Guilherme Rambo, for 9to5Mac:

Up until now, Apple Watch Series 4 users who bought their Apple Watch in the US were able to use the ECG feature just fine, provided that they completed the onboarding step on their iPhone first. In this onboarding, the user has to confirm their date of birth and also see some instructions about how ECG works.

A change to this onboarding process suggests that Apple is going to start taking more aggressive measures to prevent usage of the feature in other territories. In iOS 12.2, a new phrase has been added to the bottom of the screen, which says that “During setup, your location will be used to make sure this feature is available in your region.”. Trying to perform the setup on an iPhone without a SIM installed gave the error “Unable to confirm your location. Make sure your iPhone is not in airplane mode and has a working SIM card to proceed”.

Now that I’ve gotten used to having the ECG feature on my US Apple Watch in Europe, I really hope they don’t block it.