Wrist BP monitor showing intermittent arrhythmia - What to do?

[chris_j]

Hi, new here and looking to see if anyone can help with my situation. I was diagnosed last year with SVT which was happening occasionally - to my awareness. Happened about 3 times last year. Saw cardiologist last Dec and due to have ambulatory monitoring in Nov. He wasn't too worried and agreed to waiting and seeing how it went. Been doing ok and thought SVT been under control, but now noticing that, when I take my own blood pressure, with a wrist monitor it's started to generate a warning of arrhythmia. Weirdly, it will indicate this on and off, maybe for a couple or few readings, then not, then again. BP stays ok (normalish around 115/75 give or take) and pulse doesn't race as with my SVT (stays around 70-80). Oximeter shows ok levels (diagnosed with COPD recently) around 96 when arrhythmia showing. So, but for this come-and-go indication no sense of arrhythmia. Also, no 'look out' issues - pain/breathlessness etc. Went to GP few days agao when this started and, when he checked, got normal heart rate etc. Then, back home, it still comes and goes according to my wrist monitor. Tried monitor on my partner a few times to see if malfunctioning, and his results showed no arrhythmia. Doesn't rule out intermittent fault entirely.

So, still getting arrhythmia indication coming and going and not sure what to do. If I feel my pulse manually, can't detect any irregular beats/abnormality. No obvious pounding/flutters in chest - though sometimes I have been aware of this in recent months (without tachy though). Don't want to bother A&E with a benign intermittent issue and my GP said A&E wouldn't do anything if there was no obvious issue, but its intermittent nature makes it more tricky to demonstrate.

Any help and thoughts would be appreciated. I'm not worrying unduly, but, as ever, it's good to know a course of action just in case.

thanks

Chris

[CDreamer]

That often happens - ie:- arrythmias come and go which is called paroxysmal. Wrist BP monitors may indicate an irregular pulse but are notoriously inaccurate so I wouldn’t rely upon them. The only way of determining an irregular rhythm is by ECG - which you can buy a monitor for - see below.

If you haven’t got any symptoms and it doesn’t affect your quality of life and all the numbers are good - actually a number of members would be very envious of those numbers - what are your concerns? I ask that in all seriousness as identifying exactly what is concerning you can in itself, really help.

It may feel unsettling and anxiety goes with the territory when you experience palpitations because most people aren’t used to feeling their heart beat so I would work on pinpointing exactly what is concerning you and take that to your doctor for advice.

Also, practising easy, self help methods such as breathing exercises which in many cases can help ease the palpitations and certainly ease the stress. There are a number of exercises you could try but as you have COPD - I would suggest you consult a specialist nurse/practitioner to advise you exactly which would be good for you. We generally aim to slow the breath to 6-7 breaths per minute to ease palpitations, breathing deeply into your belly and control the out breath so it is slightly longer than the in breath.

My suggestion would be to buy a Kardia - mobile ECG - easy to obtain for about £100 - take your own ECG for monitoring purposes when you feel the palpitations and you can then take those to a specialist cardiologist for advice. Most treatments for this sort of thing is purely for QOL so if you have no obvious symptoms, if I were you, I would be happy with continuing the watch and monitor.

Know that many people will have SVT - supra ventricular tachycardia - which just means you have a fast heart rate which originates in the upper chambers of the heart. Unless it is very high for prolonged periods of time ie:- more than 24 hours, then it is usually not considered serious or life-threatening but it is disconcerting.

I can say you get used to it and learn to manage it or it gets a lot worse, you become symptomatic at which point it will be treated.

Hope that helps - Best wishes CD.

[chris_j in reply to CDreamer]

Very helpful reply CDreamer - thank you so much.

I suppose my concern comes from not knowing enough to know whether I should be concerned I ended up in A&E when I had my worst SVT (not knowing what it was). What is happening now is different in nature, so I've not been sure if I should be doing anything or not: My SVT involved HR leap to around 180, light headedness, sudden drop in blood pressure while now I haven't been getting an abnormally high HR, nor sharp drop in BP. Your advice has helped reassure regarding this. I'd also understood my SVT was paroxysmal but thought that a paroxysmal arrhythmia would happen, then disappear for some time. In my case, the wrist monitor is showing or not showing an arrhythmia with changes in minutes. Few readings yes, then others no, then next yes again, and so on. I didn't appreciate that this close-in-time sort of flipping fitted the pattern of paroxysmal episodes.

