Up to date wearable AF monitors - Atrial Fibrillati...

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Up to date wearable AF monitors

Cliff_G profile image
35 Replies

Just seen the AA's email re the Zio XT wearable heart rhythm monitor. I am aware of there being quite a few of these now, including AliveCor etc. Has anyone used one? Which one? How was it? And how much was it!?

I'm looking for one to help get what is happening with some strange rhythm disturbances to my Cardiologist, as planned 24-(or longer)-hour Holter monitors are as we know usually hopeless at picking up anything until five minutes after you gave them back. I need something I can wear for several days, day and night, medical grade, and that does not depend on an iPhone (as I don't have one!). I think he suggested the AliveCor but I now can't remember.

Thanks in advance

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Cliff_G profile image
Cliff_G
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35 Replies
BobD profile image
BobDVolunteer

AIivecor is very good but does not do monitoring and needs smart phone or tablet. Use during events. I am not aware of any device that can be used reliably for 24 hour monitoring which is not medical grade and therefor very expensive.

Cliff_G profile image
Cliff_G in reply toBobD

Thanks, Bob. Medical grade is good! Expense is secondary (for me, compared against a long-term issue I would dearly like to solve). I recall now, my Cardiologist also said the AliveCor was good but you had to take action (grab it) in order to trap a rhythm disturbance, which in my case would be no good as it's totally random and infrequent.

CDreamer profile image
CDreamer in reply toCliff_G

As far as I am aware in the UK these wearable patches such as the Zio patch, are prescription only - don’t know about the US. They aren’t in themselves expensive - $300-400 but what will be is the technology to read and interpret them.

nuffieldhealth.com/treatmen...

There is a 24/7 wearable monitoring device in trials, I believe, but it will a few years before it is on the market.

Cliff_G profile image
Cliff_G in reply toCDreamer

Thanks. Yes, I think prescription only but the website says private as well as NHS. I have contacted them to ask.

Buffafly profile image
Buffafly

If money is no object why don’t you get an Apple Watch? I have a cheap (very) fitness watch which is hopeless at catching AF HR but otherwise records my HR 24/7 and you can see where there are spikes and dips etc so I should think an Apple Watch which actually gives you a rhythm strip might help?

Cliff_G profile image
Cliff_G in reply toBuffafly

Thanks. Checking on Apple's site it says "Apple Watch is capable of generating an ECG similar to a single-lead electrocardiogram. Irregular rhythm notification requires the latest version of watchOS and iOS. It is not intended for use by ... those who have been previously diagnosed with atrial fibrillation (AF)." So that's me out, but I have to say, when every proper ECG uses leads either side of the heart, I don't really see how something worn on a wrist will be very accurate.

Buffafly profile image
Buffafly in reply toCliff_G

Apparently cardiologists accept it but I have doubts too.....

Cliff_G profile image
Cliff_G in reply toBuffafly

I'm pretty sure my Cardiologist mentioned it as not providing what he would need. More of that conversation is coming back as this thread goes on!

CDreamer profile image
CDreamer in reply toCliff_G

Not nearly as clear as Kardia, which has FDA approval whilst Apple Watch doesn’t.

The version 6 is better than the earlier versions but Still nothing like the Kardia.

Physalis profile image
Physalis in reply toCliff_G

I can assure you that the Apple watch is extremely accurate. And as for not being suitable for people already diagnosed with AFib that is silly. I had been diagnosed but getting my watch was a game changer for me.

I got a series 4 watch and bought a second hand iPhone 6 to go with it. I think series 5 needs and iPhone 7.

My watch monitors my heart rate about 300 times a day. It doesn't miss much.

Cliff_G profile image
Cliff_G in reply toPhysalis

The warning was from Apple. 300 times a day is once every 5 minutes, so surely that would easily miss a few palps, a short run of tachy, or heart rate variability of a few seconds? Or is it event-triggered?

Physalis profile image
Physalis in reply toCliff_G

As my AFib went on for many hours, several times a week, I needed to know and put on a spreadsheet when it started and stopped so that I could tell my doctor. A few palps or a short run of tachy is not something I've experienced. How does it affect you? Is it that much of a problem?

If you were simply to do an ECG as soon as you felt palpitations, etc, I should think you would easily catch whatever it was. Also, because you will be wearing the watch, your response time would be very quick.

My watch and iPhone are both on the latest version of watchOS and iOS even if they're not the most up-to-date models.

I don't really look at my heart rate variability but it seems to record it every hour or two. Yesterday mine was between 12 and 52 but it's not something I'm that keen on knowing about!!

