I regularly use a kardia moble to record irregular rhythms during the night but I can often miss an episode by the time I’ve gone into the app.
I am wondering if a smartwatch would be more efficient as could record while I am asleep. Do any of you have one and if so, do you find them helpful and can recordings be sent as pdfs to consultants?
I have an Apple Watch, it will alert if it spots AFib, but an ECG is a manual process. The ECG can be saved as a PDF and sent to the consultant.
You get an alert on watch and can see it on the app afterwards. I mute my watch overnight so it doesn't wake me up!
If you want a 24 hour ECG recording with analysis then I just got one of these and very impressed with the report. You'd need to wear it obviously whilst sleeping and their website often has extra discounts
getwellue.com/products/hear...
Hi kit,
The Apple Watch does record heart rate overnight and even for continuous days, correct ? But as you mention, EKG is a manual process. Thanks !
Correct! And you get loads of stats re resting heart rate, cardio recovery etc in the health app.
Apple watch doesn't record at all, but only checks periodically for high heart rate or afib. While helpful, it can miss episodes that a true recorder like a medical grade Holter or a Wellue 24 hour monitor (not medical grade) might pick up. Also Apple's alerts are not real time, but delayed, so if you 're looking to be alerted as soon as you go into afib, the Watch will not do that. Also, you cannot have the Watch look for both high heart rates and afib at the same time. You have to pick one when you set it up.
Jim
Not familiar, but have read and discussed the Apple Watch paired with the Cardiogram app will provide your heart rate during the night and alerts.
kitenski what say you ? 
I used to use Cardiogram but stopped when they moved to a pay only and no free model, the AW will do the alerts and tracks your HR overnight so you don't need an app for that. You can set the high and low limits on the watch.
I did buy an app called Heart Analyzer apps.apple.com/gb/app/heart... so this is what it shows for me last night. Next reply I'll show the native settings and what the native app shows.
apple watch settings on the watch (this is at rest not when moving!)
and then what you see on the iPhone without any apps mav7 four replies I'm afraid as I can't see how to put multiple pics into one post! One more post to show the app Heart Report
kitenski One final question in summary which may be redundant.
An Apple Watch will tell you your highest heart rate overnight and during the day ?
Thank you for your time and detailed explanation, kit !
I don't believe you need to pick one at all Jim. There is no setting that I am aware of where you "pick" one over the other. Looking at my settings I have Irregular Rhytm Notifications on, High HR (at rest) over 120bpm on and low HR under 40 on.
You can also set it to show your AF History (which does turn off the alerts), from chatting with someone else on a cycling forum that appears to then take a measure every 15 minutes for his HRV, so I assume it would also take HR etc more regularly with that setting on.
More reading on Apple Watch AF History inc screenshots support.apple.com/en-us/HT2...
last reply this is what the Heart Analyze monthly report looks like.
Kitenski: I don't believe you need to pick one at all Jim.
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In the United States you are asked "Do you have atrial fibrillation" at set up. If you answer "yes", then you get the "afib history" function but do not get the "high heart rate function". If you answer "no", you get the "high heart rate function" but no the "afib history" function. You cannot get both. This may differ in other countries.
Afib notifications are different from "afib history". With notifications, the Watch checks only periodically and therefore can miss episodes. It will check more often with Cardiogram, but there still will be no real time alerts. I have confirmed this via email with Cardiogram.
Jim
Yes agree with that Jim, you *either* get afib history or low/high and Afib warnings. I thought you were saying you couldn't get afib notifications & low/high warnings (which you can if you turn history off). I personally turned the history off as it doesn't report no Afib, it shows it as 2% or lower, I'd prefer it it showed 0% if it was indeed 0%!!
Kitenski: I personally turned the history off as it doesn't report no Afib, it shows it as 2% or lower, I'd prefer it it showed 0% if it was indeed 0%!!
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But "afib history" is perhaps the Watch's most useful feature
"2% or lower" is just a statistical/legal thing because it the Watch doesn't check all the time, so they can't of course claim your history is "0%" since the possibility exists that you were in afib when the Watch wasn't checking.
Because of these limitations -- and also because you can't wear the Watch 24/7 (it has to be charged) -- "afib history" has limitations and therefore you cannot rely on it 100% to tell you that you have no afib episodes. The utilty comes when you see afib history ABOVE 2%. That tells you episodes have been picked up and now is the time to go to your doctors for as 7-14 day medical grade ekg patch, or in your case, patch up and run the Wellue
Unfortunate again, that you cannot have both afib history and high/low HR alarms operable at the same time.
