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On reddit some users complain that after updating to watchOS6 it has been a bit sluggish
Might be a long time before it is available. Because it is classified as a medical device they have to get the relevant approval. That's why the feature is not available in most countries.For me a big benefit of a series 4, over the series 3, is the ECG - there is also the bigger screen and faster processor but these are less important to me. It seems the ECG is not available in SA yet!?