Apple watch and 4% afib burden

[Iamfuzzyduck]

My apple watch picked up my initial afib episode three weeks ago when I was clearly in afib, I pressed the EKG button to check that was what was happening. I was then on beta blockers for two weeks, and off them for a further week. For the first two weeks my watch said my afib burden was 0-2%. But this week it says it is 4%. Does this actually mean I am having low key afib? Initial episode was HR 150 and above so afib with rvr straight up for 40 hours. Now i feel a kind of an occasional flutter or skipped beat. Not sure if it is psychosomatic. Does anyone have experience with the apple watch readings??

Thank you!

[Buzby62]

Less than 2% is the result when no AF is detected and is the lowest result when set up for AF History as opposed to AF alerts.

AF History is the set up intended for people diagnosed with AF so that notifications are turned off.

4% means that some AF was detected over that period but you will not be able to see when and it may not have detected it all.

support.apple.com/en-gb/HT2...

From the above link

Apple Watch only checks for signs of atrial fibrillation periodically. AF History may not find every instance of your irregular rhythm.

AF History will not notify you when you're experiencing AF.

[Iamfuzzyduck in reply to Buzby62]

As I feared. I am wearing a holter monitor so I will see the results in a month . That will mean they will want to ablate me

[Buzby62 in reply to Iamfuzzyduck]

You may be able to see when the AF occurred by looking for spikes in Heart Rate Variability within the Health app. Set the graph to M for Month view. Also in the AF History, scroll down to see the Education links and About AF History. I have an ablation scheduled this week 🤞

[Iamfuzzyduck in reply to Buzby62]

Thanks for the info. I think I have to have six weeks of recording for the afib checking but I only set it three weeks ago. The initial blip was crazy!

Good luck with your ablation...

[Spoiler]

apple watch immensely helpful. I wish I did the 3rd ablation sooner. My craziness heart rate from 40-180. It was accurate when I was in ER and compared to their EKG/monitoring.

[Peacefulneedshelp]

I have my watch set to irregular heart beat, rather than the AF history. You can’t have both settings. Try that instead.

[Iamfuzzyduck in reply to Peacefulneedshelp]

Can you please explain why? Is it more useful for looking at afib or is tge afib history just picking up the occasional irregular beat? I am a bit confused!

Thank you!

[Buzby62 in reply to Iamfuzzyduck]

The two modes are 1, AF Alerts (Irregular HR) and 2, AF History.

AF alerts are for people not diagnosed with AF (As it comes out of the box)

AF History is for people diagnosed with AF including PAF.

Both modes may capture your AF but not all of it as it only checks periodically, usually when you’re at rest, thats why Apple say it’s only an estimate. My last two episodes were quite mild and I carried on doing things slowly instead of sitting out as I usually do. I have ECG app recordings of the AF but the background checks never picked them up and the AF history results reported “Less than 2%” the same as weeks with no AF.

When I had AF alerts set up before diagnosis, it took months to alert me and I can see from Heart Rate Variability readings that there were episodes. When I was alerted it was only after 5 background checks over about 5 hours showed high HRV to indicate possible AF, If I had gone to bed half hour earlier and taken my watch off that one would have been missed also.

The only reliable AF check on the watch is with the ECG app but you need symptoms to prompt you to use it.

Hope this helps

[Iamfuzzyduck in reply to Buzby62]

How much variability with HR would you consider an afib amount? I did set up the afib history after I was diagnosed and the initial afib incident I found by checking the Ekg on the watch. The first two weeks it was normal but after I stopped the beta blockers it went to 4% burden …

[Buzby62 in reply to Iamfuzzyduck]

All that 4% means is that some irregular beats were detected in at least one of the background checks while you were at rest. Irregular beats means your heart rate is varying with almost every beat so HRV will be raised. If your result was “Less than 2%” it means no irregular beats were detected so raised HRV won’t be detected or recorded either.

If you’re having asymptomatic short episodes in between these background checks they will not get picked up by the watch, you need a holter for that. Will be interesting to see how much your holter records that the watch missed.

I’ll attach a screen shot of one of my spikes when the background checks have picked it up

HRV Spike

[Iamfuzzyduck in reply to Buzby62]

I think I replied to my original post instead of yours but I uploaded my images-thanks!

[Gumbie_Cat in reply to Iamfuzzyduck]

My Apple watch actually allowed me to get AFib diagnosed, as it never appeared when tested, for years I reckon. I ignored the suggestion to change the setting to ‘AFib history’, as I was grateful for the alerts when my condition was still paroxysmal. (Although by this time I knew the signs, and as Buzby62 says, it doesn’t catch everything.)

Once I went into permanent AFib - all happened rather rapidly at the end of last year - I did end up settling it to AFib history. Otherwise I would have received countless reminders. Bad enough being told 100% every week. I guess I could switch it off, but there’s always that little hope that it might say 90% 😂

[Iamfuzzyduck in reply to Gumbie_Cat]

Thanks! I may switch back after my Monday report!! Sorry you are 100%

[Gumbie_Cat in reply to Iamfuzzyduck]

One of those things, and likely genetic. I’m doing ok though - just tired legs on hills and stairs.

[babs1234 in reply to Iamfuzzyduck]

How do you check for EKG?

[Buzby62 in reply to babs1234]

An electrocardiogram — also called ECG or EKG

support.apple.com/en-us/HT2...

Hope this link helps.

[Iamfuzzyduck]

do you think this daily one is similar?

Hr variability

[Iamfuzzyduck in reply to Iamfuzzyduck]

This is the month with the original episode

HR variability for the month

[Buzby62 in reply to Iamfuzzyduck]

I don’t think you can take much from the daily one but I’d bet that spike on the monthly is when you had AF.

Just looked at my daily and had a spike yesterday about the same time as I got up from sitting down and went upstairs for a shower. My thinking is that if a check starts while you are sitting, the check lasts for a minute and if you raise your HR before it finishes you will get some variability. My HR went from 55 to over 100 within the check but not bouncing about beat to beat like in AF.

You can drill in to the HRV data by selecting “Show All Data” down below. Keep drilling in until you see “Beat-to-Beat Measurements” and drill in to there.

HRV is very complicated and is used by athletes I believe to measure their heart fitness and responsiveness to exercise and recovery. It was just an observation I made that AF spikes it up.

[Dodgerguy]

good day!

Is it better to have it set to AFib history on or irregular heart beats if I have AFib? Mine was consistent at 2% or less the mast seven months since diagnosed until Monday where I got 4%. . EKG has no afib. Thanks for any information!