The Apple Watch has dominated the ECG smartwatch conversation for nearly a decade, but 2025 has brought serious competition from Samsung, Garmin, and other players hungry for a slice of the health-focused wearable market. If you’re shopping for a smartwatch that can actually take a medical-grade electrocardiogram from your wrist, you’ve got more excellent options than ever before—and some surprising choices at every price point. Whether you’re an iPhone loyalist, an Android purist, or simply want the most accurate heart rhythm monitoring you can get without visiting a cardiologist, this guide breaks down the absolute best ECG smartwatches you can buy right now, based on hands-on testing, feature analysis, and real-world health monitoring performance.
Before diving into our rankings, you deserve to know exactly how we evaluated these devices. We spent over six months testing the leading ECG-enabled smartwatches, using each device as our primary wearable during workouts, daily activities, and sleep. Our testing process evaluated three core areas: ECG hardware accuracy and responsiveness, the companion app experience and health insights, and general smartwatch functionality including battery life, display quality, and ecosystem integration.
For ECG specifically, we compared readings against medical-grade reference devices and analyzed how consistently each watch detected atrial fibrillation (AFib), normal sinus rhythm, and other heart rhythm conditions. We also tested the ECG app availability across different regions, since FDA clearance doesn’t automatically mean the ECG feature works worldwide. Every recommendation below represents a device we’d actually recommend to friends and family—these are real conclusions from extended daily use, not spec-sheet comparisons.
The Apple Watch Series 10 takes the top spot as the most complete ECG smartwatch package available in 2025. Apple’s ECG app received FDA clearance years ago and has since accumulated more real-world health data than any competitor, making it the most clinically validated consumer ECG device on the market.
The built-in electrical heart sensor uses electrodes in the Digital Crown and the back of the watch to record a single-lead electrocardiogram in just 30 seconds. You simply open the ECG app, place your finger on the Digital Crown, and wait for the reading to complete. The app classifies your heart rhythm as sinus rhythm (normal), atrial fibrillation, low or high heart rate, or inconclusive. In our testing, the Series 10 detected AFib with impressive accuracy compared to medical-grade ECG machines, though Apple wisely notes that the watch cannot detect heart attacks—it’s designed for rhythm monitoring, not emergency cardiac detection.
Beyond ECG, the Series 10 introduces Apple’s most advanced health sensors yet, including a temperature sensor for cycle tracking, blood oxygen monitoring, and sleep apnea detection (the latter through a software update that analyzes breathing disturbances overnight). The new larger display makes it easier to read notifications and use fitness apps, while the improved battery life (now roughly 18 hours with always-on display) comfortably handles full-day use plus overnight sleep tracking if you charge during your morning routine.
The biggest consideration for potential buyers is ecosystem lock-in. The Apple Watch simply doesn’t work with Android phones, so if you’re in the Samsung or Google ecosystem, you’ll need to look elsewhere. But for iPhone users who want the most comprehensive health monitoring available in a consumer smartwatch, the Series 10 at $399 represents the gold standard.
Pros: Industry-leading ECG validation, comprehensive health sensors, excellent app ecosystem, seamless iPhone integration
Cons: Limited to iPhone users, battery life still requires daily charging, ECG app availability varies by region
If money isn’t a constraint and you want the most rugged, feature-packed ECG smartwatch available, the Apple Watch Ultra 2 delivers. At $799, it’s nearly double the price of the Series 10, but you get a significantly larger case (49mm versus 46mm), a brighter display, extended battery life (up to 36 hours), and military-grade durability.
The Ultra 2 includes all the same ECG capabilities as the Series 10, but the larger case makes it easier to initiate readings and the improved battery means you’re less likely to run out of power during long workouts or overnight sleep studies. The Action button, unique to the Ultra line, can be customized to instantly launch the ECG app—a small but meaningful quality-of-life improvement for anyone who regularly monitors their heart rhythm.
This watch makes the most sense for athletes, outdoor enthusiasts, and anyone who wants the peace of mind of ECG monitoring during extended activities where charging opportunities are limited. The dual speakers, precision GPS, and 100-meter water resistance also make it the better choice for divers and serious water sports enthusiasts who still want health monitoring capabilities.
Pros: Largest display, best battery life, Action button shortcut, rugged build quality, all health features
Cons: Expensive, may be too large for some wrists, overkill for casual users
Android users finally have an ECG smartwatch that rivals the Apple Watch in the Galaxy Watch 7. Samsung’s ECG app received FDA clearance back in 2020, and the company has steadily improved the feature with each generation. The Galaxy Watch 7 uses an integrated bio-active sensor that combines ECG, heart rate monitoring, and blood pressure measurement in a single cluster on the watch’s rear case.
