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The Apple Watch measures electrical voltage. Every smart ring measures light bouncing off blood. These are two different physical phenomena, and the ring form factor makes ECG impossible with current technology.
The FDA's 19-page general wellness policy lets smart ring companies skip clinical validation entirely. Every wearable you have heard of lives inside that loophole. The difference between wellness and medical is not a matter of degree. It is a matter of whether anyone tested the accuracy before it shipped.