At a glance
EKG charges 0.65% a year, above the 0.62% average of the 5 funds most like it (the 4th cheapest of 6). It has $2.8M in assets, the 5th largest of that group. Over the past year it returned +31.1% with distributions reinvested (S&P 500: +11.5%), 3rd of those 6 funds; over three years it returned +25.8% a year. Its ten largest positions make up 58.2% of the fund, out of 38 in all.
The short version
First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) tracks the Nasdaq Lux Health Tech Index, a basket of 38 companies where health care meets technology, led by IQVIA, Veeva Systems and Dexcom. It offers a focused bet on digital health, but it is tiny, with about $2.8 million in assets as of June 30, 2026. Its 0.65% annual fee is slightly above the 0.62% average of similar funds.
Price history
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EKG +31.1% over the year to Oct 27, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| EKG official prospectus, to Dec 31, 2025 | — | +11.76% | — | — | — | -1.92% |
| EKG price data to Oct 27, 2026 | +28.2% | +31.1% | +25.8% | — | — | +4.2% |
- Over the year to Oct 27, 2026, EKG returned +31.1%, 3rd of 6 among similar funds.
- Its worst full calendar year was 2023 (-0.1%); its best was 2025 (+11.9%).
- The deepest fall in its price history was 43.8% (Apr 1, 2022 to Oct 30, 2023), recovered by Aug 19, 2026.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +28.2% | — |
| 2025 | +11.9% | +11.76% |
| 2024 | +6.5% | +6.65% |
| 2023 | -0.1% | 0.00% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Before this security existed |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Before this security existed |
What's inside
As of Jun 30, 2026, the fund held 38 securities; the ten largest made up 58.19% of assets.
| Holding | Weight | |
|---|---|---|
| IQVIA HOLDINGS INC | 8.26% | |
| VEEVA SYSTEMS INC | 7.46% | |
| DEXCOM INC | 7.02% | |
| GUARDANT HEALTH INC | 6.11% | |
| INTUITIVE SURGICAL INC | 6.05% | |
| RESMED INC | 5.81% | |
| ILLUMINA INC | 5.00% | |
| NATERA INC | 4.66% | |
| OSCAR HEALTH INC | 4.12% | |
| TEMPUS AI INC | 3.70% | |
| ALIGN TECHNOLOGY INC | 3.39% | |
| HIMS & HERS HEALTH INC | 3.23% | |
| GLOBUS MEDICAL INC | 3.17% | |
| QIAGEN NV | 3.00% | |
| INSULET CORP | 2.36% |
By country
United States 95.22%Netherlands 3%British Virgin Islands 1.44%By asset type
Stocks 99.66%What changed recently
- Over the three months to Jun 30, 2026, investors added a net $0.00 (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: +0.99%, +5.49%, +8.50%.
How it works
EKG is an index fund that tries to match the Nasdaq Lux Health Tech Index before fees, normally keeping at least 80% of its net assets in the index's stocks. Nasdaq runs the index, but Lux Capital decides which companies count as digital health. That label covers medical devices, gene sequencing and genetic testing, health-data software, wearables and remote-monitoring gear, online health platforms and lab services, among others.
Nasdaq keeps companies that pass screens for float, liquidity (ease of trading) and how long they have been listed. New entrants need at least 10% revenue growth in each of the two prior fiscal years. Existing members stay if they grew at least 7% in one of those years or meet the index's size rules. Stocks are weighted by free-float market value (the value of shares the public can trade). The five largest are capped at 8% and the rest at 4%.
The index is rebalanced (weights reset) and reconstituted (members added or dropped) twice a year, and the fund follows shortly after. Weights can drift between those dates; IQVIA was about 8.3% of the fund as of June 30, 2026. On that date it owned shares directly, with no derivatives. Turnover, the share of holdings replaced in a year, was 12%, per the January 2026 prospectus.
What it really costs
- EKG charges 0.65% a year, versus an average of 0.62% for the similar funds below (4th of 6, cheapest first).
In a retirement portfolio
It concentrates on 38 digital-health stocks, has no distributions on record and fell 43.8% from its April 2022 peak, which points to a small, higher-risk side position.
EKG could add a growth-tilted slice of medical-device, genetic-testing and health-software stocks. It launched March 22, 2022, so it has no record in the 2008 or 2020 crashes and missed the start of the 2022 bear market. It still fell 43.8% from April 1, 2022, to October 30, 2023, and did not recover until August 19, 2026, 33.6 months after that low. Its worst full calendar year, 2023, looks flat, but that hides a 22.33% drop in the third quarter. Anyone needing cash from it in that slump would have drawn from a much smaller balance.
