My Apple Watch is reporting an HRV which seems quite high. For example, yesterday averaged 131ms with a range of 78 to 218. And that appears to be pretty consistent over days and weeks - just up or down a little day by day.
What is your take on this observation?
my HRV on Apple Watch actually indicates when I’m in AF, when I was first diagnosed I was getting AF alerts on my watch and HRV shot up to over 300 most days. Look at beat to beat measurements where you see a high value as this is where I saw the irregularities in my pulse as well as feeling the effects of AF on my body of course.. I like to have a low value now where possible
I'm always in AF! 100% of the time.
And (as near as makes no difference) always have high HRV.
then ignore the HRV readings as the arrhythmias will determine the variability.
I am just the same and I just ignore it these days. Last year it gave me an idea of when I had gone into AFib. Now that I’m in it all the time it varies widely but is always high.
i do the same. It is the best way to detect if i had AF during sleep. Just go thru All Data and search each single recording and look for details. I ve recently activated the Afib Load functionality (I don’t know the exact naming in English because my phone is set in a different language) and doing that u get a recording every 15 min ca. instead than every 2h. Of course ectopics can lead to high measurements as well; but u know if u are more subject to ectopics or AF attacks and as i said for me is important during sleeping because during the day i can easily detect what it is with my fingers on the wrist
It’s AFib Burden on mine. I turned it on for a while after my ablation, which only lasted two days. Seeing a burden of 100% week on week was too depressing. So it’s off again.
Agree with Anne and her cardiologist’s opinion. These HRV readings are not a reliable indicator of anything in someone with any kind of arrhythmia. I have an Apple Watch and in my experience, when I’ve had an episode of AF and at times when I’m feeling a lot of ectopics, the HRV recordings show a much higher HRV. Seriously, it’s not a reliable measurement for anyone with any kind of heartbeat irregularity. Always remember that these watches are not medical instruments.
Thanks for all the replies.
I rarely feel any effects of AF - usually have no idea whether my heart rate is high or low, relatively stable or bouncing around. Just sometimes when it is very high, and stays there, I feel something.
Hidden Bailey2004 CDreamer Gumbie_Cat fra48
A higher HRV is normally good thing, but once it goes above 150 or 200mS it almost certainly is indicating that you are in afib. You can confirm this by looking at the recorded intervals from the watch. In the Heart Rate Variability window in the Health App, click on "Show All Data", then select the relevant day, then the particular HRV reading, then scroll down to the bottom and select "Beat-to-Beat Measurements. You will see the exact time of every beat, and a conversion to "BPM". If you are in sinus rhythm, the BPM will be varying only a small amount between beats , for example you might see something like 65, 64, 66, 67,65 etc. If you are having ectopic beats, you will notice something like 65, 64, 66, 101, 43, 65, 66 64, etc, where one single beat arrived early causing the apparent BPM to spike up then down. If you are in afib, it will be all over the place eg 65, 85, 45, 61, 95, 55, 111, etc. Those readings are all probably accurate, and the calculated bpm is accurate, but all it is telling you is that there is a huge variability in beat intervals, which is of course exactly what afib is. I have actually entered whole lists of these into a spreadsheet and recalculated the HRV just to check, and it is accurate. You can use the HRV feature in the Apple Health app to graph out your afib burden over time. The big spikes in HRV to >200mS show the dates when you were in afib. If you know you are in afib all the time, then the HRV measurement is of little value. It's not that it's inaccurate (it's not) it's just that the accurate reading isn't telling you anything you didn't already know. None of the metrics (eg higher is better) apply when you are in afib.
Set of that data from a random time around 1:40 in the morning - sound asleep.
103, 37, 135, 138, 118, 99, 142, 126, 124, 90, 91, 125, 95, 101, 98, 120, 87, 101, 126, 124, 100, 101, 101, 121, 86, 80, 49, 108, 104, 121, 1125, 131, 119, 99, 115, 126, 130, 108, 128, 125, 129, 139, 132, 44, 110, 89, 112, 122, 112, 38, 128, 131,133, 69, 111, 90, 113, 128, 138
I use AFib history and one thing I don't like about it is doesn't tell you when you're in AFib. I wrote a shortcut and creates a graph and highlights hours where the average HRV is over 150ms. This isn't foolproof as I think ectopic beats and also cause HRV >150ms.
Have you used the HealthFit app? It has a great section on HRV under the Health tab, but I don't know a way to differentiate ectopics from AFib when HRV >150ms. Talking the with the developer, he doesn't know either.
I'm really trying to figure out a way to know when I was in AFib when AFib History is turned on with the Apple Watch. I had an ablation almost 4 months ago and taken off Flecainide 2 weeks ago, and have more ectopics (as APRN said could happen).
I don't need to be told when I'm in fib!
I looked at the maths on this, and if your heart rate is around 60bpm and you are having more than 1 ectopic beat per minute, that will cause the HRV to increase to over 150mS, if calculated over a period of 1 minute. The Apple Watch calculates HRV approximately like that. So you couldn't use high HRV as a proxy for Afib in that case.
I haven't tried HealthFit, but I have used HeartWatch, because it lets you do a graph of HRV over long periods eg 12 months. Then you can eyeball the taller and wider spikes that probably signify afib (100% match for me).
me too! Low of 39-240🤷♀️
Flecainide and heart rate
Heart rate on bisoprolol 
Fast heart rate and altitude
Heart Rate after exercise
Afib with heart rate 147