I will certainly look into the recommended mobile ECG. It's the one my GP happened to use. As I mentioned, I've got an ambulatory ECG happening in November, but makes a lot of sense to arm myself with data in advance. I'm the sort who likes to have a degree of control which this device likely will help with and would guess it could help to work out triggers and positive responses to any arrhythmias that might happen, which appeals to me.

Thanks again

regards

Chris

[Paulbounce]

Chris - exactly the same thing is happening to me. Been fine since CV about 4 months ago but my monitor picked up afib twice last week. It does a 30 second recording - I did another one back to back and it was fine.

I have noticed my resting heart rate is up most of the time too. It was around 60 - 65 now it's between 75 - 85 at rest since I had these few blips.

I will be following the thread with interest.

[Ppiman]

I have Omron wrist and upper arm BP monitors and find they are both completely accurate. I gather that the only problem kind of heart beat they can pick up is an irregular one, which they’ve occasionally done. but it’s always been an ectopic beat / palpitation / PVC in my case.

If your heart rate is normal, I’d say that is what your monitor is likely also detecting. It’s possible to have afib without tachycardia, I gather, which an elderly friend of mine has.

If expense isn’t an issue, buying a Kardia device or the far more useful Apple Watch 4 would give you a fully accurate idea.

Steve

[Paulbounce in reply to Ppiman]

Steve - are you saying that if a monitor detects afib (showing irregular HB on the screen) that it could just be caused by an ectopic beat ? I understand these are fairly common and not cause for concern ?

[Ppiman in reply to Paulbounce]

Hi Paul. I’m only going on what the instructions on mine say and what I’ve read but, yes, I believe that a BP monitor has no means to pick up afib, only to detect irregular, slow or fast heart beat. The irregularity would most often, I would think be from palpitations or ectopic beats which are, in most people, I understand, common and harmless.

I see that Nokia / Withings and Omron both now do a combined two-lead sphygmomanometer and ECG. I gather that uses Kardia’s technology, much like the new Apple watch.

I hope you’re going on okay!

Steve

[Paulbounce in reply to Ppiman]

Hi Steve. Thank you for your help. I hope it is just showing an ectopic beat and not afib. It's a little worrying though that my HR at rest is higher since I first detected the problem ?

I hope things are going good for you too.

[Buffafly in reply to Paulbounce]

My daughter has a 'regular irregular' HB so that could also be picked up?

[Paulbounce in reply to Buffafly]

Thanks Buffafly. I'll have a Google and try to understand more about that.

[Buffafly]

As long as you feel ok in yourself why not take a little rest from checking your BP? It sounds as though you are not usually feeling palpitations either. Maybe use a Kardia once a day in the morning to establish your resting heart rate and then when you are aware of palpitations.

One of the hardest things to accept with heart arrhythmias is that you are no longer 'in control' and trying to be causes a lot of stress. Arrhythmias and respiratory problems go hand in hand so it is very important to make sure you are getting the best treatment for your COPD.

[dani777]

nobody in the world can judge you for being worried when your heart is acting funny. i for one sometimes get terrified if my palps are really bad. they have been so bad a few times that I've actually written a letter to my lovely son just in case which sits on my laptop should anything happen to me. i also have bowel disease and while this can cause symptoms that make me feel very unwell, it never really scares me. but when the heart plays up, it's scary. because it's the heart. my heart rate goes from as low as 70 to 100 something, always fluctuates. I've been told my blood pressure is sometimes through the roof, other times it's just a bit high or even normal.

Course of action? Im far from an expert on this, I know very little really, I'm new here too, but i guess just to make sure you have all the tests done and try to avoid any triggers that might set off palpitations although I know that sometimes they can come out of the blue. I'm sure other people on here will know a lot and be able to answer better x

[Buffafly in reply to dani777]

That is so true, I always say I had no worries when I had a very dangerous operation on my spine but when I had an ablation I was like a jelly, not just wobbly but runny 😀 In time you can get more used to palpitations but I doubt there is anybody who isn't bothered.