No distributions are on record. Its 0.65% expense ratio (annual fee) is slightly above the 0.62% peer average, and at about $2.8 million in assets as of June 30, 2026, it is tiny. Past results don't predict the future, and a plan should look at the whole portfolio, not one fund.
Who it may suit — and who should look elsewhere
May suit
- Investors who want a focused slice of digital health, from IQVIA and Veeva Systems to Dexcom and Guardant Health, alongside broader core funds.
- Those who prefer a rules-based index that screens new members for revenue growth and caps single stocks at 8% or 4%.
- Holders who can sit through drops like its 43.8% fall from April 2022 to October 2023, a loss not erased until August 2026.
Look elsewhere if
- Investors who want regular income: no distributions are on record for EKG, so its returns have come from price changes alone.
- Cost-focused investors: its 0.65% expense ratio tops HEAL, GNOM and FMED, which each charge 0.50% and share some of its holdings.
- Investors wary of tiny funds, which can cost more to trade or shut down: EKG held about $2.8 million as of June 30, 2026.
Close alternatives
Matched by holdings overlap from the latest N-PORT reports.
| Fund | Overlap | Cost | Net assets | 1 yr | 3 yr |
|---|---|---|---|---|---|
| EKG this fund | — | 0.65% | $2.8M | +31.1% | +25.8% |
| HEAL Global X HealthTech ETF | 51% | 0.5% | $31.2M | -6.4% | — |
| LGHT Langar Global HealthTech ETF | 39% | 0.85% | $2.5M | +4.3% | — |
| ARKG ARK Genomic Revolution ETF | 25% | 0.75% | $1.56B | +65.8% | +32.4% |
| GNOM Global X Genomics & Biotechnology ETF | 25% | 0.5% | $91.9M | +56.6% | +25.8% |
| FMED Fidelity Disruptive Medicine ETF | 21% | 0.5% | $51.5M | +21.5% | +17.8% |
Questions investors ask
What does the EKG ETF invest in?
EKG invests in digital health stocks, which Lux Capital defines as companies working where health care meets technology. As of June 30, 2026, it held 38 stocks, and the 10 largest made up about 58% of assets. The top five were IQVIA (8.3%), Veeva Systems (7.5%), Dexcom (7.0%), Guardant Health (6.1%) and Intuitive Surgical (6.0%). About 95% was in US companies, with the rest in the Netherlands and the British Virgin Islands.
How has EKG performed since launch?
Unevenly. According to its prospectus, EKG returned 0% in 2023, 6.65% in 2024 and 11.76% in 2025. Even so, it averaged a 1.92% annual loss from its March 22, 2022, launch through December 31, 2025. Its share price then climbed 28.2% year to date through October 27, 2026, for a one-year gain of 31.1% and a three-year return of 25.8% a year. Its worst quarter was a 22.33% drop ending September 30, 2023. Past results don't predict future returns.
Does EKG pay dividends?
No. EKG has no distributions on record, so it has not been a source of income. Its returns have come from changes in its holdings' share prices. That fits its design: the index adds only companies that grew revenue at least 10% in each of the two prior fiscal years. Growth-focused firms like these often reinvest cash rather than pay dividends. Retirees who rely on portfolio income would need it from other holdings.
Is EKG a good ETF for retirement?
EKG fits more naturally as a small, higher-risk side position than as a core retirement holding. It is concentrated in 38 health-tech stocks and has no distributions on record. It fell 43.8% from April 1, 2022, to October 30, 2023, and did not recover until August 19, 2026. Anyone needing cash during such a slump would draw from a much smaller balance. Its 0.65% expense ratio is slightly above the 0.62% average of similar funds. Past results don't predict future returns.
What's the difference between EKG and HEAL?
The main differences are cost, size and one-year returns. Both hold health-tech stocks, and their portfolios overlap by about 51%, based on holdings reports filed with the SEC. HEAL, the Global X HealthTech ETF, charges 0.50% a year versus EKG's 0.65%. HEAL had about $31.2 million in net assets as of August 31, 2026, versus EKG's $2.8 million as of June 30, 2026. Over one year through October 27, 2026, EKG gained 31.1% while HEAL lost 6.4%.