Interpreting Kardia readings

[Suze43]

Hello, just wondered if anyone could shed any light on kardia results which are labelled 'unclassified'? I've had quite a few of these since my ablation at the end of August but am getting very little support from the arrhythmia nurses.Any advice much appreciated, thank you.

[mjames1]

"Unclassified" with Kardia simply means your ekg does not faall into any of the Kardia classifications such as 'normal sinus rhythm", "possible atrial fibrilation", "tachycardia", etc. It could be, for example atrial flutter, or any number of arrythmia's that Kardia is not programmed or authorized to analyze. I don't know why your arrhythmia nurse or ep won't give you an answer if you email them the ekg. Other than that, at least in the U.S., you can have one of Kardia's cardiologists give you a same day reading for a reasonable fee. You can also post the ekg here, but keep in mind none of us are medically trained and some ekg's are difficult to interpret -- especially single lead ekg's -- even by an ep.

Jim

[Suze43 in reply to mjames1]

Thanks for your reply. I realise the recording doesn't fit into the main categories so am trying to find out what it is. It is only post-ablation I have been getting these 'unclassified' results. Previously I have had excellent support from my arrhythmia nurse but, unfortunately, the department has recently had a complete restructure. I now have an arrhythmia nurse I haven't even met and struggle to get a reply when I phone. I emailed some readings over a week ago requesting help but still waiting.

[mjames1 in reply to Suze43]

I saw the ekg you posted. Like Dr. Dave said, they are just PACs, albeit a lot of them. BTW he's a real doctor and runs the company that makes Kardia, so I think it's fair to say that is what it is. PACs are basically bening and not to worry about although they can sometimes trigger another arrhythmia such as aflutter or AFib, but not with everyone. Some of us have had success with breathing exercises for PACs.

Jim

[Suze43 in reply to mjames1]

Thanks, I'm feeling a lot less anxious now. I've used breathing exercises and meditation to help control PAF so need to get into more regular habits with the breathing exercises.

[lovetogarden]

Sometimes those unclassified ones are just due to a poor quality recording, background noise, etc. I get them occasionally too. I usually just do another reading and it usually comes up with a more definitive response. I’ve also submitted some of those unclassified one to the QALY service, it’s an app, they read your ecg and let you know what it means. I had a free trial for a while, seemed better than bothering my EP all the time. 😂

[Suze43 in reply to lovetogarden]

Thanks for your reply. I've done several recordings when I get the 'unclassified' label and although my pulse rate may vary (and the resulting ECGs) they remain unclassified. Is this QALY accessed through Kardia?

[lovetogarden in reply to Suze43]

it’s a separate app. If you search your phone’s app store, you should find it.

[CDreamer]

So many reasons - a few already named but also Electrical Field Interference, movement - always place both forearms on a table and keep very still, use alcohol gel to improve contectivity and if you are still getting ‘unclassified’ consistently then either send to your doctor or contact AliveCor help desk directly - they are usually very helpful.

alivecor.zendesk.com/hc/en-us

I found I got a lot of ‘unclassified’ with ectopics or going into or out of AF. I tended to ignore them.

[Suze43 in reply to CDreamer]

Ah yes, I've experienced the electrical interference and kardia flags this up. Also when the battery needed replacing the recordings were completely bizarre! I don't think it's a fault with the kardia. I'm in NSR most of the time but can sense when something different is happening and then get the 'unclassified' label. I have only had this since my ablation at the end of August and am concerned it has triggered a different type of arrhythmia.... yet to be identified.

[CDreamer]

alivecor.zendesk.com/hc/en-...

[Suze43 in reply to CDreamer]

Thanks

[KMRobbo]

I believe Dr Dave invented the Kardia so he will be able to help 😀

[Suze43 in reply to KMRobbo]

I hope someone can as the NHS certainly isn't!

[Ppiman]

If you have the Kardia 6L and won't ( as I don't now) pay the tenner a month for what Kardia call "advanced determinations", then you are limited to what heart arrhythmias it will indicate to, I think, AF only. "Unclassified" can mean anything else, such as several ectopic beats over the 30 seconds (e.g. PVCs, PACs, couplets, etc); having a wide QRS, tachycardia (over 100bpm).

In the end I gave up paying them as I found I was learning nothing more tha my finger on my wrist could tell me.

A better home ECG device seems to me to be made by a Chinese company called Wellue, which uses AI (artificial intelligence) to give a free and far more detailed reading for under £100. Sadly, apart from a 24-hour £300 version on Amazon, it looks as if the AI part isn't yet available in EU and the UK yet. As soon as it is, I will be getting one, I think.

Steve

[Suze43 in reply to Ppiman]

Thanks, I'm just confused about ectopics and really wish I had learned how to read an ECG properly.

