hi all , if someone could take a look and let me know something I don’t. Just want to know if they are eptopics or something else . Would be very grateful for some input. Thank you.
heart readings from yesterday - Atrial Fibrillati...
heart readings from yesterday
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Electricblue1
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What device did you use because that trace looks nothing like anything I get from either Kardia or Apple Watch. I also don’t get the phrase - this ECG was not checked for AF because heart rate was 150+.
I wouldn’t like to comment and think you may need an expert to give an opinion, sorry.
It’s definitely an Apple Watch report, mine says the same when the heart rate is very high. I think the newer ones may handle this better, but not sure. I have an older version.
hello, it was off my Apple Watch , it might have gone a bit funny when I was fidgety.
Hi electricblue! 2 things, first, your QRS is upside down because you likely wear your watch on your right wrist. There may be a setting to right side up it? Not sure. So that could be why it may look strange.
Second, the intervals between QRS are irregular, this likely indicates AF. At that rate it would be AF with RVR (rapid ventricular response). Your tracing looks similar to mine when I am in AF, though the particular one you posted has less irregularity than mine.
tracing
Yes, there is a setting! If you go to the Watch app, scroll down a little to select General, then change Watch Orientation to the wrist you have it on, as well as which side of the face the crown is on.
hello, I do where it on my left. The readings never come up as AF it always comes up as HHR. Before ablation it always flashed up AFIB.
Then the watch must be set differently than how you are wearing it in those options.
The watch only comes up with AF if the heart rate is below 150. You’ll see what I mean if you go in the health app, hit electrocardiograms, and scroll down and select atrial fibrillation. All of the recordings that say AF will be below 150.
Are you at rest for these readings? Your rate should not be that high at rest nor should it be sustained at that rate, and you should be checked if it is.
When I get ectopics the rate is normal 60-70 and it will be occasional early beats (looks like a double beat).
hello, yes I am at rest when this happens. Since ablation I have had episodes of HHR, I get a headache with it and feel rubbish.
Did you hold the electrodes the wrong way round as the trace looks upside down? There seems to be a "P" wave before each "R" wave, indicating regular atrial contraction, thus normal sinus rhythm (NSR). If the tachycardia was inappropriate, i.e. while resting, then I would ask my GP to comment; if it was caused by anxiety or exercise, that might well be normal.
Steve
My p waves show perfectly every time I am in AF. I assume it has something to do with it being only one lead? No clue, but I keep hearing the p wave should be missing, and the only time mine is is when my heart rate is very high and the waves have turned into one big one due to the speed.
The indication on the watch for AF is mainly going to be irregularly irregular intervals between beats. I can show you many more examples. The watch will not indicate AF with a heart rate over 150.
P waves
They can't be P waves, I wouldn't have thought (I'm no expert of course). When the atrium is in AF it is sending multiple "P" triggers to the AV node so, at beat, many P waves would show.
It's all interesting but all too complex and, as you say, the single lead (or even advanced Kardia) can get it wrong.
Steve
That’s interesting because I’ve seen p waves on my AF tracings, or so the device reckons. In some ‘inconclusive’ readings I have a mixture of both absent and visible p waves.
hello, I’m not sure what a P or R wave is, it just seems to come on at random times.
These are names given to the various peaks and troughs on an ECG trace and it is where the ECG device (such as the Apple Watch) picks up electrical activity from the heart. A "P" wave is caused when the heart is beating normally (i.e. in sinus rhythm) and is the signal sent from the top atria of the heart (the sino-atrial node) to the bottom (the atrio-ventricular node) which causes the ventricles to contract. The P wave shows as a tiny blip before the big "R" wave (which is the ventricle contracting or beating - actually "QRS" waves but the big R blip is what is easy to see).
In AF, the atria are not sending a single signal but many, resulting in multiple "P" waves which generally can't be seen, or if they can, as lots of tiny blips.
Unfortunately, any kind of agitation, such as anxiety, can also sometimes make the P waves hard to see or disappear, so AF is not easy to diagnose and the Kardia and Apple software can also make mistakes.
Steve
thank you, that explains it better for me . I’m still in unknown land as to whether my regular HHR is something to be worried about.
Persistent tachycardia is a concern as it can, over time, weaken the heart - but that’s a long way off. Your doctor will sort you out!
Steve
This is a good illustration of it. If you ever feel like taking a short 1-2 hour course to know the basics of EKG this is pretty great also youtube.com/watch?v=6mhjWqj...
NSR
This is the difference between NSR and AF - the waves in between in my experience do not show on the Apple Watch, you need to go by the irregular RR interval (as shown in the AF in the photo). I always seem to have a perfect T and P wave, maybe sometimes a U wave (which is a single wave between T and P), but I never see "f" waves on mine.
NSR vs AF
Thanks for that link. You are right about the Apple Watch not showing "f" waves. Runs of ectopic beats can also create a similar "irregular" appearance, however, and the Watch and Kardia can both be fooled to report this NSR activity as AF, as I have found (or as the cardiologist who reviewed them told me). I wonder whether a lot of what people feel as being "AF" might, instead, be multiple ectopic beats as these, at least to me, seem more able to be felt as "thumps" in the chest. On the odd time I get AF, I cannot feel it any differently from ectopics (in fact, I don't think the atrial activity itself can be felt, only the valvular activity).