Jim
kitenski Greatly appreciate your detailed explanation and graphs.
When I used the term "alert" I was referring to the low/high warnings. The Apple Watch seems to be one of the best for continuous monitoring overnight which is primary for most people.
It certainly is understood you can't wear it 24/7 without charging.
May have more questions later. Do you mind if I DM you ?
Thank you so much for your very helpful reply and the link. I’m looking it all up now.
None of the smart watches "record" as in a continuous ekg recording. For that you would need a medical grade Holter device, or something like the Wellue 24-hour recorder (not medical grade). However the Watches do have other helpful afib tracking features that the Kardia doesn't. I have both the Apple Watch and the Kardia and find one compliments the other. Thinking of getting the Wellue, but it's a bigger commitment as you have to wear an adhesive patch and download software. Reviews are mixed as to accuracy, but if you really want to record 24/7, it's one of the only games in town, other than a Holter from your doctor.
Jim
Thank you for your helpful info Jim.
You don't need to wear an adhesive patch for the Wellue, you can use the provided elastic chest strap.
From the online reviews, the provided elastic strap can move -- especially during sleep -- and can cause artifacts and miss episodes.
To be clear, I'm a big fan of Apple Watch -- wear one all the time -- and am looking into getting a Wellue. As to the Watch, a very useful companion to my Kardia6L, but still has the limitations of no continuous afib monitoring and no real time alerts. As to Wellue, the accuracy versus a medical grade Holter, still seems in question based on online reviews and my understanding is that the Wellue also has no real time afib alerts, although please correct me if I"m wrong on that.
Jim
as far as I know (I've only had it 24 hours) the Wellue doesn't do real time afib alerts. You record, then upload it into the app and then get the AI analysis done all after any events. It does show lots of detail! Ie this is from a 41 min test.
That is my understanding -- no real time alerts with Wellue. In fact, no real time afib alerts with ANY device now on the market. Hopefully, someone will come up with this feature but there may be regulatory/legal/liability issues.
Jim
I think the AW has to record a number of events in parallel to alert? The PDF is very interesting, from apple.com it says apple.com/legal/ifu/irnf/2-...
The feature is intended for over-the-counter (OTC) use. It is not intended to provide a notification of every episode of irregular rhythm suggestive of AF and the absence of a notification is not intended to indicate no disease process is present; rather, the feature is intended to opportunistically display a notification of possible AF when sufficient data is available for analysis. This data is only captured when the user is still. Along with the userʼs risk factors, the feature can be used to supplement the decision for AF screening. The feature is not intended to replace traditional methods of diagnosis or treatment.
The feature has not been tested for and is not intended for use in people under 22 years of age.
Correct. The Apple Watch, which I find extremely useful, has many limitations in regard to tracking afib and also does not provide real time alerts. The problem is many people do not understand this and the Apple documention is vague at best and hard to find is an understatement Hopefully, devices like Wellue will fill this gap, however the caution has to be that they are not medical grade so accuracy is an issue.
Jim
Kitenski : as far as I know (I've only had it 24 hours)
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Please keep us updated as you use it more. I'm particularly interested in accuracy/consistency as many online reviews talk about a lot of noise/artifacts, unless you are very still. Also, strap versus patch, both when moving and during sleep.
Before some of these programs existed, I used my Polar Chest Strap, coupled with a now discontinued high heart/low rate alert program on my Iphone. Combining the two, I was able to get both high and low heart rate notfications REAL time, with an alarm loud enough (talking voice) to wake up, not just with a notification you might miss.
Unfortunately, in addition to the program being discontinued, the chest strap would often shift during the night producing artifacts and a VERY LOUD voice scaring the *** out of me in the middle of the night that my HR was dangerously low, when in fact, the strap had just shifted
Jim
just thinking out loud but on the AW could you run an indoor workout with heart rate alarms?? discussions.apple.com/threa...
If you're working out, a high heart rate would be expected, therefore the Watch would not check. If you want simply a high heart rate alarm, probably best to look at some sports/workout watches like Polar. My issue is that the alarm on those would not be enough to wake me up while sleeping, although I haven't tried any watch. The other issue is that you can have afib at a normal heart rate, so simply a high heart rate alarm isn't enough to detect afib.
Jim
I think you can set alarms if you go outside of certain hr zones now either coming in v10 or already there in v9 of watchOS. This is different to high and low alarms. It’s aimed at people wanting to workout in certain zones but I don’t see why you couldn’t tinker with it to get close to what you are looking for?
