# iPacemaker Device vs EchoRef

The clearest difference is review sentiment: EchoRef at 100% against iPacemaker Device's 28%. EchoRef also leads on in-app purchases (none vs 7) and rating (4.9 vs 4.7). iPacemaker Device's advantage is update cadence (every 4 days vs every 2 months) and chart position (#78 vs unranked). On price, ads and device support there is nothing between them.

Both are free to download. iPacemaker Device sells 7 in-app purchases, starting at $9.99 per month. EchoRef asks for nothing beyond the download.

EchoRef holds the better App Store score, 4.9 against 4.7. Both are backed by a comparable volume of ratings — 365 and 1.4K respectively. Written reviews point the same way: 28% of iPacemaker Device's written reviews are positive against 100% of EchoRef's.

iPacemaker Device ships an update every 4 days, EchoRef every 2 months. The most recent releases landed on October 10, 2026 and October 11, 2026 respectively.

## The numbers

| Metric | iPacemaker Device | EchoRef |
| --- | --- | --- |
| Price | Free | Free |
| Rating | [4.7 (365 ratings)](https://appshunter.io/ios/app/ipacemaker-device/id1126088055/reviews) | **[4.9 (1.4K ratings)](https://appshunter.io/ios/app/echoref/id1434016053/reviews)** |
| Number of ratings | 365 | **1.4K** |
| Positive reviews | 27.9% of reviews | **100.0% of reviews** |
| In-app purchases | Yes | **No** |
| Ads | No | No |
| Update frequency | **Every 4 days** | Every 2 months |
| Monetization | Free with in-app purchases | **Free** |
| Best chart rank | **#78** | — |
| Size | 218 MB | 105 MB |
| Requires iOS | **17.6** | 26.0 |
| Devices | iPhone, iPad | iPhone, iPad |
| Age rating | 4+ | 17+ |
| Developer | [IPACEMAKER S.R.L.](https://appshunter.io/developer/1780219062) | [Rishi Kumar](https://appshunter.io/developer/1434016052) |

## What reviewers say

### iPacemaker Device

[App page](https://appshunter.io/ios/app/ipacemaker-device/id1126088055)

**Currently charting:** #78 Top Grossing · Medical (US App Store)

Access a vast database of implantable cardiac devices, including pacemakers and defibrillators. Get detailed technical specifications, connector information, advisories, and MRI compatibility checks. Compare devices and explore algorithms to aid in selection and management.

**Highlights:** Extensive device database, Detailed technical datasheets, Connector and tool information, Advisories and safety warnings, Multibrand MRI compatibility evaluation, Algorithm descriptions, Side-by-side device comparison

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases (7)**

| Purchase | Price | Billing |
| --- | --- | --- |
| 1 month subscription REGULAR | $9.99 | per month |
| 3 Months Subscription | $49.99 | per 3 months |
| 12 months subscription REGULAR | $49.99 | per year |
| 6 Months Subscription | $59.99 | per 6 months |
| 12 Months Subscription | $99.99 | per year |
| 12 months subscription PREMIUM | $109.99 | per year |
| 12 months subscription PREMIUM | $109.99 | per year |

**What reviewers like**

- 👍 Great resource for cardiac rhythm devices
- 👍 App is useful for professionals
- 👍 Some users find it helpful
- 👍 Support team helped some users

**What reviewers complain about**

- 💸 Prohibitively expensive
- 💸 Price increase is steep
- 💸 So expensive for no reason
- 💸 Creator got greedy
- 💸 Subscription fees are ridiculous

**Reported bugs**

- App keeps refreshing, cannot open
- App cannot be opened
- App enters interface and stops, cannot open
- App has not worked for years
- App hasn't worked for days

**Requested features**

- More equitable evaluation of company representation
- Fix app hanging/slow opening
- Update for newer devices
- Grandfather in lifetime members
- Refund original charge for lifetime members


### EchoRef

[App page](https://appshunter.io/ios/app/echoref/id1434016053)

This educational reference app provides comprehensive information on point-of-care ultrasound (POCUS), echocardiography, and cardiac measurements. It includes lessons on interventional procedures and hemodynamic calculations for medical professionals.

**Highlights:** Point-of-care ultrasound (POCUS), Transthoracic echocardiography (TTE), Transesophageal echocardiography (TEE), Cardiac dimensions and valve measurements, Hemodynamic and ultrasound calculations, Interventional procedure lessons

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none


## Frequently asked questions

### Is iPacemaker Device free?

iPacemaker Device is free to download, with in-app purchases available.

### Is EchoRef free?

EchoRef is free to download, with no in-app purchases.

### Which has better reviews, iPacemaker Device or EchoRef?

EchoRef is rated higher. iPacemaker Device averages 4.7 out of 5 from 365 ratings, while EchoRef averages 4.9 from 1.4K ratings.

### Do iPacemaker Device or EchoRef have ads?

Neither iPacemaker Device nor EchoRef shows ads.

### Which is updated more often, iPacemaker Device or EchoRef?

iPacemaker Device ships an update every 4 days, and EchoRef every 2 months. Most recently, iPacemaker Device was updated on October 10, 2026 and EchoRef on October 11, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*