Is this 'normal' AF?

Hi - I was diagnosed with AF after being taken to A&E a month ago (feeling unwell with a heart rate around 135).

I have an appointment with a cardiologist in 4 weeks time and meanwhile, have been keeping a record of heart rate readings - just so I can try to understand AF a little better.

The HR readings vary so much no matter when I take them - they're up around 130, then within a couple of minutes, they're down to 70-80.

Here's some actuals from yesterday and today. (I use a finger tip oximeter and record readings at 15 seconds then 30, 45 and 60 seconds).

54: 61: 48: 38

130: 86: 54: 114

129: 74: 130: 130

60: 113: 130: 130

I'd appreciate views on this - are these results normal for AF?

Many thanks

PS I take 2.5mg bisoprolol and 2x 5mg Apixaban daily

6 Replies

  • Hi there heekle and welcome.

    AF is really a double whammy: it is a combination of heart rate - which you have been measuring - and irregularity of rhythm, usually with no P wave at the start. Usually the standard tests are an echocardiogram (which often shows up, among other things, an enlargement of the left atrium) and a 24 hour, 48 hour or 72 hour ECG which records both heart rate and heart rhythm. Perhaps you have already had these.

    The forum is crammed with useful information for you to absorb. You might also like a look at Cardiac Dysrhythmia Dances on YouTube - look for a guy with a hat and a heart on his white T shirt. The opening music isn't the best but stick with it or fast forward. Atrial Fibrillation is about half way through and is followed by Atrial Flutter.

    I'm no expert but I don't think your readings are unusual for AFibbers or indeed for non AFibbers. AF is a very common condition but there is no typical AF. You get people who have a slow irregular rhythm all the time which doesn't have a very detrimental effect and you get others who are laid low every now and then with bouts of much faster irregular rhythm. Some of us have it often for short spells and it goes away all on its own, some need to stop it with medication, some have AF for weeks and have to have a cardioversion and some just have it rumbling away all the time and it won't be shifted. Lots of unfortunate people have AF and don't know they've got it.

    You're on the medication that a lot of us take and I hope you will soon find AF is not quite as bad as you thought it might be.

  • Sometime my heart rate would go up and down between 80-160 in a few seconds, and then back again. I actually couldn't feel it that much, but I just felt fairly rubbish.

    I'm really not sure that the readers can accurately tell you your heart rate if your AF is anything like mine. An EP once told me why that was, something to do with the machine not being able to tell what was an actual beat and what wasn't. He said the only way to tell was by using a stethoscope and actually listening, he also said he wouldn't bother and just to go with how you feel.

    I know from one hospital visit that even the big machine I was put on couldn't cope. I was on it for hours and my rate never went below 80, and then shot up to 160+ and back again. But the machine also said the average was 72, which is impossible.

    Some people do seem to get accurate readings, but I guess it depends on your type of AF and maybe how chaotic it is, I'm guessing!


  • A finger pulseometer is of little use for measuring HR for someone who is in AF. It could be 20% or more out but unfortunately even a single particular one could be out by quite a different % between two readings. Often wrist monitors are also quite inaccurate. A cuff monitor designed for AF (eg Microlife WatchBPHome A) is much more accurate but better still is an electronic device such as the Kardia (aka AliveCor). I was told this by a number of medics and after I bought my AliveCor I did some cross checks against wrist monitor and finger and Microlife cuff. The wrist monitor was a well known make available on the high street and results were up to 50% out on the high side and 30% out on the low side. Finger one closer but still quite inaccurate. Cuff monitor much better and sometimes within 2 or 3 beats at circa 80 to 90 but still can be 10% to 15% out.

    On finger pulseometers initially I thought that they were good for SpO2 level but my SA consultant said that even though medics use them if you are in AF the reasing can be out primarily due to the fact that your circulation is not good or consistent.

    I have not checked an AliveCor against Fitbit.

    Note that inaccuracies are higher when someone is in AF as opposed to someone in NSR.

    I am in persistent AF.

    About a year ago I worked out by trial and error that the optimum setting for the AliveCor time recording was 2 minutes.

    About 6 or so weeks ago I started adding to the notes the lowest HR and the highest HR that I observed whilst taking the reading and this has produced some interesting results. It does show the chaotic status that AF causes. Even if I have been sitting down for say 15 to 30 mins the HR can show a big range. One such is a range from 60 to 104 and the average was 77. On this mornings resting recording it was 49 to 91 average 77.

  • I have a fingertip pulse oximeter, BUT I only use it as a sort of confirmation that I am in AF. If the pulse rate seems steady(+or-5) and the other symptoms are absent, or may be misinterpreted, I'm not, but if it jumps about like a kangaroo on speed, I take it as confirmation that I am. I have some symptoms that could be AF, or could be something else, and I sometimes need the support of the readings to decide to medicate.

    If you find you are using it frequently or need more reassurance, I'd get something else, but if, like me, you have PAF sometimes, and want to "Jump" on it early with meds, then the pulse oximeter can be a good indicator. However, do not imagine that this is telling you ANYTHING definitive EXCEPT that your heart rate is totally out of order!

  • Thanks for your replies...

    Is there anything - like exercise - that triggers your AF?

    Is there a top-end reading that's considered dangerous?

    Or is it how long it persists that's the danger?

    Thanks again


  • Unfortunately that so much depends on the individual and also can vary from day to day.

    With some things you just have to suck it and see. One key thing is not to get into a situation of excessive sweating nor heart racing for you.

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