# ECHO On vs Periop Pacemaker

The clearest difference is in-app purchases: ECHO On at none against Periop Pacemaker's 2. ECHO On also leads on update cadence (weekly vs every 2 months). Periop Pacemaker's advantage is iOS requirement (13.0 vs 15.6). On price, rating, review sentiment and ratings volume there is nothing between them.

Both are free to download. Periop Pacemaker sells 2 in-app purchases, starting at $2.99 per year. ECHO On asks for nothing beyond the download.

On the App Store both sit at effectively the same score — 4.9 for ECHO On against 5.0 for Periop Pacemaker. Both are backed by a comparable volume of ratings — 14 and 8 respectively. Written reviews split almost evenly too, at 100% and 100% positive.

ECHO On ships an update weekly, Periop Pacemaker every 2 months. The most recent releases landed on October 13, 2026 and September 27, 2026 respectively.

## The numbers

| Metric | ECHO On | Periop Pacemaker |
| --- | --- | --- |
| Price | Free | Free |
| Rating | [4.9 (14 ratings)](https://appshunter.io/ios/app/echo-on/id1519707786/reviews) | **[5.0 (8 ratings)](https://appshunter.io/ios/app/periop-pacemaker/id6615070538/reviews)** |
| Number of ratings | **14** | 8 |
| Positive reviews | 100.0% of reviews | 100.0% of reviews |
| In-app purchases | **No** | Yes |
| Ads | No | No |
| Update frequency | **Weekly** | Every 2 months |
| Monetization | **Free** | Free with in-app purchases |
| Size | 414 MB | 43 MB |
| Requires iOS | 15.6 | **13.0** |
| Devices | **iPhone, iPad, iPod** | iPhone, iPod |
| Age rating | 12+ | 17+ |
| Developer | [Robert Arrigo](https://appshunter.io/developer/1519707788) | [Rhythm Management, LLC](https://appshunter.io/developer/1761518402) |

## What reviewers say

### ECHO On

[App page](https://appshunter.io/ios/app/echo-on/id1519707786)

This medical education app helps users learn Transesophageal Echocardiography with a question bank, cognitive aid, case log, and reference library. It provides guidance on performing and interpreting a standard 28-view exam, including anatomy, function, and Doppler interrogations.

**Highlights:** Transesophageal Echocardiography education, Enlarging question bank, Rescue TEE cognitive aid, Case Log system, Perioperative Quick Reference library, Offline echo loops, Pathology, technique, and normal loop examples

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

**In-app purchases:** none


### Periop Pacemaker

[App page](https://appshunter.io/ios/app/periop-pacemaker/id6615070538)

This app provides medical professionals with a decision algorithm for managing surgical patients with implantable defibrillators or pacemakers. It is based on guidelines endorsed by the Heart Rhythm Society and updated annually by an expert committee.

**Highlights:** Decision algorithm for pacemaker/defibrillator management, Endorsed by Heart Rhythm Society, Based on ASA Perioperative Cardiac Implantable Electronic Device Management Aid, Annual expert committee updates, Designed for medical professionals

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

**In-app purchases (2)**

| Purchase | Price | Billing |
| --- | --- | --- |
| PERIOP PACEMAKER ANNUAL FEE | $2.99 | per year |
| Periop Pacemaker | $7.99 | one-time |


## Frequently asked questions

### Is ECHO On free?

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

### Is Periop Pacemaker free?

Periop Pacemaker is free to download, with in-app purchases available.

### Which has better reviews, ECHO On or Periop Pacemaker?

Periop Pacemaker is rated higher. ECHO On averages 4.9 out of 5 from 14 ratings, while Periop Pacemaker averages 5.0 from 8 ratings.

### Do ECHO On or Periop Pacemaker have ads?

Neither ECHO On nor Periop Pacemaker shows ads.

### Which is updated more often, ECHO On or Periop Pacemaker?

ECHO On ships an update weekly, and Periop Pacemaker every 2 months. Most recently, ECHO On was updated on October 13, 2026 and Periop Pacemaker on September 27, 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.*