Apixaban dosage and heart watches - Atrial Fibrillati...

Atrial Fibrillation Support

31,322 members36,990 posts

Apixaban dosage and heart watches

Freddiejosh profile image
27 Replies

Hello everyone , I’m fairly new to all of this but finding your posts very helpful.

I was fitted with a pacemaker last July after having heart pauses. While I had a monitor fitted I had a 9 second pause in my sleep! Anyway pacemaker fitted, sent home and thought that was job done but 8 weeks later I got a call from my GP saying letter from consultant said I had PAF and should start on medication.

I was prescribed Apixaban 2.5mg twice a day. I’m female and just on 60kg. Just wondering if anyone else on this dose as I notice most of you are on 5mg twice a day. I’m also unsure about the watches to monitor heart. Does anyone know if they interfere with pacemakers? Sorry if this sounds a stupid question but I’m still getting my head round all of this and don’t know if these watches have any sort of magnets in them.

Written by
Freddiejosh profile image
Freddiejosh
To view profiles and participate in discussions please or .
Read more about...
27 Replies

Click on the link below and it will explain why you have been prescribed a half dose of Apixaban

cks.nice.org.uk/topics/anti...

There’s no such thing as a stupid question 😉 but I’m not able to offer an answer about pacemakers other than why would you want a monitor. Purely out of interest, I tried my Kardia monitor on a friend who has a pacemaker and the results were, for want of a word, jibberish. I’ll be interested in what others say though…..

Ps I googled “pacemakers and heart monitors” and the results were not encouraging!

BobD profile image
BobDVolunteer

A monitor will at best read your paced rhythm so absolutely pointless IMHO. Your PM keeps a record of any anomallies which will be read at each of your PM clinics. FJ has explained the reduced dose of apixaban.

Freddiejosh profile image
Freddiejosh in reply to BobD

Sorry don’t know if I was confusing. I had a monitor on for 7 days before I had the pacemaker fitted. I’m just not sure about these watches you can buy interfering with my pacemaker and bringing another bout of af on.

baba profile image
baba in reply to BobD

If Freddie Josh has PAF, the monitor would tell her if she is in sinus rhythm or AF same as anyone without a pacemaker.

Dollcollector profile image
Dollcollector in reply to BobD

Most pacemakers only correct your pulse if it goes too low it doesn't stop it going too high. When the consultant is happy that your pacemaker is working correctly, it is checked only once a year. I need to know if my pulse is too fast and high when l feel l am going into a. fib. I just use an oximeter occasionally as l think a Kardia could interfere with the settings on my pacemaker.

Mike-tyson profile image
Mike-tyson in reply to Dollcollector

The latest pacemakers the CRT-p has three wires and has brought my heart rate down from 140bpm at times to a smooth consistent 70bpm. So think they have improved a lot ?

Dollcollector profile image
Dollcollector in reply to Mike-tyson

It depends on the condition of your heart which pacemaker is implanted. Mine is just a 2 lead one which is the most common one used if your pulse goes too low and then pauses. Then they said they can give high doses of beta blockers to stop my pulse going too fast. That was the plan which a number of patients follow, but l refused the drugs as l have no q.o.l. with them.

baba profile image
baba

I haven't used a heart monitor watch but do use Kardia mobile, to check my heart rate occasionally. I am in permanent AF and my pacemaker only "kicks in" if I have a long pause and my heart rate drops below 50 (each pacemaker is set individually).

I suspect it was the AF that was causing the pauses as was in my case.

Freddiejosh profile image
Freddiejosh in reply to baba

Yes same here, my pacemaker is set at 40 and it was the AF apparently causing my pauses.

Dollcollector profile image
Dollcollector in reply to baba

I have a pacemaker but wouldn't use a Kardia as the magnets could interfere with the settings on your pacemaker. I use an oximeter on my finger occasionally if l think l am going into a.fib. just to see the rate of my pulse.

baba profile image
baba in reply to Dollcollector

What magnets?

An oximeter will not give an accurate heart rate if you are in AF.

Dollcollector profile image
Dollcollector in reply to baba

There are magnets in a pacemaker , smart phone, induction hob etc. That is why you have to keep your phone 6 inches from your pacemaker, and 2 feet from your induction hob. My oximeter gives the same result as my blood pressure machine and the monitors in the hospital. I can feel when it is fast and when it is jumping about and it shows that on my oximeter..

baba profile image
baba in reply to Dollcollector

As far as I’m aware there are no magnets in a Kardia., and I know how to use my mobile phone with my pacemaker.

