Can the Apple Watch help save your life?

Value of ECG feature up for debate, but device can detect when you’ve fallen

Can Apple products save you from a stroke, cardio episode or devastating fall? Apple is cautious about making such direct claims.

But during Apple’s press unveiling of the new Apple Watch Series 4, Chief Operating Officer Jeff Williams referred to the new timepiece as an “intelligent guardian” on your wrist.

And Williams highlighted what are potentially important health-oriented initiatives for the new watch. Through a companion app on the iPhone and an electrical heart sensor on the watch, you can generate an ECG (electrocardiogram) merely by placing your finger against the Digital Crown. Apple says this FDA-cleared feature, a first of its kind offered over the counter, will become available to owners of the Series 4 watches in the U.S. in an update later this year. What’s more, the latest watches can also automatically detect if you’ve taken a spill and summon help if you’re immobilized or unresponsive.

These new features further cement what appears to be a major push by Apple into health care. Apple will tell you that it didn’t have strict business ambitions in the health field but that many of its initiatives in the space have happened organically.

A chief purpose for the heart rate monitor inside earlier Apple Watch devices was to help calculate calorie burn. But then customers who noticed when their heart rates appeared too high or too low began writing the company. Last year, Apple made a small but profound change whereby the watch, in effect, started passively looking after you.

In fact, Apple has had a Health app for iOS since 2014, used for, among other purposes, tracking your steps, nutrition, and housing a medical ID with your blood type, medications and emergency contacts.

More recently, Apple added a feature, still in beta, inside the Health app to help you keep all your relevant medical records in one place rather than having to chase down those lab reports, immunizations and other records by visiting disparate online patient portals. A number of hospitals and medical providers are participating.

Last November, in collaboration with the Stanford University School of Medicine, Apple launched an Apple Heart Study app that used the heart rate sensor inside the Apple Watch to collect data on irregular heart rhythms consistent with atrial fibrillation, a leading cause of strokes. If an irregular heart rhythm is detected, participants in the study are notified through the Apple Watch and on their iPhones and offered a free consultation with a study doctor. But Apple cautioned that it won’t catch every instance of AFib and that people shouldn’t rely solely on the study.

Meanwhile, the clearance from the FDA that Apple announced Wednesday relates to two features: First is that the watch can passively monitor your heart for irregular rhythms and deliver alerts if and when it detects them – this feature is available on all Apple Watch models dating back to the original.

The second, for the Series 4 only, is the ECG feature – which you, as the wearer of the watch, have to manually activate through the Digital Crown. The watch has a titanium electrode that works with the electrodes in the back crystal. The experience is supposed to take about 30 seconds, with the ECG classifying the results as either a normal “sinus rhythm” or AFib.

Still, there is controversy about the value of the ECG itself. The U.S. Preventive Task Force recommends against ECG screening for adults with a low risk of cardiovascular disease. The group, which identifies itself as “an independent, volunteer panel of national experts in prevention and evidence-based medicine,” says there is “insufficient” evidence for adults with medium or higher risks.

One potential question mark surrounds false positives. Apple says it will educate you when you first start using the app, but that process was not previewed in advance. You’re encouraged to share the results and consult with your doctor; you can send over a PDF with the ECG waveforms.

Apple’s new watch has already attracted the requisite “I’ve fallen, and I can’t up get up” quips. But, all kidding aside, falls can be deadly serious, and the fall detection feature in the Series 4 might, in fact, be a lifesaver. It relies on the device’s accelerometer and gyroscope. Apple says such sensors can analyze wrist trajectory and impact acceleration. If a tumble is detected, a notification will appear on the watch face. You can tap to acknowledge the fall but say you’re OK. Or you can tap an emergency SOS button to solicit assistance.

If you haven’t responded within a minute – perhaps you hit your head and blacked out – the watch can call 911 using your nearby phone or its own cellular transmitter and send a notification with your location to your preset emergency contacts. To help prevent accidental 911 calls, you’ll start to hear everlouder beeps 45 seconds after the fall occurs – much like those home-based medical emergency systems – alerting you that the 911 call is about to be made.

Fall detection is automatically enabled for users over age 65; otherwise, you can turn on the feature inside the Watch app on your iPhone.

The ECG feature on the Apple Watch Series 4 must be activated by the user. APPLE