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Smartwatch health sensors explained: ECG, SpO2 and GPS

What the sensors measure, which claims are regulator-backed, and how platform lock-in can switch a feature off.

Updated September 19, 2026

Modern smartwatches list an intimidating array of health sensors. Some are genuinely useful and regulator-reviewed; others are best treated as trends, not diagnoses. And in a twist most buyers never expect, a feature you paid for can be switched off by a legal dispute. Here's how to read the sensor list.

ECG: the regulator-backed one

An electrocardiogram (ECG) feature checks the heart's electrical rhythm for signs of atrial fibrillation. This is one of the few consumer health features with a real regulatory pedigree: Apple worked with the US FDA for years to receive De Novo classification for the Apple Watch's ECG app and irregular-rhythm notifications, making it the first direct-to-consumer ECG available over the counter. If clinically meaningful heart features matter to you, look for ones with that kind of clearance rather than a vague wellness label.

GPS: multi-band is the real upgrade

For runners and hikers, location accuracy depends on the GPS hardware. Multi-band (dual-frequency) GNSS is the meaningful step up: independent testing by DC Rainmaker found it delivers industry-leading track accuracy, especially in tough terrain like cliffs and forests where signals bounce. If your tracks look messy among tall buildings or trees, multi-band is the feature that fixes it.

Battery reality and the lock-in twist

Be realistic about battery. Apple officially rates the Apple Watch Series 10 for up to 18 hours, and that figure already assumes a light day — so a full-smartwatch experience means charging daily, which clashes with sleep tracking. Water resistance is spec'd too: the Series 10 is rated to 50 metres under ISO 22810, i.e. swim-proof but not for scuba or high-velocity water.

The most surprising lesson is that features can disappear. After losing a patent dispute with Masimo, Apple disabled the blood-oxygen (SpO2) sensor on new Apple Watches sold in the US via a firmware update. It's a reminder that a sensor on the spec sheet isn't always a sensor you'll be able to use — platform and legal context matter.

Sources & further reading

This article is original analysis grounded in independently verified references, including non-English outlets. The facts above are sourced so you can check them yourself.

  • ECG app and irregular-rhythm notification (FDA De Novo, first OTC ECG) — Apple Newsroom
  • Fenix 7 Pro multi-band GNSS accuracy in the field — DC Rainmaker
  • Apple Watch Series 10 — 18 h battery, 50 m ISO 22810 water resistance — Apple
  • Los últimos Apple Watch se quedan sin SpO2 (bloqueo por patente) — Xataka (ES)
  • Garmin Fenix 8 Pro vs Garmin Venu 4 →
  • Read the buying guide →
  • Compare smartwatches →
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