ECG App Threshold of 50 BPM on Epix Pro (Gen 2) Is Too High

It seems to me that you are looking for a device to diagnose a potential medical condition. That would require Garmin to fulfill a lot of regulatory requirements, do significant investments and perform clinical trials, before any medical diagnostic claims can be made.

The ECG feature is a nice gimmick. However, that also comes with a lot of restrictions. Garmin does not market any medical devices. Visit a healthcare professional if you have any health concerns.

Actually, the ECG does not read electrical activity at all if your HR is below 50 bpm. Works fine above 50. If you're below 50 (as many athletes are), the app gives this message: "This ECG recording could not be checked for AFib because your heart rate was below 50 bpm." If above 50, the app will indicate if you're in normal sinus rhythm, if aFib is detected, or if the results are inconclusive (e.g., if you're in atrial flutter). Other single lead devices report results at all resting HRs. Kardia Mobile's $79 single lead device reports "Bradycardia. No AFib detected." for resting HRs below 50. The Epix Pro appears to have an arbitrary 50 bpm cut-off that renders the app useless for those with athlete's bradycardia. The only way I can get a reading from the app is to jog in place long enough to get my HR over the 50 bpm threshold and then quickly take an ECG reading. Hardly a solution.

I'm simply wondering why the Garmin device doesn't function the way other single lead ECG devices function. Kardia Mobile reads ECGs no matter what the user's resting HR. Garmin, on the other hand, functions only when the user's resting HR is above 50 bpm. That means the Garmin app is ineffective for many athletes. And, yes, I have lots of healthcare professionals to call if I have concerns. The goal is simply to detect aFib, which all the currently available ECG devices (including the Epix Pro) are designed to do.

But does it give you an ECG tracing? 

The Kardia gives an ECG tracing, but the Epix Pro (2) does not. The Kardia seems to be fairly accurate as a single lead but, as you said, it's not a 12 lead so it has many limitations. Still, my electrophysiologist and cardiologist both ask for copies of my Kardia tracings from time to time, and they rely on them as evidence of atrial fibrillation, atrial flutter, normal sinus rhythm, or "unclassified".

I use the Kardia at home, and my hope was that the Garmin Epix Pro could serve as a quick heart rhythm check when I'm away from home. If I'm biking or running with my HR above 50 bpm, I can use the Garmin for that purpose. But if my HR is in the 40's, as it often is if I'm simply out and about but not exercising, it won't provide a reading at all. I'd be interested to know if Apple's ECG watch has the same limitation. 

I figured garmin would still give a tracing so interesting. I had to lookup kardia mobile but it does appear to do a medical grade ecg and has the 10mm/mv reading so there's that. Smartwatches aren't that accurate but they can help detect atrial dysthymia for sure. If its portable enough I'd just carry that amd as soon as you felt like you afib rvr or something just run one. 

John said:

Garmin does not market any medical devices.

www.garmin.com/.../716808

"The smart upper-arm blood pressure monitor is an FDA-cleared medical device."

That's probably the best solution for now. The Kardia requires a paired cell phone to take a reading, so it's not quite as convenient as a watch. But the actual Kardia device is very portable (can velcro to the back of cell phone). I'd hoped that the algorithm for the Epix Pro could be adjusted so that the lower end operating threshold is 40 bpm rather than 50 bpm, but I can't find any relevant instructions or information.