This is a Kardia trace that reported as AF:
Kardia AF trace.
And this is a trace from my Watch which reported as AF but which I am guessing is multiple ectopic beats:
Apple Watch "AF"
Yes that looks quite like ectopics. Mine are the same. A “double beat” and the beat after each ectopic pair is slightly longer to come than the SR rate of previous normal beats.
I can see how it may have fooled the watch into thinking it is AF on some of mine as well. It only seems to do it if I’m getting many ectopics in a row. If I get less than 4 during the reading, it says SR.
I definitely have a different feeling for my AF vs my ectopics. The ectopics feel kind of like a rubber banding feeling, is the only way I can describe it. And I feel them with a sort of “stomach dropping feeling” too. AF is always very fast for me so I start to get a myriad of other symptoms and persistent pounding when in AF.
Yes - same here but I have only ever had fast AF once, two weeks after my ablation for fast atrial flutter when I stopped bisoprolol too soon. Both fast AF and AFl created a debilitating set of symptoms. Since then I have only had sporadic AF with a slower rate of between 90-135 and it feels much the same as ectopics.
Steve
I’m just so desperate to be normal again. I’ve had some toasted tea cakes recently and I just looked at the ingredients and they are full of E numbers so I’m hoping it’s just this . I get long runs where everything is settled and normal and I feel great , just hoping the ablation hasn’t gone wrong now .
hello, my readings are looking upside down but the Watch is on the right way and is all how it should be .
Additives and "E" numbers won't cause any harm to your heart, by the way. I'd guess that what most often affects the heart is the effect of anxiety caused by overly focusing on its activity. For example, I've found that it's easy to notice a few normal ectopic beats (i.e. "palpitations"), but then to become anxious over them and for the heart to start racing as a result.
Your GP is best placed to help, I'd say.
Steve
I wouldn’t imagine that E numbers are good for you though. I can eat the same thing twice and one day it will affect me and the next day it won’t.
The imagination is important, for sure, but the science also shows that additives are entirely safe for the majority of people. A very few people will remain who are affected, but that is the nature of things in these days of profit-driven mass production.
In our home, we aim to buy organic where available and cost effective, and, as a family, we also try to make our food from raw ingredients, but, overall, for myself, I feel certain that individual foodstuffs and additives do not contribute to heart conduction issues.
Steve
yes totally agree . I’ve just posted another reading . I changed my watch in the app from right wrist to left. Not sure if that would make it all upside down but I looked over all my other readings and they all looked upside down.
What Ppiman said about the p wave. Hopefully, the rate has since come down. If it hasn't and if it were me I would want to be seen by a physician asap.
hello, yes it has since come down but I seem to get a lot of episodes of HHR with headache and heart feels like it is thumping.
it is Afib with heart rate of above 150 in general and 300 bpm blips. It requires strict rate control medication . At 300 bpm heart does not get oxygenated correctly and vtach and vfib might happen if it lasts more than 30 seconds or a minute or more . I mean by it you might be coding during your episodes. So see with your medics asap.
hello, it’s all so complicated to understand. Since ablation I’ve had HHR a lot , anywhere between 120 up to 158 . Might last 10 mins or 5 plus hours .
you have high heart rate during your Afib episodes so high , 300 bpm, and it is not compatible with life if such high heart rate lasts more than 30 seconds or a minute or two. If the heart beats so fast it does not have enough oxygen to survive and it will fibrillate. The heart does not have time to fill the blood in to pump it out at 300 bpm. No blood no oxygen . Your heart coronary arteries oxygen are supplied thru the blood during the heart contractions .
hello, my HHR was up to 150 something.
hello, is that serious or is it normal after ablation. My last ablation was in January this year.
thank you , I’ve just emailed them to see if I can send them readings. When I had AFIB befor it felt different to what I’m getting now.
Definitely get advice from your EP as soon as. If it happens over the weekend call 999 and get the paramedics out to you so they can do a full ECG. Do you have any PIP to take?
oh you’re worrying me now .
No, please don’t worry! It’s just that as the others have said, it’s not good for you to have a high HR for too long and you really shouldn’t be suffering in silence and trying to figure this out by yourself. I’m just saying that you deserve healthcare.
I have LBBB and my EKG always look different then a normal EKG, even in NSR. The QRS does not spike upward but goes downward. I have had this for 10 years, and had no issues until my viral Cardiomyopathy, which eventually brought AF.
hello, if the reading looks upside down does that mean there is something wrong.
please send this reading to your cardiologist or EP if you have one. If your watch is definitely on the right way and working correctly this trace needs a specialist review. I’ve PAF and non sustained ventricular tachycardia. I’ve sent my Apple Watch recordings to my cardiologist and EP and it’s helped with the diagnosis.
yes I have emailed them and I’m hoping they don’t mind me sending my readings. Let’s hope all is not going wrong for me .
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