I'm at the age where I long for clear, well written and comprehensive instruction manuals like we used to have. In the age of twitter, they don't exist any more and the result is that either people don't know or don't care how things work Or maybe if you're under 30, you're able to figure it out
Jim
This might explain what I’m trying to do Jim?
Right down the bottom of the article myhealthyapple.com/complete...
Yes, Zone training can be very useful. I used to do it religiously with my Polar Watch and/or Strap. Now, I just use the Apple Watch by just putting it in "workout mode" and glance down occasionally. After my ablation, I left it on all the time so I could monitor heart rate at a glance, but it sure eats up battery! That may be the reason that Apple watch will only check periodically in the background for afib, high heart rate, etc -- because it it checked all the time, the battery would run down in 5-6 hours.
Jim
Hi
Whow it all seems unnecessary and apt to make folks apprehensive and anxious.
A friend of mine has his various apparatus near him at home at least all the time.
Its time to get up, get out and stop the panic.
I relied on H/Specialist DHB then and before any change had a 24 hr Heart Monitor used. I had 3 in 2021.
1. On Metoprolol. 186bpm avge Day with 47bpm avge Night 2 pauses x 2 seconds
2. On Bisoprolol. 156bpm " " 47. " " No pauses
3. on CCB AM Diltiazem 120mg. 88-96. " 47bpm " No Pauses
on BB. PM. Bisoprolol 2.5mg for BP. 120-124/69
CONTROLLED FINALLY with help of private H/Specialist
A year in on this regime, H/R Day avge has dropped to 60s. CCB appears 1/2 24 hr life.
If H/Specialist is doing his/her job their should be an automatic check with ECG and 24-hr monitor. I couldn't push the button to alert some exertion movement.
I'm 74. don't have a Smart Watch/Phone, I have an I-Phone to text and talk and MacBppk Air for emails, Google, etc.
I'm not spending lots of money on gadgets.
As I have Persistent AF and it was Rapid with Stroke I'm all settled with no symptoms except for increasing energy as time goes on. A drop of 5kgs now.
I'm braced off with this heavy cold as I am missing the BOI JAZZ FESTIVAL PAIHIA AND RUSSELL NZ.
cheers JOY 74. (NZ)
I have a FITBIT and it states quite definitely that 'this programme is not for you if you have been diagnosed with A/F', this is the programme it has specifically for detecting arythmia so investigate before you buy. I use mine just to see my heart rate etc., during the course of the day due to current problems I have.
I have the fitbit versa 3 and it says it's not for people diognosed with atrial fibrillation but I had to try it anyway and wow next morning I had an alert for A/F and there were reams of info and every second it seemed the rate changed it was quite alarming.I switched that notification off
Thank you, that’s interesting to hear.
Ok, thank you for that.
I also have a fitbit versa 3. Yes, I've been diagnosed with AFib. So, it claims not to be for me. I am interested in how the information can be used better, so I've switched it on. Over 114 days of monitoring, I've had an AVERAGE of 12 notifications a night! I believe I have persistent AFib. My consultant agreed when I suggested this to him.
My main symptom is getting tired easily. My heart rate is quite normal. I used to do research and am interested in how the AFib notifications are created by AFib. It's not obvious. It is also hard to examine the data Fitbit has available. For any one notification, there are a lot of (often overlapping) sub notifications.
A single subnotification (for 02:25:00 to 02:29:59) had 356 heartbeat times, to the nearest millisecond. By a fluke, I've found a way to copy all those timings (along with the BPM associated with each interval). Previously, I had copy them by hand, a real pain. The way I copy them now is still slow and awkward, but better than copying by hand.
I am very interested in how we can get smartwatch makers to provide good background info on what information is gathered, how it can be easily downloaded to a PC and how they identify what they consider to be AFib. They should also provide an easy way for medics to systematically examine this data, but that will take longer.
There are two key things that interest me in the immediate future that smartwatches using PPG can probably help with:
Estimating AFib burden - how much of the time you have AFib. If, like me, there is no racing heart to worry you, can you get an idea of how often you are in AFib from your smartwatch.
Once an intervention has taken place, can a smartwatch be a useful first detection of AFib, assuming the intervention was successful in the first place.
I believe there is real potential for citizen science in this space.
I would be interested in other's experience of looking in detail at the data collected about their AFib.
I hope to have a CardioVersion a week on Friday, so this is very relevant to my situation.
I'll see my Consultant tomorrow.
