How to measure heart rate accurately with af

[redshock11]

Any advice?

Is the reading from the heart rate device at clinic reliable enough?

[CDreamer]

Kardia or ECG machine or a pulse manually taken are quite reliable - but if pulse is very fast and because in AF irregular I find it can be difficult to count manually.

BP monitors are not accurate - whilst on a BP machine a nurse told me I was OK because my pulse was only 90 but at the same time my Kardia was showing 165.

[Mercurius]

ECG is the good method, but please keep in mind, that the tachycardia is the information. The avarege HR of 30 min segments is fluctuating. With long records (several 10 mins) the average HR is mostly stable.

[Hidden]

A stethoscope placed over the heart might be worth considering. Amazon sell them quite cheaply.

[JaneFinn]

This is a question that’s also been troubling me, redshock.

Many of you say what your heart rate is in AF - how are you guys measuring this?

I had an implanted loop recorder that showed retrospectively that my events have averaged 180 bpm. But neither my Omron AF BP monitor nor my finger oximeter can tell me any pulse reading. Is counting at the wrist (if possible) going to give my rate?

(And is there any rate you’ve been advised to seek medical help, or is it always ok to wait?)

Thanks so much for your help x

[Izzle]

Well, you've raised an interesting subject.

My BP and oximeter machines are only good when I'm in sinus rhythm. Anything over about 90bpm and they're unreliable.

When I exercise I use an athletic pulse meter with chest band transmitting pulse readings to a watch. They're not expensive. I calibrated mine when in AF with my surgeries ECG machine. Mine showed up being just a little faster bpm which we put down to the machines having different algorithms, however it was close enough to be a good arrangement.

These athletic types are not without their issues. They can read very high due to outside interference from other electrical equipment being too close, eg a laptop or motor. Another problem I recently experienced. My readings were in the 120-150 region as normal for me during an AF episode, then a little later it was just 50 bpm and lower. To cut a long story short, the ambo's checked me out as being my normal paroxysmal AF. Later I changed the pulse meter battery and found operation reverted to my usual expectations.

I would say the chest band/watch system sensing electrical activity near the heart is a reasonable method to give real-time indication of pulse.

Alan

[EngMac]

I have a three lead EKG device that shows the rate. What it shows is a very irregular chart and when I have shown the chart to the ER staff and my cardiologist, they seem to think the representation is accurate. I suspect the rate is erratic since the heart is adding and missing beats in a random fashion. This is a layman's guess. EKG devices are available on the internet. Each has a different number of leads. The one I have was specifically designed for a cardiologist to monitor his patient's AF and other arrhythmias so I suspect it shows a chart somewhat close to reality. This cardiologist gave me feedback on my charts. Unfortunately, the makers of the device no longer sell it to the public. Purchasing an EKG device is likely the best way to get a picture of what the heart is really doing.

Kardia, being a one lead device, I believe uses an algorithm to generate the chart. DrDave01,who posts on this forum, can likely explain how it really works and maybe if it really depicts all the heart iterations when it is in AF.

I doubt that you can manually count the pulse accurately when the heart is in AF. I also doubt if heart monitors on the chest can either. By feeling the pulse, and when it is very erratic, you can tell the heart is beating irregularly; and, for me, when I record a chart, the heart is always in AF. So all I have to do is feel my pulse to know when my heart is in AF and when it is not. Too bad doctors would not tell us what the feeling is. But, then they do not have AF and maybe have not felt the pulse when it is in AF. By looking at hundreds of my charts, I have noticed that when my pulse misses a beat, it is often an extra beat, which I cannot count by feeling my pulse. So my heart has not missed a beat, but instead added one.

I hope this has helped.

[JaneFinn in reply to EngMac]

It’s helpful to me, thank you!

[redshock11]

When i measure heart rate feeling the pulse for my dad with af, it is usually about 18 beats for 15 secs. I cannot concentrate for longer than that as the pulse is irregular in both rythmn and intensity. That gives 72 beats per minute. The blood pressure machine at the clinic gives a reading of 94. I notice it flutuates between 80-97, then it somehow decides that the final reading will be 94. So which is more accurate?

[momist in reply to redshock11]

redshock11 the blood pressure monitor is designed for measuring just that - blood pressure. Whilst in AF not all the heart beats generate any pressure, as those that come too soon after the last one have little or no blood left to pump (the heart has not filled up again). Consequently, the blood pressure machine can't see those beats. This also applies to the pulse you can feel at the wrist or the neck. To me, not a doctor, the only way to track an errant heart is from it's electrical activity - I use a Kardia. However, the cheapest solution might be the stethoscope, as you might be able to hear them in the chest? I've no experience to back that up.

[redshock11]

I just recieved stethoscope and use it on my dad. The result i get (based on taking heart beats with that in one min) seems to indicate that a blood pressure meter will tend to overestimate heat rate for someone with af.