For those told they have AF and trying to make sense of an ECG, I thought that I'd post a copy of my ECG. I have permanent AF but thankfully without symptoms so it has no effect on my life other than having to take 1.25mg of Bisoprolol and 60 mg Edoxaban every day.
This is what my ECG always looks like (recorded on a two lead Wellue home ECG device).
My ECG clearly shows the two major indications of AF: an absence of p-waves and a completely irregular heartbeat ("irregularly irregular" as it's called).
At 77, I remain healthy and expect to continue to do so for many years!
Paul
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Engineer46
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That’s interesting because my paroxysmal AF is a lot more irregular than that, jumping from very fast bursts to very slow sections, which may explain why I am symptomatic and you are not. I think I could cope with that quite well too 🤔
A Fib is like a blunt saw and A flutter to a lot more jagged. The will be no second peak on the rhythm EVER with A Fib (P wave) - just like Engineer's image. Mine was misdiagnosed because of cat purring when it jumped into bed and snuggled up, I reckon. The fact there were P waves on my EGC showed that it was motion that caused the slight waves. Yet, the ECG 12 lead computer algorythm intrepeted it as A Fib. Good job I ask for a copy of it then consulted two cadiologists to look at it because I was prescribed a blood thinner for nothing - that is not on. Post your ecg to make sure.
Buffafly, I think that most people who are stuck permanently with it are asymptomatic. On the one hand I think that's great (no trauma) but Im jealous of people in nsr
Yes, there are no P waves and mine had them, which is why I was misdaignosed. When I thought I did have it, I came on here for help and also learnt from reading that it's just like you said - you can live a good life as normal with it. Thank you for your help.
Thanks for sharing. I'm assuming that the reason you're on bisoprolol is because your heart rate is too high without it? I ask because someone I know also had asymptotic permanent afib and was only put on anti-coagulation, as their heart rate was normal.
Of interest is that they naturally converted after about a year, but felt no different
My resting HR pre AF was 70-80 bpm, but was a little over 100 by the time that I noticed the AF and went to my GP. With the 1.25mg OD Bisoprolol my resting HR is typically 80-90. Spontaneous conversion to SR would be great, but at my age (77) I don't really expect that to happen.
Thanks Engineer46. Here’s my trace from my last episode in May. Rate is quite low @ 63bpm, taken while I was asleep with frontier x device. Low rate probably due to bisprolol pip - it was 130 before that kicked in. I converted in the morning, and have been ok since, not holding my breath.
Hi Buttondog. In the absence of p-waves from the atria the heart gets its electrical signal to beat from other, less organised sources and this gives a heart beat with no pattern at all. For example, if you had an ectopic beat every five beats this would be described as an irregular heart rhythm but with a regular pattern. In AF there is no repeating pattern and the intervals between each beat are random. If you take your pulse at the wrist when you are in AF you should be able to tell that there is no pattern to them. In comparison, when you are in sinus rhythm your resting pulse will be very regular.
In NSR, the distance/time between the R peaks will all be very close to identical. In afib, you can visually see (and verify by measurement) that most/all the time the distance, R to R, is all over the place! Very irregular!
This is what I call a "regularly irregular" heartbeat, and is NOT afib, but merely an ectopic beat. They also feel "funny" in your chest. This is just a portion of the trace, but note the regular distance between the R peaks is ~22mm, and the distance between 3 of the R's is ~44mm. But now we have that beat that's out of place, that I have labelled (arbitrarily) PAC, too close to the preceding R wave. But, there's still about 42-44mm between the R waves that bracket the spurious beat, so except for this one out of place beat, rhythm continues normally. This is what I believe is called an "ectopic" beat, one that's out of place. Also further note the distinct P waves before the R waves, which pretty much rules out afib.
Looked again at my latest ‘‘signs of AF’ reading on my ecg watch and see big variations between R waves plus no P waves. I seem to be 3 days on 3 days off. On AF days my HR can fluctuate wildly also. Will also check pulse manually from now on.I feel OK and am waiting to see cardio man soon.
I'd say that what you're seeing are pretty darned good indicators of afib. I guess I should have said pretty darned "bad" indicators, as no one wants to see them! Good luck at that the cardio-guy!
Billblue. It's a Wellue Pulsebit EX. It's the basic two lead model. It doesn't need a smartphone as it has its own screen. It will store a large number of ECG recordings (for two people separately) and when its memory is full you download the recordings to a laptop or PC for permanent storage, printing or sending to your GP. It also comes with sticky pads to put on your chest if you need a less noisy recording.
Thanks, Paul. That's interesting and useful. A nurse took my ECG at a recent annual check-up and, seeing a graphic reading like the one you have shown, took the print-out to the GP. She returned with this comment from the doc: "It's not acute." I was told to record episodes that seemed even more abnormal than usual by first downloading a Kardia app to my phone, but when I explained the app wasn't free of charge, the nurse said she'd arrange for an "old school" Holter monitor to be fitted. That was six weeks ago -- I'm still waiting. Paul's case and his positivity have been (haha) heartening.
Many thanks for your comments. I took the GP's "it's not acute" remark as meaning "no emergency ambulance required"! I don't have my ECG recording but am interested to know that I have a right to a copy of them. This latest ECG recording was not shown to me at the time. I don't think I could make much sense of it anyway. As you refer to it (so succinctly), my heartbeat is also "irregularly irregular". I feel OK most of the time but suspect that my heart rate drops too low when I'm asleep at night. I take two 2.5 mg hits of Bisoprolol daily. I'm 75.
In the UK you have the right to see all of your medical records whatever they are. You should also try the NHS app and the airmid app if you haven't got them. Someone on the forum said they (the apps) don't apply in NI though.
Am I misunderstanding what you are saying? or just stupid? "... the App wasn't free of charge ..."? The Kardia App is free, and free to use, and you only pay a subscription if you want "advanced determinations". Although you do need to buy a Kardia 6L first. 🤔
The nurse made an appointment with me to talk me through the Kardia app, which she wanted me to download prior to the appointment. When I duly downloaded the app onto my phone and prompted it to respond, it just gave me the option of paying monthly or annually. I tried to contact the nurse in question but was disallowed from doing so. When it came to the appointment, I explained the problem to the nurse, and she said, "Oh, I see. Kardia must have stopped the free use of the app. I'll have to get you a Holter monitor." Well, thanks for your comments; I will pass the info on to my local GP practice and perhaps they (and I) will revise their/my understanding of the Kardia app.
Thanks for the explanation. I understand better now. I think AliveCor (Kardia) have contractual arrangements with various GP Practice Groups around the country, who use Kardia to keep in contact with their AF patients, and who pays for "extra determinations" in these contracts will be different to an individual private user like me. But if you as a patient have been advised by your GP to join their Kardia AF monitoring group, you shouldn't be being charged for that, either monthly or yearly. Seems to me your GP Practice needs to get organised properly and ensure you are not paying. Don't give up.
I have a big hump and reasonably low line across. But my ECG always shows abnormal ECG, AF diagnosed as Rapid and persistent since Stroke Sept 2019.
Due to thyroid Cancer Papillary. Undiagnosed gave me a secret AF which ultimately gave me a stroke at 2am - suddenly awoke with a out-of-this world sore head, I rushed to toilet, didnt look in mirror and went back to sleep. I live alone with my m. schnauzer JAZ.
It is better with AF for a physical count for your H/R if you can keep up with it.
Thanx for your ECG. Always get your monitor checked at your clinic.
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