Help please trying to understand this ECG

Hi,

I’m hoping someone can shed some light on the following.

Looking through the previous ECG’s I’ve taken with my Kardia I found by accident that if I download one of these there is a sheet that gives a graphical view of my heart rate over the 30 seconds.

I then found on many of my past ECG’s that for example my heart rate is relatively constant between a band of say 65 and 100 for the 30 seconds but with one beat dropping from say 80 to 40 and then back up to 80 over 2 seconds.

My question is what effect that odd beat would have, would it make one dizzy momentarily.

I’ve attached a photo (hopefully)

[mjames1]

Denboy,

Second by second heart rate varies with afib, so the graph is consistent with afib. I sometimes feel dizzy when in afib but you also have previously reported you feel like you might black out, If you haven't already, I would definitely report it to your doctor right away. He might want to question you further, make a medication change or do some testing. It may just turn out that it goes with the territory but you definitely want to report it.

Jim

[Hidden in reply to mjames1]

Hi Jim,

Thank you for the response.

Yes I intend to report it back but first I just want to review my other ECG’s to see if it’s a once in a while or something that occurs more often, I don’t want the doctor to dismiss it out of hand as a one off if it’s not.

To my mind if something like this could make me dizzy (although I don’t know at this time) then it only takes the heat beat to be a bit lower or the interval a bit longer to cause a faint or blackout.

With my blackouts I had at most 1 or 2 seconds warning and was unconscious for maybe a second.

The only thing missing is knowing your blood pressure at the time so I am going to purchase a blood pressure monitor which looks the same as a smart watch and is relatively cheap at around £25.

[mjames1 in reply to Hidden]

Yes but you're in persistent afib now as I understand it?

If that is the case, it's normal to have the heart rate variances shown. The only concern as I see it is the dizziness and especially the black outs. Taking your blood pressure is a good idea. Your doctor may want to lower the dose of the beta blocker or calcium channel blocker you're on or run other tests.

Collecting information is always good but I would still report the blackouts right away.

Jim

[CDreamer]

What’s your BP when you feel dizzy? You probably won’t know but what sometimes happens is that when in AF your BP, not only your HR will vary considerably. Dr Gupta compared it to a hose attached to a tap. With tap fully open the BP will be stable. When the tap is turned on and off then the pressure will be intermittent. That alone could cause you to be light headed but there are many other reasons - as I mentioned in your earlier thread so you need to get to the cause.

Everyone gets the odd missed or extra beat - ectopic beats. When they become very frequent or run in two’s or three’s for any length of time they can make you feel very weak and dizzy but for what you are mentioning, most people would experience them and shouldn’t in themselves make you feel dizzy.

Secondtry posted a really good explanatory video on Ectopic beats recently, I’ll repost the link for you.

[Hidden in reply to CDreamer]

Hi CDreamer,

Thank you for your response.

No I do not know what my BP was at the time which is always the missing part to the puzzle, I have therefore ordered a wrist mounted blood pressure monitor which actually looks like a smart watch but is considerable cheaper.

Once received then straight forward to do some tests on it to ensure its accuracy.

I was a little bit dizzy a couple of times this morning although my HR was in the 60’s so strange ! but of course I did not know what my BP was.

At the time I was a little bit breathless which I’m not sure if that was down to my Asthma. My consultant is in the process of changing my Bisoprolol to Diltiazem to see if that improves matters although Bisoprolol is cardio selective and shouldn’t be a problem for Asthma at my low dose of 2.5mg.

Be interesting to see the video on Ectopic beats when you repost it.

[Ppiman]

I have likely misunderstood what you are asking, sorry. It looks from what you've posted that this is the last but one graph from the Kardia PDF output, showing the "R-R" trace. This apparently plots the QRS intervals. From what I have read, it's not very helpful to a non-physician, and I've never been able to make out what mine shows, even though I do have a "wide QRS" *which Ipresume the Kardia algorithm works that out from this graph).

I was told by my GP that it is the top of each of the first Kardia graphs that will show you whether your heart is in SR or otherwise. If you place a piece of paper over the any two peaks of the "R" wave, and mark these on your own paper, then move this along each other peak, you will be able to pick up any irregularity in the pulse. This will help ascertain whether you have either AF or ectopic {"missed") beats.

Next, if you look for the presence of a blip on the graph just before the "R" wave; this is the "P" wave which shows the atrial pulse. It's the first small blip before the big "R" spike and shows whether you have AF, since in AF, the vibrating left atrium stops this small pulse / blip from occurring.

Steve

[Hidden in reply to Ppiman]

Hi Steve,

Thanks for the response.

Yes the graph is the one but last from the Kardia and plots the R-R trace although I was looking at the rhs of the chart where it reflects this information as beats per minute and how on many of my charts I suddenly have a very low beat.

I’ve checked the spacing at the top of the first graph which shows an irregular spacing and also the ‘p’ wave which is missing on mine which therefore shows I am in AF.

Took me a little bit of time to understand and follow the points you identified in your post but now I’m much the wiser.

[Hidden]

Hi,

I’ve attached a photo of page 1 of ecg but not sure if you need other pages.

Unfortunately my knowledge is not good enough to upload all 6 pages in one go

Page 1

[Hidden]

Thank you