Cliff_G profile image
Cliff_G in reply toPhysalis

Yes, unfortunately the short-term stuff does bother me, ectopics, tachy, palpitations, speed-ups and slow-downs lasting 5 beats. Any of these stops me from sleeping. I had AF in the 90's ablated 2002 NSR till 2017, an Aortic Dissection, and post-op AF, now on Amiodarone for 3 years, mostly in NSR but the above problems, want to get off the Amio so I need to know what's going on and the options available from my Cardiologist seem to me unlikely to catch it as you can bet the standard holter won't see anything (it all is, of course) intermittent.

Physalis profile image
Physalis in reply toCliff_G

What do you want to achieve if you manage to catch these short periods of AF, palpitations etc. You are hardly a prime candidate for ablation so I wouldn't think that is an option .

You could come off the Amiodarone and your symptoms could get a lot worse or it might not make any difference.

I don't know much about Flecainide but that might be an option if you used it as a pill in the pocket. You could talk to your EP about other drugs which might suit you better.

At the moment you seem to be wanting to record something which happens very infrequently in order to be able to say 'here it is, this is what's happening. The way you've described it seems that they already know what the problem is.

Do you have any underlying issues like being overweight, having high blood pressure, something you can work on that might improve things.

Anyway, if you can afford it get the watch. I don't regret for one minute getting mine.

With the Pillow app you might be able to pick up sleep apnoea. That could be detected and sorted out.

Maglynne007 profile image
Maglynne007 in reply toPhysalis

I agree. I have an Apple 4 watch. Treated myself last year for Christmas. Weirdly Christmas night I felt unwell and used the ECG for the 1st time and it recorded as an AF. Not knowing what AF was and feeling rather unwell and uncomfortable I went to bed but couldn’t settle all night. Next morning still recording AF. It frightened me slightly to be honest but I didn’t want to panic and go running to A&E. after 2 days of AF I went to DR on 3rd day because I felt dreadful. He used his ECG and still recording AF. He didn’t offer any medication just wrote a referral. After the 3rd day AF stopped but having read up about it I decided to pay privately to see a Cardiologist as was too impatient to wait for NHS. Luckily AF hasn’t come back but I do use the ECG when my heart is doing silly things and they do reflect irregular rhythm at that moment. I too believe Apple Watch is ideal for catching ad hoc heart rhythm using the ECG.

Barny12 profile image
Barny12

I just had a 14 day patch monitor from the NHS:

uk.cardioscan.co/technology...

Cliff_G profile image
Cliff_G in reply toBarny12

Interesting, thanks.

Gowers profile image
Gowers

I had a heart monitoring device fitted nearly 3 years ago at nhs hospital, the battery in it lasts about 3years. - so grateful as it confirmed af & af flutter. I have device that comes with it to click if having various symptoms eg.. ectopics/tachycardia. Each time I had af lasting hours at a time it would pick it up, you can download the readings to a monitor placed at side of bed - so cardio dept at hospital can see it & advise best treatment. Worth taking a look online at more in-depth information about it.

Macmedal profile image
Macmedal

Apple Watch 4 onwards is type 2 FDA approved medical device. My Apple watch 5 alerted me to my first A fib which lasted about 4 hours although at the time I had no idea what was going on. Unfortunately as my heart rate was high averaging 150 the ECG did not confirm A Fib ( the algorithm has now been updated as of this week on the ECG app to include higher and lower heart rates). I thought the watch was playing up and I went back into NSR after 4 hours. Spoke to my GP the next day but nothing was followed up. Five months later Apple Watch picked up elevated heartbeat again which this time resulted in a trip to A&E and a cardio version after 24 hours which was only conducted as my Apple Watch could verify the time the A Fib started, being less than 24 hours, which was important as not being on any medication at the time. So understandably I am a big fan of them, although not for everyone and by no means infallible, but worth considering.

mjames1 profile image
mjames1

Wearable recorders like Zio Patch and holters are very different animals from event monitors like Kardia and Apple Watch. You first have to decide which type you need.

Wearables record everything 24/7, while the event monitors mentioned only reliably record when you take action. If your events recur frequently enough, and long enough (over a few minutes) then an event monitor should suffice. If the events are very sporadic, or very short, then you want the continuous monitoring of a wearable.

I don't know about where you live, but here in the states, you should be able to get a Zio patch for about 2 weeks. If your event is not captured during this time, you might be able

to get an extension.

If you need longer continuous monitoring to capture an event, there is a new and interesting wearable called QardioCore, which is not available in every country, including the U.S. You could wear this 24/7 for as long as you want, but my understanding is that the ecg data will only be released to a participating MD. Hopefully that will change in the future.

As to Kardia vs Apple Watch, I have all versions of Kardia, including their discontinued Watch version, and while excellent products, I find myself using the Apple Watch almost all of the time due to its convenience. The tracings are perfectly fine for a non 12-lead ecg. Don't get confused about which one is better at detecting this or that, because they both generate very similar ecg tracings. And unless you are knowledgeable, best let your ep

at least initially, tell you what they mean. Because both Kardia and Apple's auto interpretations are imperfect.

