Garmin Elevate 4 to get ECG and AFib – soon?

Fenix 6 Shown, Weather image shown

Garmin to get ECG and AFib from ELEVATE 4 – later in 2021?

Currently, Garmin supports abnormal heart rate detection by a method that simply alerts you to sustained periods of high heart rate when you appear to be inactive. This has some usefulness but is an ineffective tool when compared to Garmin’s competition. Indeed Garmin is clearly behind the competition in this important health space. Other competitors’ watches that have EKG/ECG include

  • Apple Watch Series 4, 5, 6
  • Samsung Galaxy Watch 3
  • Fitbit Sense
  • Withings Move ECG
  • Amazfit Smartwatch 2

In 2018, Garmin collaborated with the University of Kansas Medical Centre for an AF study. I would assume this study used the previous generation of Garmin Elevate sensor and I would further assume that Elevate Gen 3 plus associated algorithms did not meet the required standard, otherwise, Garmin would have released AF features quite some time ago.

Garmin has recently released their Gen 4 ELEVATE sensor which has so far only been introduced on their Venu 2 and Forerunner 945LTE models. Now there is an active and ongoing Garmin-sponsored validation study to confirm their software algorithms can perform on a clinically equivalent basis to a Lead I ECG/EKG. This study is due to end in July 2021, with the results probably being leveraged soon after.

If the study goes well, we could expect AF/ECG features later this year on the top-end Garmin health & fitness devices, ie both the Vivoactive/Venu and Fenix ranges. Indeed this could perhaps end up as one of the headline features for this year’s Garmin Fenix 7 and Vivoactive 5.

The studies aims are stated thus:

The purpose of the study is to confirm the Garmin ECG (electrocardiogram) software algorithm can detect and classify atrial fibrillation and normal sinus rhythm on single lead ECG data derived from a Garmin wrist-worn, consumer device. The study will also confirm the software’s ability to create a Lead I ECG that is clinically equivalent to a reference device.

Why would I want EKG/ECG or AF Capabilities?

A study showed cardiomyopathy to be the major cause of sudden cardiac death in 8 cases out of a cohort of 11,000 young football players.

Only yesterday, Christian Eriksen (Denmark) collapsed as a result of a cardiac arrest during an International Football Game ( Although this is NOT now thought to be AF-related, every top-level footballer will be regularly scanned for heart abnormalities and, in the UK, the Football Association operates a scheme to get young footballers scanned by ECG. Clearly, Garmin and the competition will not be marketing their devices as diagnostic tools but should they throw up readings of concern then you would be wise to immediately seek a full medical evaluation.

via @DH, thank you for the heads up!

Edits from feedback by @Circe, below

Info: Electrocardiogram

Info: Atrial Fibrilation




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12 thoughts on “Garmin Elevate 4 to get ECG and AFib – soon?

  1. Dear tfk,
    I’ve been following your site for several years now; I think you are very expert about sport tech and devices. But… this kind of information are medical related and only a doctor (or nurse or healtcare personnel) can explain well. You made some mistakes:
    –         Atrial fibrillation is not life-threatening (not immediately)
    –         Atrial fibrillation is very very rare in young people
    –         Most of cases of Sudden unexpected death in health people (without coronary artery disease) are due to Ventricular fibrillation (this is LIFE-THREATENING!)
    –         You can’t recognize VF with WHR: you haven’t pulse activity!
    –         For VF screening you need a 12-leads EKG (and also, it’s very difficult to recognize all type of arrhythmias)

    Screening for AF will be very useful for older people to prevent stroke and cerebrovascular events: this is why Garmin and competitors are investing in this technology

    –         Eriksen collapsed during match….

    1. Long term endurance exercise as a risk factor for atrial fibrillation in the middle aged, independent of age related risk factors, is well described. Afib can certainly be life threatening if unstable, stroke due to occult afib can be devastating and also life threatening. Often afib is occult, which makes continuous monitoring features on an athlete’s watch make a lot of sense. In fact it is one of the main features I am considering for a training watch as a middle aged long-term endurance enthusiast myself. Not sure why you would want to screen for vfib as would be sort of a moot point… would be nice to screen for other arrhythmias, WPW etc.

      Here is an American College of Cardiology article on the subject of athlete’s and afib.

  2. I remember you writing that you thought fenix 7 would come out in 2022. Is 2021 starting to seem more likely again?

      1. So 2022 is more likely? I’m just confused as this article says this years Fenix 7.

  3. Dear TFK,

    I love your site and think you do a great job of spreading tidbits of information to the public who – rightly – want to know if a new device is going to land in the next few months before dropping hundreds of dollars on a watch.

    But i think you may have unintentionally mislead some folks here. Just to be clear, i am not 100% certain you wrong, so take this with a grain of salt. Your article left the impression, at least to me, that the ELEVATE 4 sensor could provide ECG data. But i think that isn’t possible. I believe a 1 lead ECG describes a single electrical pathway from one point to another through the heart. So the Elevate 4 sensor would have to have these two electrical contacts. On the Apple watch the electrical contacts are the back of the watch and the crown, which the user has to touch to complete the electrical path. On the 945 LTE, which i own, i don’t believe the buttons or the back of the watch are configured to be electrical contacts for an EKG function – of course, i could be wrong.

    To me, it sounds like Garmin has developed a new prototype watch that has those contacts, and it is testing its software algorithm to ensure it is accurate. Again, to me, it sounds like this could be a headline feature for a next generation watch – i would suspect the 955, Fenix series, and perhaps Venu series. I have no evidence to support that, it is just speculation on my part.

    In any event, i am not trying to criticize you – i think you are doing a great job – just wanted to pass along my understanding of things. Again, i could be wrong.

    1. 😉
      ty for being very polite. I confess to making mistakes so am always happy to rectify them.
      the 945 has the gen 3 sensor. here is the gen 4 sensor on the venu 2: which is the same as the 945LTE that you have.
      yes the method you describe of taking a watch-based ecg reading is, afaik, correct on apple watch 4-6, Samsung and presumably other devices too.

      Perhaps a fenix 7 could have a metal button on the bezel and a metal contact (charging port or somewhere else) on the underside and still use the gen 4 sensor?

      ie it would have a subtly different implementation to the one we see on the venu 2 and 945lte.

      i could be wrong.

      I would say it is impossible that Garmin has a gen 5 sensor planned for anytime in the next few years.

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