Kardia readings Tachycardia, followed by AF

[Speed]

I have PAF, episodes maybe weekly but not lasting more than 5 to 10 hrs after taking Flecainide PIP.

Taking single lead Kardia readings, the normal profile is initial readings of “Tachycardia” (circ 115 bpm) dropping to “possible AF” (circ 85bpm) after a few hours and then NSR (62 bpm) after say 5-10 hrs. I would take 100mg PIP on first identification and sometimes require a 2nd 100mg after 3 hrs if not resolved.

I’ve always presumed the reading of “Tachycardia” @ 115 bpm is actually AF but that it doesn’t quite match the requirements of the Kardia algorithm as the trace does look very regular, far more regular than when it drops down to “AF”.

I will contact and forward my cardiac trace to the AF nurse, but in the meantime, has anyone else experienced this and if so do they have a definitive explanation? Is it possible to have Tachycardia that then slows to AF? Note this is the profile pretty much every time I have an episode. Or is it AF but not defined as such by Kardia?

[Autumn_Leaves]

I don’t know if it’s the same thing but my Kardia has identified “possible AF” when it’s actually been ectopics, including a random mix of PACs and PVCs interspersed with the occasional normal beat. I didn’t have any way of knowing that it wasn’t AF until I showed the tracings to the consultant at the arrhythmia clinic. It was quite bizarre because these weren’t occurring like normal ectopics but a fairly prolonged episode of random beats over a couple of hours. In my mind, it felt like AF and the Kardia said “possible AF” so I thought it definitely was AF. But it wasn’t. I wasn’t sufficiently skilled to interpret the tracing. The only clue was that my HR was in the 70-80 range, but that’s only with hindsight. The best opinion is from someone who knows what they’re looking at on an ECG, not someone random on the internet who “knows a lot about” whatever.

[mjames1]

Yes, and for me, Kardia's tachycardia determination is almost always aflutter. Atach is another possibility. A good ep will be best to evaluate. PS If you have a 6L, use it for these kinds of readings, as easier to differentiate these types of arrhythmias versus the single Lead Kardia Mobile.

Jim

[Speed in reply to mjames1]

Hi Jim.

Thanks for your response.

I’ve previously had Aflutter but we believe this is now resolved having had 2 ablations. I don’t believe therefore my tachycardia is flutter as I’m quite tuned in to how that feels.

The ECG for tachycardia shows it as being very regular and not like a typical AFib trace as it does when the rate is slower. I’m a bit perplexed as I’m thinking that it consistently being tachycardia and then always droping into AFib seems unlikely! I hope to be able to get in touch with my AF nurse later and get some clarity.

[JeanetteH in reply to Speed]

Ive just been in hospital with Atrial Flutter 125bpm.It is regular but fast but when i was put on hospital monitors in cardia unit it was saying Afib.The cardiologist said not to take too much notice of what it said and Im thinking if hospital monitor couldnt tell it was flutter would Kardia watch be any better ?

[JeanetteH in reply to Speed]

Also there were times when I couldnt feel the flutter as its regular.Ive had 3 ablations for Afib and they say because of the scar tissue the electric signals now go round and round resulting in flutter.

[secondtry]

First thing that hits me is that for such regular AF episodes you need to go for a private cardiologist appointment and discuss going on a regular Flec 100mgs x2 daily, as well as other strategies.

I fully empathise as to why you prefer PIP but the more AF you have the faster the repetition, the less options remain.

Having had a positive experience myself, I am in favour of a 'hybrid cure' that is pills and lots of Lifestyle changes.

[Speed in reply to secondtry]

thx for your response.

[ian16527]

I have gone from fast Tachycardia to AF a few times recently when my AF burden increased dramatically. But unlike yours mine goes into fast AF 160-180 bpm which is not controlled by the bisoprolol. I have found that if I took the flecainide straight away it doesn't work. If I take it after 2 hours it works with 2-3 hours

On Easter Monday they put me on the Flec 100mg twice daily which took a week to work.

[Speed]

Tachy

Tachycardia 115

[Speed]

Thanks Dave

Pos AF

[Speed]

Clicking on the image appears to bring up the full trace.

[Speed]

An added dimension is that for the last 2 episodes, I’ve actually performed the valsalva manoeuvre (the first time in 4 years of AFlutter / AF) that I’ve considered it) The first time I had just taken 200mg Flecainide and confirmed 10 mins later I was NSR. Thought maybe coincidence. The next time I did VM straight away and Kardia confirmed 30 mins later I was in NSR. No Flecainide taken. Maybe not a coincidence? My EP believes the source probably Pulmonary Vein - but would that respond to VM?

🤔

[Speed]

Thank you Dave. Your input is very much appreciated.

Would the absolute regularity of the faster one suggest it’s not AFlutter, as you would expect that to be regular irregular for Flutter?

Is it a known situation that a Tachychardia can switch directly to AF before switching to NSR?

What I’ve noted is that my AF was being triggered during running if I went over circ 145, whereas more recently this Tachycardia has started and is happening spontaneously.

Time to have a discussion with my EP me thinks.

[Vonnegut]

Tachycardia is a very fast heart rate unlike atrial fibrillation which is an irregular heart rate which can be fast but not always or it might be fast and irregular