Best Smartwatch with ECG for Fitness – Top Picks 2025

Picking a smartwatch with ECG is one of those decisions that sounds simple until you start looking at the options. Every brand claims their watch is the best, the most accurate, the most feature-packed. The truth is, plenty of good choices exist—it mostly comes down to what ecosystem you’re already in and what you actually need.

This guide covers the top ECG-enabled smartwatches for fitness in 2025, organized by who each one makes the most sense for.

Quick Recommendation

The Apple Watch Series 10 is the best overall pick for most people. It has FDA-cleared ECG, solid fitness tracking, and the most developed health app ecosystem. Samsung’s Galaxy Watch 7 is the move if you’re on Android. Garmin dominates if you’re a serious runner or cyclist who cares more about workout data than smartwatch bells and whistles.

How We Tested These Smartwatches

We spent weeks testing each watch in real-world conditions. ECG accuracy was checked against medical-grade equipment—basically, we compared what the watch said against what a proper EKG machine recorded. Battery life got tested through normal use: heart rate on, occasional workouts, sleep tracking, the usual stuff.

We also ran multiple workouts with each watch to check step counts, distance accuracy, and how useful the post-workout data actually was. Interface quality and companion app experience mattered, because a watch is only as good as the software backing it. Price factored in too—we made sure there were good options at every budget level.

Apple Watch Series 10 – Best Overall

Apple’s latest flagship brings meaningful improvements over previous generations, starting with a bigger always-on display that’s genuinely easier to read during workouts. At 9.7mm thick, it’s the thinnest Apple Watch yet—comfortable enough to wear 24/7, including during sleep.

The ECG app has full FDA clearance for detecting atrial fibrillation. It uses both electrical and optical heart sensors working together, which is more reliable than single-sensor setups. Beyond ECG, you get blood oxygen monitoring, temperature sensing for cycle tracking, and fall detection. Useful stuff if you take your health seriously.

Battery life hits about 18 hours with typical use, which means nightly charging for most people. The fast charging helps—you can get to 80% in 45 minutes. Workout tracking covers over 100 activity types, with advanced running metrics like stride length, ground contact time, and vertical oscillation that serious runners actually care about.

The main downside is price—this thing costs as much as a decent used car. And if you’re on Android, it’s a non-starter since it requires an iPhone. But if you’re already in Apple’s world, there’s simply no better option that combines ECG with this level of fitness tracking.

Samsung Galaxy Watch 7 – Best for Android Users

Samsung continues to lead the Wear OS charge with the Galaxy Watch 7, offering the smoothest ECG experience for Android owners. The BioActive sensor handles heart rate, ECG, and blood pressure measurement—though the blood pressure feature needs initial calibration with a traditional cuff and isn’t available everywhere.

The Galaxy AI features are genuinely useful. Instead of just logging your workouts, the watch provides personalized health insights based on your patterns. The Energy Score combines sleep quality, resting heart rate, and activity into a daily readiness metric that tells you whether to push hard or take it easy.

Automatic workout detection works well—it catches walking, running, cycling, and swimming without you needing to start anything manually. Samsung Health gives solid analytics, though some features require a Samsung phone for full access. The 5GHz Wi-Fi is a nice touch for streaming workout content without buffering.

Battery life is about two days with moderate use. Heavy GPS tracking or always-on display will drain it faster. The rotating bezel is divisive—some people love it for navigation, others find it gimmicky.

Apple Watch Ultra 2 – Best for Athletes

This is Apple’s tank of a smartwatch, built for people who treat their training seriously. The titanium case, sapphire crystal, and 100-meter water resistance handle anything from CrossFit to open water swimming. The 49mm case is big, but the 2000-nit display is absurdly bright—you can read it in direct sunlight no problem.

The dual-frequency GPS is the real deal for runners and cyclists who need accurate distance tracking. Battery life hits 36 hours normally and up to 72 in Low Power Mode, which is enough for a full ultramarathon or multi-day backpacking trip. The Action button is customizable—you can set it to start workouts instantly, mark lap splits, or activate a flashlight.

ECG functionality matches the Series 10 with FDA clearance for atrial fibrillation detection. The depth gauge and water temperature sensors make it legit for swimming and diving. The 86-decibel siren can reach 180 meters—a legitimate safety feature for wilderness adventurers.

