One of the most amazing features in Apple Watch Series 4 is undeniably the ability to take Electrocardiogram (ECG) right from the wrist. This feature has the potential to save lives. However, as with all medical equipment and technology, approvals from regional health authorities are required. So far, Apple only has regulatory approval from the FDA in the United States.
Apple had originally announced ECG during their September even where they launched Apple Watch Series 4. However, they said that ECG would be releasing later in the year. With Series 4, taking an ECG requires the user to place their finger on the Digital Crown for 30 seconds. The Watch users sensors and electrical signals to generate a report and check whether your heart rhythm is normal or requires attention.
Fortunately, all Apple Watch Series 4 models, no matter where they are sold, ship with ECG hardware. A little investigation in watchOS 5.1 beta code by 9to5Mac has confirmed that the limitation for United States is just a soft lock. This means that bypassing the limitation is as easy as changing the region on the paired iPhone to United States.
This is not something out of the ordinary and many users, including yours truly, use this to get access to iOS features like Apple News, which are geo-restricted to a small number of countries. Of course, changing the region on a device changes its currency, date and time formats but they can be manually adjusted.
If you have an Apple Watch Series 4, you should be able to turn on ECG after watchOS 5.1 is released later today by going to Settings > General > Language & Region > Region and changing it to United States.
We will soon have confirmation whether this method continues working with the final watchOS 5.1 build or not. We will update this post if there is any change.
P.S. Just because ECG would work on the watch with this method, does not mean that its report will be accepted by hospitals in your country.
Update: It seems that Apple has tied the ECG app in watchOS 5.1.2 with serial numbers of Apple Watch Series 4 sold in United States so unfortunately, this guide will not help. So far, there is no workaround for this. We will update this guide if and when a workaround is found to enable ECG on Apple Watch Series 4 models sold outside United States.