By using AnyGo or iAnyGo or similar Apps. It's safe, easy, works on Win/Mac and can unlock everything within 3 minutes. But you need to pay for 1 month subscription.
General steps:
- Power off the watch, use airplane mode or remove sim card from your phone.
- On your computuer, connect to your phone with Bluetooth mode, following the guide of the fake location app, you may need turn off/on location service.
- Move your location to USA, check your location on your phone in the Apple Maps app.
- Open Health Checklist on phone in the Health app and turn on everything.
- Connect your watch and check it.
For the details or trouble-shooting, see the comments below, like starting from https://gist.github.com/imReker/fba069c6cae7407509863b0ed78da2a7?permalink_comment_id=5889305#gistcomment-5889305 And this: https://gist.github.com/imReker/fba069c6cae7407509863b0ed78da2a7?permalink_comment_id=6286130#gistcomment-6286130
Below are plist files for Apple Watch to Enable ECG, Atrial Fibrillation(IRNF), Sleep Apnea Notify. No AfiB History.
After a lot of testing by the people in the comments, it looks like only ECG will work.
So just replace the first three files:
com.apple.HeartRate.notifications.plist
com.apple.HeartRate.plist
com.apple.private.health.feature-availability.plist


I had success with enabling ECG with iOS 18.3.2 + WatchOS 11.3.1 (Apple Watch 10); here are some recommendations from my painful experience.
Recommendations
Original manuals from 2019 with outdated screenshots and files, but fresh comments are:
Use an APFS disk on your Apple device for the backup location (not tested with other filesystems). I had a lot of problems with an ExFAT external disk; also, with ExFAT in the end I got a triple-sized backup that I could not edit (
Editable backups are not supported on your chosen backup location for XX iPhone. Please use the "Export to Folder" option to make a local copy which you can then editerror).For editing plist files, use an app (BBEdit (Paid), PlistEdit Pro (Paid), etc.). I used this Vim plugin because it's free and easy to use. Do not recommend XCode, because of its strange behaviour with plist files and its non-user-friendly edit mode.
Do not replace existing files with text files from a gist! Use the apps above to edit existing plist files, carefully changing existing parameter values with the parameters in the gist files. This is important because at least
UDIDeviceIdentifier,YearOfRelease, andUpdateVersionwere different in my case.Be careful with restoring: you need to have more than 50% free space available on your iPhone. If not, you could restore without photos (it will erase all photos on your phone), then restore with photos. Do not check the erase checkmark when restoring, because in this case all your esims and other stuff will be wiped!
After restoring you will need to re-add all Apple Wallet cards, and some Bank/Telecom apps will be logged out. Keep this in mind.
How to check functions availability: