Reported by Kardia as sinus rhythm. I wonder if it is slow atrial flutter or heart block.
I have had permanent atrial fibrillation for years after ultimately unsuccessful ablations. I only take an anticoagulant but last night I was batting along at 112 per minute during a tense online chess game so I took Nebivolol 5mgs which slowed it down to my normal rate of 80 in AF.
This morning 12 hours later it looks like this and I think I can see extra p waves.
The recording is from my right leg (? Lead II or III) using the old standard Kardia mobile. I wonder if DrDave01 who invented Kardia is up yet🤔?
sinus rythm, heart rate 50 bpm, second degree mobitz type 2. It seems you might need a pm in the close future. A loop recorder first to monitor it and next the pm. Please see with your ep.
I’m not sure I understand his reply. I understand the algorithms but kardia can detect tachycardia. I have a 6L or is it because you used an old standard that hadn’t been upgraded?
The only tachycardia (other than fast atrial fibrillation) that either KARDIA will identify is sinus tachycardia. So not atrial flutter, atrial tachycardia or ventricular tachycardia. Or ventricular fibrillation.
Thank you. I have only had tachycardia detected when it’s been over 100 so hadn’t realised. I tried for ages after the reply from dr Dave to find what tachycardia’s can or cannot be detected but drew a blank. I only ever use my kardia if I’m feeling off and so far it has been accurate……I think.
it could be atrial flutter but I doubt your heart can block one out of 4 p waves regularly like that. The morphology of the complexes is more on the size of atrial tachycardia and here I doubt your heart can block regularly one out of 4 p waves too. Bottom line, please see with your ep. If it is atrial flutter or atrial tachycardia you don’t need a pm. If not then you might need one depending on his decision. I am more of a decision oriented person than discuss back and forth. Your ep might propose a loop recorder what I call wait and see strategy?
This reply feels rather nerve racking to me. Those of us who feel relieved at a NSR result, may have caused to worry after all ! Also, recently I posted here that one of my Unclassifieds results, when sent for Kardia’s Physicians Analysis, came back as Junctional Rhythmn. That was bad enough, but Bill64’s result surely shows that every single result should be questioned. I get a lot of NSR results that surprise me because they don’t look normal ( but I haven’t become proficient at analysing the read outs like some people here ), but now I am really anxious. I have a phone consultation with my cardiologist in 4 weeks, but he doesn’t seem interested in home device ECG readings so I’m thinking perhaps my Kardia is stressing me !
It is simple to find a tutorial which will explain what NSR (normal sinus rhythm) looks like. If you would like to post some images of the strips in question here, one of the many medics or electrocardiographers on the forum may report them for you. DrDave01 is particularly helpful.
No, the vast majority of reports of NSR on KARDIA are exactly that. So not “every single result should be questioned”
We can all learn how to identify the basic rhythm of most ECG strips from Lead I which is the default on the original Kardia, if we want to. It’s not rocket science. Knowledge is power …. although a little knowledge can be a dangerous thing admittedly (=:
Thanks for the reassuring words Bill64. I will try and select a couple of images to post here. My Kardia is the original one, with ‘enhanced determination’. Perhaps the newer 6L would be better, but I would have to feel more confident in it than I do at the moment, to pay for one of those. Meanwhile I will do as you suggest and try to learn how to read the ECG strips myself. Fingers crossed ! Thanks again.
My husband is a retired cardiologist and says it doesn’t look like normal sinus rhythm but like atrial flutter. Yes, even though he’s a cardiologist I’m in this group. There’s a lot doctors don’t know - as we here all know.
Looks just like my atrial flutter to me. Im no expert but was shown the atrial flutter on my kardia recordings by my specialist nurse and this looks the same or very similar. My kardia also tends to either say NSR or long QR or sometimes unclassified when it happens. I tend to get atrial flutter when my AF starts then my heart seems to mess around for weeks or months before either reverting to NSR or having another ablation.
-My EP, head of a good dept., said the six-lead is worth it as "it just provides more data."
-You mentioned the right leg. With the six-lead, which I know yours is not, it is supposed to be on the left leg. Below is the abstract of a study looking at the sensitivity of a one-lead Kardia in lead II position for A-Flutter determination using left leg to right hand. There are other interesting details.
The tools--hardware, software, and interpretive--are all improving.
Good luck!
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Modified positioning of a smartphone based single-lead electrocardiogram device improves detection of atrial flutter.
This study evaluated the use KardiaMobile in the lead II position (right hand to left leg) to improve visualization of flutter waves and clinician diagnosis of atrial flutter (AFL), compared to traditional lead-I tracings. Fifty patients were recruited (25 in sinus rhythm, 14 in AF, 11 in AFL). Lead-I AFL sensitivity was 27% for both electrophysiologists (EP), which individually improved to 73% and 55% in lead-II. KardiaMobile appropriately diagnosed lead-I AFL as unclassified in 18% of cases, compared to 55% in lead-II. Overall clinician agreement (AF, sinus rhythm and AFL) was modest utilizing lead-I position (EP1: κ=0.71, EP2: κ=0.73, p<0.001), which improved with lead-II tracings (EP1: κ=0.87, EP2: κ=0.83, both p<0.001). In summary, lead II position of KardiaMobile improves clinician diagnosis of atrial flutter.
Rajakariar K, Koshy AN, Sajeev JK, Nair S, Roberts L, Teh AW. J Electrocardiol. 2018. 51(5): 884-88.
This extract from the manual for the original Kardia reminded me that some years ago, I was able to self diagnose my atrial flutter using the left leg position (Lead II) as described here, and by yourself.
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