Dollcollector profile image
Dollcollector in reply to baba

If you look under cautions on your Kardia instructions it will say " Do not use with a pacemaker or any other implanted electronic device "

baba profile image
baba in reply to Dollcollector

Yes I’ve read that

bantam12 profile image
bantam12

The watches don't give accurate results in those with pacemakers, that's what my pacing team told me.

Freddiejosh profile image
Freddiejosh in reply to bantam12

Well that will save me some money I guess ! I only get to go to pacemaker clinic once a year so was wanting to monitor my own af etc.

baba profile image
baba in reply to Freddiejosh

As I said, I use the Kardia to check my heart rate for example after walking or if I feel breathless, or just to have a check .

I know I'm in permanent AF, so that won't change, but it would show if I was having a different arrythmia.

It is not "approved" for use with a pacemaker but works perfectly well and doesn't interfere with my pacemaker, I don't know whether it's different for someone who has had "pace and ablate" and is pacemaker dependent.

alivcor.com/

CDreamer profile image
CDreamer

Hi Freddie - the full dose for Apixaban is 5 mg so you are on half dose which would be advisable for your body weights.

Secondly I have a RST pacemaker and both Kardia and my iWatch work perfectly, although Kardia say they won’t guarantee it will work. I’m not as happy with my iWatch for ECG readings but the HR seems OK.

Betty57 profile image
Betty57

I have a pacemaker fitted as well . And I’m on 5mg apixiban twice a day , i wear an Apple Watch series 7 , had no problems at all with it . Although i use my watch mainly for fitness …

Skertchly profile image
Skertchly

Magnets should avoided. Your mobile is better in your bag

momist profile image
momist

There are varieties of 'heart watches' and not all work the same way. While I agree with BobD that anyone with a pacemaker doesn't need one, I can explain the way they work.

Most pulse monitor watches use little flashing (often green) lights on the back together with a photocell receptor to detect the colour of your skin. When your heart beats a normal, strong, beat, the tiny capillary blood vessels in your skin swell up slightly and the skin therefore goes slightly redder. This is detected by the monitor and interpreted as a heart beat. Within specific limits, 60 - 120 bpm usually, any rhythm to this effect is averaged out and presented as your pulse rate. Some work better than others, and can judge AF but still not give accurate results.

The problem with this is that during any arrhythmia not all heart activity will produce a strong pulse. Often your heart will beat when the chambers are not properly filled, and the pulse will be weak or non existent. Also, they will not come in a regular way, and therefore are rejected by the watch as not a pulse.

More expensive and intelligent watches will also include an ECG function which relies on your active co-operation to initiate a test, and place your other hand on the watch to make two contacts across your chest and down your arms. This can then monitor the electrical activity of your heart. As all muscular activity generates electrical activity, you also have to sit quietly while the test is conducted, and not be near electrical interference like a microwave cooker or an active social media channel on the smart phone you also need to use for this test. This is the way the Apple watch, Samsung, Withings etc does it, and also the Kardia device which is not a watch and not worn on the wrist.

I can't see any way that either of these could possibly affect the operation of your pacemaker, as they are passive monitoring without any intervention.

baba profile image
baba

“ anyone with a pacemaker doesn't need one, “

Why? Please explain your reasoning.

Freddiejosh profile image
Freddiejosh

I’m on half dose for my weight but nhs says you must meet 2 of the criteria to only be on 2.5mg apixaban and I only meet one. Don’t mind being on the lower dose as long as it does the job!

Mike-tyson profile image
Mike-tyson

Have used the heart rate free app on my smart phone for 5 years now to check my heart rhythm and rate. It’s easy to use and accurate and free 😊

TracyAdmin profile image
TracyAdminPartner

Welcome to the Forum - I can see all our Members have been very helpful already by sharing advice and their experiences with you. If you would like any help or support, feel free to visit out website, you may be interested in registering for our upcoming 'virtual' event 'LIVING WITH A PACEMAKER' on Thursday 3 February? To register for free follow the link : heartrhythmalliance.org/afa...

Alternatively, visit the patient resources on the webpage and view some of the videos? You may find the booklet 'Pacemaker Patient Information' booklet helpful?

booklet

You may also like...

Apixaban Dosage

reason, it was all the same. Mine are 5mg and I take them twice a day. Not asking for advice,...

Heart Rate Monitor Watch?

looking at getting a heart rate monitor watch to keep an eye on what sort of heart rate to stay...

Heart rate monitor watch

a flutter. To help, I just wear my Polar heart rate watch with the band around my chest that I...

when to reduce apixaban dosage?

being monitored for kidney deterioration on a regular basis because of taking 5mg x 2 daily...

Apple Watch v wearing heart holster 24 hours

Apple Watch heart rate has been different to the monitor. On my husband Apple Watch his heart rate...