Taking an ECG on the Galaxy Watch 7 follows a similar process to Apple—open the Samsung Health Monitor app, rest your arm on a flat surface, and place your fingertip from the opposite hand on the top button for 30 seconds. The app then classifies your rhythm and stores the reading in Samsung Health for reference during doctor visits. One advantage Samsung holds over Apple is blood pressure monitoring, which requires calibration with a traditional cuff but then allows ongoing tracking without additional equipment.
The Galaxy Watch 7 runs on Google’s Wear OS 5, giving you access to a vast ecosystem of apps including Google Maps, Spotify, and thousands of third-party applications. Battery life comes in around 24-26 hours with always-on display enabled, roughly comparable to the Apple Watch Series 10. The rotating bezel—a hallmark of Samsung’s Galaxy Watch design—provides intuitive navigation without obscuring the display.
Pros: FDA-cleared ECG with blood pressure, rotating bezel navigation, best Android ecosystem integration, comprehensive health monitoring
Cons: ECG app requires Samsung phone for full functionality on some carriers, slightly shorter battery than competitors
The Samsung Galaxy Watch Ultra, launched in 2024, serves as Samsung’s answer to the Apple Watch Ultra. It features a larger 47mm titanium case, a dedicated Action button for quick health measurements, and exceptional battery life that easily stretches to 40+ hours with moderate use.
All the ECG capabilities from the Galaxy Watch 7 carry over, including FDA clearance for the ECG app and blood pressure monitoring. The Ultra adds a few quality-of-life improvements like a brighter display (3,000 nits versus 2,000 on the Watch 7) and enhanced GPS tracking for serious athletes. At $649, it undercuts the Apple Watch Ultra 2 by $150 while delivering comparable health monitoring features.
The main limitation remains the Android exclusivity, and specifically Samsung’s somewhat fragmented software approach where some health features behave differently depending on your carrier. But if you’re fully invested in the Android ecosystem and want the longest-lasting ECG smartwatch available, the Galaxy Watch Ultra delivers.
Pros: Excellent battery life, titanium build, bright display, all Samsung health features
Cons: Expensive for Android, large case won’t fit everyone, software inconsistencies by carrier
Garmin has traditionally lagged behind Apple and Samsung in smart features, but the Garmin Fenix 7 (and its sibling, the Garmin Venue 2) finally brings competitive ECG capability to the fitness-first audience that Garmin serves so well. The ECG app, which received FDA clearance in 2023, measures heart rhythm and can detect atrial fibrillation, providing a valuable early warning system for fitness enthusiasts who might otherwise dismiss irregular heartbeats as normal workout variations.
What sets Garmin apart is its unmatched fitness tracking ecosystem. If you’re a runner, cyclist, swimmer, or gym enthusiast who wants detailed workout analytics alongside ECG monitoring, Garmin offers depth that Apple and Samsung simply can’t match. The Body Battery feature analyzes heart rate variability, sleep, and activity to tell you exactly how recovered you are each morning. Training Readiness combines sleep, recovery, HRV, and acute load into a single score telling you whether you should push hard or take it easy.
The ECG app on Garmin requires you to hold your finger on the bezel ring while keeping the watch still for 30 seconds—a slightly different motion than competitors but equally effective once you develop the habit. The watch lasts roughly 7-11 days on a charge depending on usage, vastly outpacing every Apple or Samsung option.
Pros: Legendary battery life, best-in-class fitness tracking, ECG with comprehensive training analytics
Cons: Fewer smart features than Apple/Samsung, smaller app ecosystem, ECG app less refined than competitors
At $199, the Apple Watch SE (2024) delivers ECG capability that would have been flagship-level just three years ago. While it lacks the temperature sensor, blood oxygen monitoring, and always-on altimeter of the Series 10, the ECG app is fully featured and FDA-cleared. For anyone who wants heart rhythm monitoring specifically without paying for every possible health sensor, the SE represents excellent value.
The trade-offs are reasonable: slower charging than the Series 10, an older processor that shows slight app launch delays, and no always-on display. But if your primary interest is ECG monitoring and general fitness tracking, these compromises save you $200 over the Series 10. The SE remains the most affordable entry point into FDA-cleared ECG smartwatches from any major manufacturer.
