please could you settle a dispute. Two years ago my husband had a total heart block and was hastily fitted with a pacemaker. Since then we have discovered he has Atrial Fibrillation 1.9%of the time and so takes Edoxaban.
Nurse at surgery yesterday sat for ages clutching his pulse before finally telling him he wasn’t in AF then. Question is, can she actually tell from his pulse or is she just feeling his pm pounding away.
Di
Yes you can tell from taking a pulse whether or not you are in AF at that time as you can feel the longer pauses between beats or quicker beats whatever. My Cardio nurse says it is the best way. When in paroxysmal AF my friend quite often went to A&E in an awful state with very high heart rate - sometimes up to200 and over but by the time her hubby had driven her there she was not in AF but just feeling like a wet rag after a particularly bad event. Having said that she was cardioverted several times in A&E as the attack had not passed by the time she got there. Its the nature of paroxysmal AF that it can be hard to catch on examination ECG, EKG and such things.
Yes, but did she have a pacemaker?
Yes she did but with a high heart rate it wouldn't kick in as I understand it?
Hi
So the hospital gives the patient a heart monitor for x amount of time. I had 3 in one year when I had one before change then after every change in meds.
Cheri Joy 74. (NZ)
I know zippo about PM’s but out of curiosity, a friend who has one did try using my Kardia and it produced a spectacular graph. BobD will probably know more and I look forward to seeing your replies…..
So do I John because I don’t see how you can!
If you take a kardia trace then you will get a lot of interference from the pacemaker if it is operating but even so mine will pick up AF - I just have to ignore the interference. Does depend upon the pacemaker but if less than 5 years old, should work but kardia do not advertise it and the conditions do state that kardia does not work with pacemaker - but I can show you a graph I did tonight that picked up AF - not that I needed confirmation!
Well, all I can say is that I had my PM installed three months ago, and I too have a KARDIA , when I didn't have a PM, my Kardia results were AWFUL, ABNORMAL and BRADYCARDIA, but now since my PM, the results are always: NORMAL and the graph looks beautiful!, before, the graph of the EKG, looked like "severe earthquake graph!" 
My mum had a pacemaker because of heart failure after a HA. She continued to have AF, as far as I understand it it ( and it makes no sense to me I admit) the PM just stops you sensing the irregularities.
Perhaps someone knows more it's always made me curious, especially now I am in remission from AF myself after ablation.
That wouid depend on PM settings of course. Mine is default at 60bpm so if my HR is higher than that it is not working so should I be in AF (I'm not) with a rate of 90 then that would be obvious. Since my rate is generally around 75-85 the PM only kicks in if the block hits so anybody taking my pulse would know I am not in AF.
Just to confuse people I always offer my right arm first and watch the total shock and confusion spread over their faces. I have no pulse in my right wrist since an angiogram caused arterial stenosis in 2017. I usually add to it by asking if they had ever met a ghost before. lol 😁
I always thought you had an evil streak 😂
Bob! absolutely brilliant!
When my boys were very young and we were at the pediatricians office we had an unusually long wait in one of the examining rooms. We practiced over and over the reflex muscle in the knee. So when the dr finally came in and he would tap the left knee my son flexed the right leg and the opposite as well. The dr was totally thrown and the look on his face was priceless, we all laughed out loud. We still laugh about that after all these years.
Pm just been checked, set at 60 but nurse sat holding his pulse for minutes before stating he had no af at the time. I maintain the pulse she is getting is from his pm so how could she tell!!
Unless he had an AV node ablation his pacemaker is only stopping his HR falling below 60 or whatever the pacemaker is set at. So if his rate was 60 my guess is it was the pacemaker, if above and steady, NSR.
He has total heart block. Completely dependent on pacemaker
Maybe I am being a a bit thick here but my basic understanding of pacemakers is:- Basic pacemaker only kicks in when H/R goes below 60. My Dad had one, did not have AF but low H/R, often caused problems so fitted with one. Then there is the two/three lead one (resynchronising sorry about spelling) CDreamer has this see some of her posts. Finally pace and ablate where AV node ablated and pacemaker is in total control of your H/R. Hylda - is your husband's pacemaker a standard pacemaker, what was his pulse reading when nurse took it - if over 60 pacemaker would be doing nothing.
Cassie
PS - I am looking at the 2nd option at the moment and finding not an easy one to get, as I was told pace and ablate or stay on meds is all that is left for me.
That’s a very interesting question - depends on many things - competence of the nurse to take an accurate pulse, the settings and the algorithm and the type of the pacemaker and the nature of the AF.
It is possible to be and feel AF and to have what feels like a regular pulse, I know as it’s happened to me. Sometimes my iWatch or my Kardia picks up the AF, sometimes not as the purpose of my PM is to synchronise ventricles.
I have a RST Pacemaker - my clinic tells me exactly when I’ve been in AF and not known it as Pacemaker records the AF episodes so the best way to know is ring your pacing clinic and ask if you can have a report at your next review. If you give them a specific date and time they could check - whether or not they would is another matter. They usually will tell only your ‘AF Burden’ is but if you can charm the physiologist you can often get more information.
How do you know you are in afib 1.9% of the time?
I wouldn't trust a medical practitioner that told me that.
He had read my husband’s pm report and is a top consultant so I would hope we could take his word at that price’
Yes, A/F is felt in the pulse beat of the heart. Depending on your Pacemaker......... mine ensures that my heart rate does not fall BELOW 60 however it does not stop me going into A/F, I take drugs to help stop it. At my yearly pacing checks the technician can tell when and how often I have been in A/F
I’ve had my pacemaker almost 12 months, it will only kick in if pulse goes below 50; not if it goes high, you can still get AF, my doc could tell last week from my pulse I was in nsr
That sounds as though your PM is only set to pace when your rate drops below 50 - I would imagine for occasional Bradycardia? Hylda’s husband is completely pacemaker dependant so will always have a regular pulse but still be in AF so you would not be able to diagnose AF from pulse but maybe able so feel the AF - I certainly can - but most of the time I would have a regular pulse.
Only an ECG can determine AF - according to NICE.
I have a pacemaker for a total heart block. It takes over the function of the AV node and is set so that my heart rate keeps between 60 and 130. I have had one episode of AF since it was fitted 18 months ago which was certainly felt by me, at my pulse, and recorded on my pacemaker. My apple watch recorded it when I pressed the ECG function too.
Did they do a ECG.
Yes that's is certainly the best way to feel that your pulse is out of rhythm when mine was taken by doctors/ consultant etc. You can feel missed irratic beats.
If the pacemaker is doing it job there shouldn’t be a pounding. Has he had an node ablation
Hi, I have a pacemaker and have AF, though not at moment. My understanding is pacemaker is to stop HR going too low, it doesn't stop it going high, there's some other insert for that but not called a pacemaker. AF can be felt at pulse by someone who can recognise it. When I go into AF my pulse can go towards 200, I can't feel a pulse, its too fast. PM doesn't stop AF or control it. Careful with kardia's etc cos if too near PM they can mess it up.
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