover a bunch of different genres and topics,” Zuckerberg said.

For podcast creators, Zuckerberg said the company will build out tools for those who follow podcasts and creators through Facebook Pages, but don’t currently have a way to access podcast content via the social network. He noted that there are now 170 million Facebook users who are connected to a Page for a podcast, which it why it wants to ensure they have a way to access this audio content more easily.

Image Credits: Facebook

For these users, they’ll be able to discover the audio and start playing it, even in the background. Or they could choose to launch a second app to continue play it, Zuckerberg said. We understand that the experience will actually allow users to directly open Spotify, if they would prefer to listen to the music or audio there, instead.

The feature will also help users with new podcast discovery based on your interests, and users will be able to comment on podcasts and recommend them to friends.

Related to these audio efforts, Zuckerberg referenced Facebook’s partnership with Spotify, which is now being expanded with something it has internally referred to as “Project Boombox” — is an integration that would allow people to share content from their favorite artists, playlists and other types of audio in their feed. That content would then appear in a little, in-line player for others to click and play.

We understand from sources familiar with the Spotify integration that this player will support both music and podcasts. It has already been tested in non-U.S. markets, including Mexico and Thailand. It’s expected to arrive in about a week.

“Facebook’s interest in audio is further validation of the category and reinforces what we’ve known all along — the power and potential for audio is limitless,” a spokesperson for Spotify told TechCrunch. “Our ambition has always been to make Spotify ubiquitous across platforms and devices — bringing music and podcasts to more people — and our new integration with Facebook is another step in these efforts. We look forward to a continued partnership with Facebook, fueling audio discovery around the world,” they added.

Zuckerberg also referenced the need to serve the growing creator economy with its new products.

With Live Audio Rooms, fans will be able to support creators through Stars, Facebook’s existing in-app tipping feature, or donate to causes. Facebook says it will later offer other monetization tools like access to Live Audio Rooms on subscriptions. There’s also an Audio Creator Fund being made available to kick off the launch of Soundbites.

The exec also spoke about Facebook’s plans for a newsletters product, all under the umbrella of serving the creator community with a suite of tools — something Twitter is now doing, too, with its plans for Super Follow.

“I think a product where a journalist or a creator can basically create a subscription for people who want to follow them, that spans both a newsletter and a podcast, is going to be a really powerful thing,” said Zuckerberg. “So that’s a big part of what we’re going to enable with some of the monetization tools around podcasts. That dovetails with the work that we’re that we’re planning to do…our work on on our newsletters and giving tools for for independent journalists. I think enabling both of those things to come together on extremely favorable terms to journalists and creators, will be a pretty powerful thing,” he noted.

The product launches, which Vox scooped on Sunday, indicate how seriously Facebook considers the disruption to its dominance that could be attributed to the growing number of places where fans connect with creators. The threat for Facebook today is not just a new app like Clubhouse or Substack’s newsletters or even Patreon, but the fact that the creator economy, in general, isn’t being centralized and owned by Facebook itself.

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