It costs nearly twice what the Series 10 costs, and the size is genuinely bulky on smaller wrists. Some people also find it too heavy for comfortable sleep tracking. But if you need battery life and durability above everything else, this is the watch.

Garmin Forerunner 965 – Best Running Smartwatch with ECG

Garmin keeps its grip on the running watch market with the Forerunner 965, bringing ECG to its most popular endurance-focused line. The ECG app records heart rhythm data for later review—useful to share with your doctor, though it’s not FDA-cleared for formal diagnosis in the US.

Running dynamics go deep: ground contact time, vertical oscillation, stride length, all measured without chest straps. The training readiness score tells you when you’re recovered and ready for hard efforts versus when you should take it easy. Garmin Coach offers free training plans for 5K, 10K, and half marathon distances, which is genuinely helpful for newer runners.

Battery life is ridiculous—up to 23 days in smartwatch mode and 31 hours in GPS mode. The multi-band GPS tracks accurately even in canyons or downtown areas with tall buildings. SatIQ automatically picks the right satellite system to balance accuracy with battery life.

It’s expensive, and the ECG doesn’t have the same regulatory clearance as Apple or Samsung. If you’re primarily walking or doing casual workouts, you’re paying for features you won’t use. But for serious runners and triathletes who want detailed workout data alongside heart monitoring, this is the move.

Samsung Galaxy Watch Ultra – Best Android Alternative to Ultra

Samsung’s answer to the Apple Watch Ultra is the strongest competitor in the Android space for premium fitness watches. The titanium frame and 10ATM water resistance hold up to serious abuse—swimming, triathlons, whatever you throw at it. The 3000-nit Super AMOLED display is readable in any lighting condition.

The BioActive sensor handles ECG, blood oxygen, and blood pressure. Galaxy AI gives personalized coaching and recovery insights. Battery hits up to 60 hours regular use and 100 hours in power-saving mode—good but not quite matching Apple.

Over 100 workout modes with automatic recognition cover most activities. GPX loading works for hiking and cycling navigation. Samsung Health adds social challenges and community features that some people actually use.

The proprietary band system limits your accessory options, and the circular design with the digital bezel feels a bit dated next to Apple’s rectangular watch. But Android users who want the most complete fitness smartwatch with ECG will find everything they need here.

Fitbit Charge 6 – Best Budget ECG Option

Fitbit has always been the affordable fitness tracking leader, and the Charge 6 brings ECG to a much wider audience. It’s not a full smartwatch—it lacks apps and most smart features—but it nails activity tracking and heart health monitoring at a fraction of the flagship prices.

The ECG app came through firmware updates, giving existing owners atrial fibrillation detection. Combined with 24/7 heart rate and SpO2 monitoring, it’s a solid health tracker. Google Maps and YouTube Music controls add some smartwatch convenience without the full smartwatch price.

Battery life reaches about seven days, which means weekly charging instead of daily. The always-on display option is useful during workouts. Fitbit’s Premium subscription adds more insights, but the free tier covers the basics well.

No onboard GPS means you need your phone for outdoor distance tracking. No app support and no contactless payments in most regions limits its appeal as a true smartwatch replacement. But if you want ECG and fitness tracking without spending $400+, this is the obvious choice.

Withings ScanWatch 2 – Best Hybrid Smartwatch with ECG

The ScanWatch 2 fills a specific niche: people who want health monitoring but don’t want to look like they’re wearing a computer on their wrist. It looks like a regular analog watch but hides ECG, SpO2, and temperature sensors underneath.

To record an ECG, you hold the crown for 30 seconds. Results save to the Health Mate app and export as PDF—useful to show your doctor. Sleep tracking covers duration, quality, and consistency. Temperature sensing picks up overnight deviations that might indicate illness.

Battery life of 30 days is almost absurd—it’s the only watch on this list you can genuinely forget to charge. The analog hands stay readable always, unlike battery-draining digital displays. Notification support covers calls, texts, and app alerts, though you can’t do much with them beyond reading.

No onboard GPS means outdoor workouts need a phone nearby. The premium materials and unique design command a higher price than basic trackers. But if you want ECG without the tech aesthetic, nothing else comes close.

Amazfit Balance – Best Value All-Rounder

Amazfit keeps pushing premium features at aggressive prices with the Balance. You get ECG, blood oxygen, heart rate, stress measurement, and more in a package that typically costs half what the big brands charge.