I use Apple 7series and it has proved very useful & effective. I used to print off ECGs for my consultant. It will alert you with any periods of AF, high/low HR etc. You manually take an ECG if you’re feeling symptoms or feel unwell so can quickly & easily do a recording if you wake up and have the watch on your wrist. I don’t recall it taking an ECG automatically but it does log your heart rate to the second and logs them so you can see the data changes eg sudden tachycardia or bradycardia. Hope this helps.
Why is it important to record what happens at night. How do you actuallly feel, does it stop you sleeping, do you race to A&E or does knowing only increase stress,
If you are taking medications/had a procedure to prevent AF it's useful to know if it came back whilst sleeping IMHO.
"Why is it important to record what happens at night. "
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For the same reason that doctors have you wear Hoters or 7-14 day ekg patches. Not everyone is aware of every afib episode . Knowing your true afib burden can help your doctor correlate your symptoms to episodes. It can help correlate medications to rate, to prevent heart damage. And afib frequency is used by some doctors (at least in the US) to help determine the necessity of anti-coagulation along with the updated CHADS risk score.
Jim
not sure NHS works that way. If you feel ok why do you need to be aware of every Afib episode,surely that just causes more worry/stress especially when you can't do anything about it
I agree, for most of us it's not necessary to be aware of every afib episode by always wearing an ekg recorder. That would be overkill. However, Holter type devices, including 7 and 14 day ekg patches can be useful for afib management and that's why they are used by ep's both in the US and within the NHS system.
The Apple Watch, Kardia, Wellue and other such devices, now offer similar features for home management which can be helpful to both you and your doctor. This doesn't mean they are right for everyone.
Jim
Hi i have a Withins watch it does ECG any time any place and tells you when your in A-FIB. Had mine 2 years no problems ,also can send results to docs.
Me too and it will alert you if you go into AF whilst it is checking your pulse
I use an Apple Watch and have done for years as it was recommended by my Cardiologist. Whilst it doesn’t alert to high rate AF (over 150) it does still alert to the high rate and you just do a manual ECG. If I have a bad incident I just send it to my Cardiologist via email (unless I have to go to hospital). I use an Apple Watch Ultra now. None of the watches out there are 100% but as I was recommended Apple Watch by my cardiologist who I trust that’s what I use. You can collect the info from the different parts off the Health app to get a good overall view of what’s going on
Looks like you have plenty of good input here. I'm a Garmin guy but to date I think they only have one watch in their lineup with ECG capability, with more to come pending approvals. I use my watch for general health metrics like HR and Stress and Sleep etc .not ECG. I have a Kardia 6L I've used to send snapshots to my doc. I also have a Wellue that I can wear via chest strap and record up to 24 hrs that has definitely captured little blips here and there and especially useful for days where the heart is feeling a bit more flip floppy than normal. That's a medical term. :)I like my gizmos but I can always tell when I am in Afib for any significant time. So it's only for confirmation or sending to the doc, really. I've heard Apple watches are great, but for me the battery life was a non starter, and I just prefer the Android ecosystem. For now anyway. The Pixel watch and Fitbits are good ECG options and basic health metric watches also.
Good health to you!
I've heard Apple watches are great, but for me the battery life was a non starter,
Good info in your post. Any info you can share on the battery ?
kitenski or anyone - Any info on the average longevity of an Apple Watch ?
Look at the Withings, the battery lasts for 30 days, yes and it does unless you spend a vast amount of time double checking your measurements.
I have an Apple Watch and at same time I had an implanted loop recorder which records in present time and is used when Holter monitors and EKG cannot catch afib, due to being not-very-often..
I can say with 100% guarantee that my Apple Watch matched exactly the information recorded by implanted loop recorder, and woke me up with alarm to tell me I was in Afib ( documented by the loop recorder’s information at electrophysiologist office which was only available weeks later. )
I would not live without my Apple Watch; best purchase I ever made!
I just use a bog standard Garmin Forerunner 35 tracker. Keep it on my wrist 24/7 ... it records to the App on my smartphone - then, if I want more detail I connect Garmin to my laptop and explore readings on Garmin Connect App installed on my laptop. Not that important to me these days as am hardly ever in AF anyway. Get more benefit from Garmin for recording my sleep patterns. I depend more on my BP Monitor than anything else which will tell me not just BP and HR but if I'm in AF or if my heart is chucking a wobbly - but only when I take my BP reading of course.
I do not understand your desire to record your heart while you're asleep.
Heart Monitors
iwatch setting - AF history or AF alert?
Monitoring 
Recommendations for an electrophysiologist
Recommendation for Private hospital / electrophysiologist (Midlands)
