diff --git a/src/lib/apple-health/ecg-csv.ts b/src/lib/apple-health/ecg-csv.ts
index 76c6458a8..b32285671 100644
--- a/src/lib/apple-health/ecg-csv.ts
+++ b/src/lib/apple-health/ecg-csv.ts
@@ -71,6 +71,23 @@ function mapClassification(
   }
 }
 
+function resolveUnitScale(value: string | undefined): number | null {
+  switch (value?.trim().toLowerCase()) {
+    case "µv":
+    case "μv":
+    case "uv":
+    case "microvolt":
+    case "microvolts":
+      return 1;
+    case "mv":
+    case "millivolt":
+    case "millivolts":
+      return 1_000;
+    default:
+      return null;
+  }
+}
+
 function splitPair(line: string): [string, string] | null {
   const comma = line.indexOf(",");
   if (comma < 0) return null;
@@ -90,6 +107,8 @@ export async function parseAppleHealthEcgCsv(input: {
   const metadata = new Map<string, string>();
   const samples: number[] = [];
   let inSamples = false;
+  let singleColumn = false;
+  let unitScale = 1;
   let lead: string | null = null;
   const lines = createInterface({
     input: input.stream,
@@ -99,7 +118,46 @@ export async function parseAppleHealthEcgCsv(input: {
   try {
     for await (const rawLine of lines) {
       const line = rawLine.replace(/^\uFEFF/, "").trim();
-      if (line === "") continue;
+      if (line === "") {
+        // Apple's single-column layout declares the lead and unit as
+        // metadata rows and separates them from the waveform with a blank
+        // line; one bare number per row follows.
+        if (!inSamples && metadata.has("Lead") && metadata.has("Unit")) {
+          const scale = resolveUnitScale(metadata.get("Unit"));
+          if (scale === null) {
+            throw parserError("sample unit is unsupported");
+          }
+          unitScale = scale;
+          const declaredLead = metadata.get("Lead") ?? "";
+          if (declaredLead.length > 0 && declaredLead.length <= 32) {
+            lead = declaredLead;
+          }
+          inSamples = true;
+          singleColumn = true;
+        }
+        continue;
+      }
+      if (singleColumn) {
+        if (line.includes(",")) {
+          throw parserError("row is malformed");
+        }
+        if (samples.length >= input.maxSamples) {
+          throw parserError("sample limit exceeded");
+        }
+        const value = Number(line);
+        if (!Number.isFinite(value)) {
+          throw parserError("sample value is invalid");
+        }
+        const microvolts = Math.round(value * unitScale);
+        if (
+          !Number.isSafeInteger(microvolts) ||
+          Math.abs(microvolts) > 100_000
+        ) {
+          throw parserError("sample value is invalid");
+        }
+        samples.push(microvolts);
+        continue;
+      }
       const pair = splitPair(line);
       if (!pair) {
         throw parserError("row is malformed");
diff --git a/src/lib/measurements/__tests__/apple-health-ecg-import.test.ts b/src/lib/measurements/__tests__/apple-health-ecg-import.test.ts
index 3f18c9378..d939c7638 100644
--- a/src/lib/measurements/__tests__/apple-health-ecg-import.test.ts
+++ b/src/lib/measurements/__tests__/apple-health-ecg-import.test.ts
@@ -135,6 +135,28 @@ function validCsv(overrides: Partial<Record<string, string>> = {}): string {
   ].join("\n");
 }
 
+function singleColumnCsv(
+  overrides: Partial<Record<string, string>> = {},
+): string {
+  const metadata = {
+    "Recorded Date": "2026-07-18 08:14:03 +0200",
+    Classification: "Sinus Rhythm",
+    "Average Heart Rate": "64 bpm",
+    "Sample Rate": "512 Hz",
+    Lead: "Lead I",
+    Unit: "µV",
+    ...overrides,
+  };
+  return [
+    "Name,Private Patient Name",
+    ...Object.entries(metadata).map(([key, value]) => `${key},${value}`),
+    "",
+    "1.5",
+    "-2.4",
+    "3",
+  ].join("\n");
+}
+
 async function collectMembers(path: string, limits = LIMITS) {
   const subject = await loadArchiveSubject();
   const members: ArchiveMember[] = [];
@@ -347,6 +369,40 @@ describe("Apple Health HKElectrocardiogram CSV parser", () => {
     await expect(parse(validCsv(), 2)).rejects.toThrow(/sample|limit/i);
   });
 
+  it("normalizes Apple's single-column waveform layout", async () => {
+    const parsed = await parse(singleColumnCsv());
+    expect(parsed).toMatchObject({
+      recordedAt: new Date("2026-07-18T06:14:03.000Z"),
+      samplingFrequency: 512,
+      samples: [2, -2, 3],
+      lead: "Lead I",
+      averageHeartRate: 64,
+      rhythmClassification: "NOT_DETECTED",
+    });
+    expect(JSON.stringify(parsed)).not.toMatch(/Private Patient/i);
+  });
+
+  it("converts millivolt single-column samples to microvolts", async () => {
+    await expect(parse(singleColumnCsv({ Unit: "mV" }))).resolves.toMatchObject(
+      { samples: [1500, -2400, 3000] },
+    );
+  });
+
+  it.each([
+    ["unsupported unit", singleColumnCsv({ Unit: "V" })],
+    ["paired row after the blank separator", `${singleColumnCsv()}\nI,0.001`],
+    ["out-of-bounds amplitude", singleColumnCsv().replace("-2.4", "999999")],
+    ["non-numeric sample", singleColumnCsv().replace("-2.4", "waveform")],
+  ])("rejects a single-column recording with %s", async (_label, csv) => {
+    await expect(parse(csv)).rejects.toThrow(
+      /invalid|malformed|unsupported|sample/i,
+    );
+  });
+
+  it("stops single-column reading once the sample cap is exceeded", async () => {
+    await expect(parse(singleColumnCsv(), 2)).rejects.toThrow(/sample|limit/i);
+  });
+
   it("never logs or returns plaintext health values on failure", async () => {
     const subject = await loadParserSubject();
     const spies: MockInstance[] = [