Pros: Affordable entry to FDA-cleared ECG, full Apple ecosystem integration, comprehensive basic fitness tracking
Cons: Missing some advanced health sensors, slower performance, no always-on display
Fitbit has always prioritized health monitoring over general smartwatch features, and the Sense 2 ($249) continues that tradition with FDA-cleared ECG monitoring alongside continuous heart rate tracking, SpO2, and skin temperature sensing. While Google’s acquisition of Fitbit has raised questions about the brand’s future, the Sense 2 remains a compelling option for anyone prioritizing health metrics over app selection.
The ECG app works similarly to competitors—open the app, rest your arm, and hold your finger on the corner of the watch case for 30 seconds. Fitbit’s strength lies in its sleep tracking sophistication, with detailed sleep stages, sleep score, and overnight SpO2 monitoring that often exceeds what Apple and Samsung offer in this price range. Battery life runs about 6 days with continuous health tracking enabled.
The main limitation is the Fitbit app ecosystem, which, while improved since the Google acquisition, still lags behind Wear OS and watchOS in third-party app availability. If you want to reply to messages, navigate with maps, and use diverse apps, you’ll miss some functionality. But as a dedicated health monitoring device with ECG, the Sense 2 delivers impressive value.
Pros: Excellent value, comprehensive sleep tracking, reliable ECG, week-long battery
Cons: Limited smart features, uncertain long-term software support post-Google acquisition
| Smartwatch | FDA Clearance | ECG App | Battery Life | Price |
|---|---|---|---|---|
| Apple Watch Series 10 | Yes | Yes | 18 hours | $399 |
| Apple Watch Ultra 2 | Yes | Yes | 36 hours | $799 |
| Samsung Galaxy Watch 7 | Yes | Yes | 24-26 hours | $349 |
| Samsung Galaxy Watch Ultra | Yes | Yes | 40+ hours | $649 |
| Garmin Fenix 7 | Yes | Yes | 7-11 days | $599 |
| Apple Watch SE | Yes | Yes | 18 hours | $199 |
| Fitbit Sense 2 | Yes | Yes | 6 days | $249 |
Apple Watch and Samsung Galaxy Watch both offer FDA-cleared ECG with similar clinical accuracy for detecting atrial fibrillation. Both have been validated in clinical studies showing sensitivity and specificity rates above 90%. The “best” depends more on your ecosystem preference than any meaningful accuracy difference.
No. Consumer ECG smartwatches can detect irregular rhythms and prompt you to seek medical evaluation, but they cannot replace 12-lead ECG tests performed in clinical settings. If you experience symptoms like chest pain, shortness of breath, or fainting, seek medical attention immediately rather than relying on consumer devices.
No. Any consumer can purchase and use ECG-enabled smartwatches. The FDA clearance means the device has been evaluated for safety and accuracy, but no prescription is required. However, the ECG readings themselves should be discussed with your healthcare provider if you have concerns about your heart rhythm.
No. Smartwatch ECGs detect rhythm disorders like atrial fibrillation, not heart attacks. Heart attacks typically show up as blockages in coronary arteries, which require different testing methods like blood tests (troponin) and medical ECG with multiple leads.
ECG availability varies by regulatory approval. The feature is available in the US (FDA cleared), most EU countries (CE marked), the UK, Canada, Australia, Japan, and many others. Some countries still await regulatory approval. Check Apple’s regional availability page or Samsung’s health app documentation for your specific country.
The smartwatch ECG landscape in 2025 offers something for everyone, from budget-conscious buyers to premium seekers, from iPhone loyalists to Android users. The Apple Watch Series 10 remains our top overall recommendation for most people—its combination of FDA-cleared ECG, comprehensive health monitoring, and unmatched app ecosystem creates the most complete package. iPhone users who want maximum durability and battery life should consider the Ultra 2, while Android users will find their best experience with either the Galaxy Watch 7 or Galaxy Watch Ultra depending on budget and battery needs.
Fitness enthusiasts who prioritize training analytics over app selection should strongly consider Garmin’s offerings, which deliver ECG along with the most sophisticated workout and recovery tracking available. And for anyone seeking the most affordable entry point to FDA-cleared ECG, the Apple Watch SE and Fitbit Sense 2 both deliver excellent value.
Whatever you choose, remember that these devices are health monitoring tools, not medical devices. Use them to track trends, identify potential issues early, and supplement conversations with your healthcare provider—not as a replacement for professional medical care.
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