[Ppiman in reply to Suze43]

Normal sinus rhythm heartbeats (NSR) arise from an electrical trigger sent from a group of specialised heart cells at the top of the left atrium, called the sino-atrial node. An "ectopic" beat is one that arises from an electrical trigger sent from elsewhere in the heart. It can be pretty much anywhere, from what I have read. This rogue electrical signal interrupts the regular flow from the SA node and causes the ventricles to contract at a different time in the NSR cycle (it will be too early, hence the term "premature contraction"). These extra beats can be premature ventricular contractions (PVCs - 99%) or PACs (atrial - 1%). This early beat is then usually followed by the normal beat, which will seem to be delayed, a delay that will have allowed more blood to flow into the ventricle, causing the valve to shut with more force, which can be felt as a "thump".

These abnormal beats happen in everyone at some point during each day, it seems and tend never to ;lead to any future issues, hence they are called "benign". If they come in runs they can be called "couplets" or "triplets" and then there are no compensatory pauses between them; more than three is termed a brief episode of ventricular tachycardia.

I get them too regularly for comfort!

Steve

[Suze43 in reply to Ppiman]

Thanks very much for taking the time to explain this. Complicated isn't it? So well done for managing to get a handle on it all.

I agree, whatever is going on with me is too regular for comfort!

[Ppiman in reply to Suze43]

Some people struggle badly with anxiety caused by ectopic beats. They do feel frightening if there are many. Some people have thousands a day and remain fully healthy. The best way out of the worry is to get a doctor to explain it to you. They are always very reassuring about them!

Steve

[Suze43 in reply to Ppiman]

Thanks Steve, generally I have been so much more relaxed and less anxious since my ablation but I guess once you've had PAF for a while you can't switch off being very aware of any slight changes to heart rates & rhythms.

[Ppiman in reply to Suze43]

I think so. The heart and its (mis) beating easily sets off deep anxiety.

Steve

[ETHEL103]

Hi I had 18 months of possible a fib and unclassified from my Kardia.In the end I paid the yearly fee and get 6 free interpreted cardio reports a year.My unclassified was in fact atrial flutter.Hope this helps.

[Suze43 in reply to ETHEL103]

Thanks. I guess mine may be flutter, or it may be ectopics so just trying to find out what it is and if it is cause for alarm.

[Ppiman in reply to Suze43]

The Kardia won't detect atrial flutter, I gather; but it will affect the tracing. Here's an "inconclusive" trace showing multiple ectopic beats that certainly felt "fluttery":

Apple ECG snipping showing multiple ectopic beats.

[Suze43 in reply to Ppiman]

Are you able to make any sense of this please?

kardia reading

[Ppiman in reply to Suze43]

I’m only looking on my phone but if you get a piece of paper and mark the gap between two big regular looking peaks (i.e. the R wave of the ventricular contraction / pulse), then you’ll see that most are regularly spaced (= NSR); where some aren’t, they come in too early and are “premature ectopic beats”. These can be PVCs or PACs.

The tiny bump before the big one (the P wave) is the atrium contracting. If that is missing, it can indicate AF (or AFl, I suppose). It’s sometimes hard to see, though. Also, AF causes irregular beats (different gap sizes).

You seem to be having ectopic beats, like I do and, in general, these are nothing at all to be worried about. It’s said that in prone individuals these can set off fibrillation, however.

You do have one short run of beats that might be AF or brief tachycardia - or just ectopics.

Steve

[etheral in reply to Suze43]

This is not flutter. You are basically in NSR with a rate of 60. The ectopic beats are junctional premature contractions, which are suprraventricular but don't originate from the SA node which is normal. In any case I have never seen this to be dangerous, but obviously you should discuss this with your EP. Best, etheral

[Suze43 in reply to etheral]

Thanks for this. I wasn’t aware of any ectopics before my ablation but maybe they were lurking and just overshadowed by the AF. I will continue to pursue a response from my arrhythmia nurse.

[Suze43]

Thanks. Hope this is clear enough, I wasn't sure how to do it.

kardia recording

[Tenshun]

Hi Suze, I get regular unclassified ECG readings on my kardiamobile. In fact l had one this morning. l re-done it and the reading said supraventricular tachycardia. I also use QALY for which l pay an annual fee. I get almost instant interpretations and there is no restrictions on how many l can send.

[Suze43]

Thanks for this. Is QALY part of kardia or something separate?

[Tenshun in reply to Suze43]

It's not part of Kardia but another service that can also read your ECG.

[Suze43 in reply to Tenshun]

OK, thanks.

[ozziebob in reply to Suze43]

I think QALY is a phone App ... you get it from Playstore. And then you pay a fee. Check the reviews in PlayStore.

[Suze43 in reply to ozziebob]

Thanks

[SeanJax]

your Kardia shows normal sinus rhythm with a bunch of pacs( premature atrial contractions) . People called it ectopic beats. Magnesium and coconut water will calm them down. Avoid stimulants such as alcohols or coffee. I don’t know your background so I cannot advise more.

[Suze43]

That's helpful thanks, I just wanted to identify what they were. I don't have coffee or alcohol but will look at adding magnesium & coconut water.

[Suze43]

Thanks Dr Dave, should I be worried?

[Suze43]

Thanks. No chance of speaking to the EP but I will keep pursuing the arrhythmia nurse.