Jim

Cliff_G profile image
Cliff_G in reply tomjames1

Thanks Jim, I definitely need a 24/7 wearable monitor

Lamadre profile image
Lamadre

Hi, I’ve had a Zio patch here in the UK but had to do it privately. It was on for 7 days and I think was about £300. It’s very unobtrusive and you can shower! I have a Kardia but by the time I get my phone out and sit down to do the recording the hop skip and jump has often receded.

Cliff_G profile image
Cliff_G in reply toLamadre

"by the time I get my phone out and sit down to do the recording " my concern entirely, no chance of me trapping my oddities

ibuputih profile image
ibuputih

Hi, I have also had a Zio patch twice here in UK for monitoring purposes, each time for 7 days. This was private healthcare. Much better than Holter and on each occasion picked up the few random 30secs of 'action' during the 7days. The Zio doesnt get in the way and you can shower with it. My only down side was that before application they have to abrade your skin slightly so that the adhesive makes a good contact. I have sensitive skin anyway and on the first occasion the nurse went beserk with something like a pot scourer. I had a very uncomfortable, itchy week. Second time - no problem.

momist profile image
momist

If I were you, I would read up on how these monitors actually work. Your idea that a watch cannot trace your heart activity is wrong, because you do not understand the technology involved. Most watches use a green LED light to see the colour change of your skin during the pulse event. The electronic trace from such as the Apple watch or similar, and the Kardia devices, come from the electrical disturbance measured up one arm, and down the other (hence across the heart area) filtered out for the heart beats. Because of this, to take a reading you must make contact with the device using the 'other' hand to get a reading, and also sit still and relaxed during the scan to avoid interference from other nerve and muscle activity. I assume the Apple watch can see something is wrong from the pulse, and then alerts you to do a trace? I use the Kardia.

Cliff_G profile image
Cliff_G in reply tomomist

Thanks but "to take a reading you must make contact with the device using the 'other' hand to get a reading, and also sit still and relaxed during the scan to avoid interference from other nerve and muscle activity" is exactly why it wouldn't work for me, e.g. asleep, which is when most of my problems are

Physalis profile image
Physalis in reply toCliff_G

No, you've got it wrong. To take an ECG you have to be wearing the watch and then press on the crown which looks like a watch winder.

However, at night the watch records your pulse every four or five minutes so in the morning you can look at your heart data and see how your heart has behaved. If you wake up with an attack of AFib or something you will be able to see what has been recorded just before or just after.

The watch would be better than a Kardia which only records during or after a short episode.

It would also be quicker off the mark at doing an ECG than a Kardia.

The Kardia is fine and, if I had not been so mean, I probably would have bought one instead of a useless wrist monitor. I only bought the watch for its fall detect feature. It was Serendipity!

Cliff_G profile image
Cliff_G in reply toPhysalis

Still needs user action so no good for what I want. Thanks for all your help though.

Physalis profile image
Physalis in reply toCliff_G

Do you want something that says 'you've just had an attack of AFib, or whatever, and it lasted 30 seconds' so that you can take it to your GP. Or that takes an automatic ECG? If it wakes you up how quickly would you be able to spring into action and catch it on an ECG? I think I could do it in 5 seconds.

You say you are woken up but what is it that you experience then?

"Because of this, to take a reading you must make contact with the device using the 'other' hand". Watch on left wrist, right forefinger on watch, could hardly be easier.

Also you say that you have to sit still etc but I've found that not to be true at all. Last year I was in town waiting for the bus to come and I knew that I was in AFib. I leaned against a wall and my heart rate (average over the 30 sec reading) was 195.

You are probably thinking of taking your blood pressure, sit still, relax, etc.

What is it that you really want? How do you feel when you are woken up? Do you feel breathless?

TracyAdmin profile image
TracyAdminPartner

Please visit the AF Association website for purchasing details on both the 1L and 6L AliveCor Kardia Mobile, or contact the helpline for further advice.

Cliff_G profile image
Cliff_G in reply toTracyAdmin

Thanks Tracy, will do

baba profile image
baba in reply toCliff_G

You need to be awake to use Kardia

momist profile image
momist in reply tobaba

AND it still needs two hands on (or one hand and a leg etc.).

Papabear752 profile image
Papabear752

Hi Cliff I have a three lead pacemaker fitted which is checked every 6 months and the pacemaker technician can tell me when I had AF and for how long it lasted. I have never felt my AF and amazed how long some of the episodes are yet nothing seems to alert me.

Physalis profile image
Physalis

What symptoms do you have when it happens during the daytime?

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