The PAI (Personal Activity Intelligence) system gives a single-score health metric based on activity intensity—simple to understand, easy to use. Sleep tracking covers stages, breathing quality, and naps. The Zepp app connects to popular fitness platforms and provides detailed analytics.

Battery life hits about 14 days, competitive with premium options at a much lower price. The 1.5-inch AMOLED display looks good. Over 150 sports modes with automatic recognition cover virtually everything.

The Zepp app isn’t as polished as Apple or Samsung. Third-party app support is limited. Customer service and software updates can be inconsistent compared to established brands. But for the price, you get an awful lot of watch.

Comparison Table

Key Features to Consider Before Buying

ECG Accuracy and Regulatory Clearance

FDA clearance matters more than some people realize. Apple and Samsung have gone through clinical validation—their ECG readings meet actual medical device standards. Other watches have ECG but no formal clearance, making them better for general wellness tracking than anything medical. If you have heart conditions, talk to your cardiologist before relying on any smartwatch for monitoring.

Battery Life Expectations

Battery life ranges wildly here. Apple and Samsung need daily or every-other-day charging. Garmin and Fitbit can go weeks. Think about your lifestyle—if you travel a lot or hate charging routines, longer battery life is worth prioritizing. Fast charging helps but doesn’t replace the inconvenience of more frequent top-ups.

Ecosystem Compatibility

This is the boring but crucial part: Apple Watch needs an iPhone, Samsung works best with Samsung phones, Garmin works with both but favors Android for some features. Before spending money, make sure the watch you want actually works fully with your phone.

Fitness Tracking Depth

Casual exercisers need basic step and activity tracking. Serious athletes want running power, recovery analysis, training load, and sport-specific metrics. Check that your watch supports your actual activities—some watches have better swimming tracking, others excel at running or cycling. Automatic workout detection is convenient if you hate fiddling with menus.

FAQs

Does Galaxy Watch have FDA approved ECG?

Yes, the Galaxy Watch 7 and Galaxy Watch Ultra have FDA clearance for atrial fibrillation detection. This meets US medical device standards. Other countries have their own regulatory processes, so check your local situation.

Which smartwatch has the best ECG?

Apple Watch Series 10 and Samsung Galaxy Watch 7 are essentially tied—both have FDA clearance and extensive clinical testing. The difference is negligible. Pick based on your phone ecosystem, not ECG accuracy.

Can Apple Watch detect heart problems?

Apple Watch detects atrial fibrillation. It cannot detect heart attacks, strokes, or other cardiac emergencies. Don’t use it as a substitute for medical care if you’re experiencing chest pain, breathing problems, or other serious symptoms.

Is ECG worth it on a smartwatch?

If you have heart rhythm concerns, a family history of cardiac issues, or just want proactive health monitoring, yes. The ability to quick-check your heart rhythm and share data with your doctor is genuinely useful. If you’re young and healthy with no concerns, it’s less critical.

Do I need a prescription for ECG smartwatch?

No. These are consumer wellness devices, not prescription medical equipment. Anyone can buy one. That said, they’re meant to complement professional healthcare, not replace it.

How often should I take an ECG reading?

Most people take readings when they notice symptoms—palpitations, dizziness, lightheadedness. Some take daily readings as part of a health routine. There’s no harm in checking more often, but consistently abnormal results need medical evaluation regardless of frequency.

Conclusion

There’s no single best ECG smartwatch for everyone. The Apple Watch Series 10 is the strongest all-around option if you’re on iPhone—FDA-cleared ECG, excellent fitness tracking, and the most mature health ecosystem. Android users should look at Samsung’s Galaxy Watch 7 or Ultra depending on whether battery life and premium features matter.

Serious athletes get the most from Apple Watch Ultra 2 or Garmin Forerunner 965—these prioritize workout data and battery life over smartwatch features. Budget buyers can’t go wrong with Fitbit Charge 6 or Amazfit Balance, which deliver meaningful health tracking without flagship prices. And if you want ECG without looking like a tech product, the Withings ScanWatch 2 is the only game in town.

Whatever you pick, ECG capability gives you insights into your heart health that were inaccessible to regular people just a few years ago. It’s not a replacement for medical care, but it’s a genuinely useful tool for staying aware of what’s going on inside your chest. The right watch for you depends on your budget, your phone, and what matters most in your training. This guide should help you find it.