Just wondering how many others use this feature of the Apple Watch?
I turned it on in August and it's been 2% or less every since, however last week its shows 3% or less for the previous week.
What I can't figure out is where I can see what's changed/when I had an Afib event?
Highlights shows my daily history but it says that is over the last 6 weeks?
Specifically interested in other Apple Watch users who have/are using this function vs anything generic please.
I use that feature and always have had the "under 2%" reading, which is the lowest reading you can get as the Watch will never say "0%".
If you're getting "under 3%" that means that the Watch has detected some afib during the last reading cycle.
Since the Watch doesn't monitor for afib, 24/7 by default, you might want to bring this to attention of your Cardiologist or ep and they may want to put you on a 2-4 week ekg Patch which will give you 24/7 data.
Jim
Thanks Jim, as far as I understand it turning on AF History then the watch takes a sample every 15 mins, which is far more regular than it does with that settings off.
I've done some more digging, looks like it reckons Wed was 3% and after midnight, so if I go back into another 3rd party app I can indeed see an elevated HR up to 80bpm around that time that drops back to around 50 by 0130 so that is probably the incident in question.
Just a shame the AW can't show that without me having to use a 3rd party app!
Every 15 minutes sounds right, but my understanding is that certain conditions may have to be met such as not moving, etc, but not sure. I believe with the Cardiogram App, it might check even more often. I use their built in sleep app in Apple Health and part of the app will show your heart rate while you're sleeping. And while it won't say afib or not, an elevated rate might be a clue. Not sure how often the sleep app checks. Apple publishes it's alogorithm's, but they are very hard to find and not altogether clear. It's also a shame that you can't get high heart rate alerts with "afib history" turned out. So basically no real time afib notifications.
Jim
Try drilling in to Heart Rate Variability from Show All Data right in to Beat-to-Beat Measurements, look for the higher HRV then look if the beats are jumping about from beat to beat (AF) rather than building up and dropping down gradually (exertion)
Yeah hrv readings spiking up do seem to correspond now I look back with hindsight! Also with af history on you get much more regular hrv readings taken. You can see up to July I was having regular afib which I tracked down to the flecainide.
Erratic HRV is what AF History uses to indicate possible AF I believe.
I find the AF recording from the optical sensor on the background checks to be very hit and miss, not at all reliable in either Alert mode or History mode but is good as an indicator as long as you know it’s restrictions.
The ECG using electrical sensors is much more reliable but you have to instigate it manually every time.
In AF
Interesting cheers I wish Apple would release some more detail on all this! This wasn’t flagged as afib but does correlate with a time period I was having lots of afib, ectopics etc etc. this is hrv readings
Those HRV figures don’t mean much while you’re in AF as they a just a measure of variation in milliseconds which will be all over the place as expected with AF, mine are very similar with highs up to 300ms. What they are useful for if you have an inquisitive mind is spotting where your AF starts and stops as when in NSR it is usually below 50ms
I found this useful when my AF was still paroxysmal. It was good to see that dip back to ‘normal’ HRV. Now that I’m in permanent AFib the HRV is high all the time.
so do you think this could be afib? Trying to decide whether to abstain from wine and take beta blockers!!
Use the ecg function on your watch when you think you are having an episode? Or turn off AF History and turn on A fib alerts!
That's just it, it is the odd beat that is funky and isn't picked up on the ekg plus the ones at night I am sleeping through ...
What does the beat to beat show for one of the periods you are concerned about?
one of two photos
I’m not medically trained looks like one instance of a high reading amoungst normal ones, so likely caused by turning over or something like that.
Looks like 1 high reading which happens with these watches on the optical sensor sometimes, I ignore them. My opinion is the watch moves or splits a beat in to two giving approx twice the rate either side in error
Second photo
That looks like 1 slow beat followed by a few quick ones to catch up. Or put another way, one missed beat followed by a couple of quick ones. Is that what an ectopic would look like? I don’t know.
What in the world is an ectopic? Now I have to go down a rabbit hole researching that!!
Use the search bar on here, you’ll find lots on ectopics.
You need to drill in another 2 steps to get to Beat-beat measurements and see if they are bouncing about with every beat.
Well I can't figure out why it is giving me 4% afib and if it is correct!! I will wait for my holter monitor results and drink the occasional glass of wine until then!!
afib?
No way of knowing really from HRV
and best to beat
The beat to beat BPM is jumping around with almost every beat which is what AF is. You can also get elevated HRV in NSR when the beat to beat is more gradual up and down, like when you start doing something from rest while the check is going on.
Interesting stuff, think there are also false positives though, look at this then the beat to beat. 159 is a big outlier, beat to beat is steady from 41-59
Nowt here really!
Probably that low of 34 is contributing to the HRV. More a case of not understanding HRV calculations properly than false positives maybe 🤷🏻♂️ The main thing is there’s nothing there that worries you. I’m sure there’s lots more to learn. I’m on nil by mouth now for a cryoablation tomorrow so may go quiet for a while.
Ah cheers appreciate the replies, good luck with it! Fascinating what the Apple Watch actually can record vs what the health app actually shows!
awwh, good luck, I was going to pick your brain some more about the hrs, I will upload some more photos. It seems like I get big spikes between 12-2 every single night, why do you think that is, is it afib? I will post more photos from my phone in a minute...
Is it ok to have a heart rate that low ? Are you on bisoprolol ? How do you get to go on these reading s ? I’ve never seen that before . Thank you
Hi, I wouldn’t get too obsessed with these readings, it really is looking too deeply in to things but some of us like to have the lid off things to see what’s going on. The more you see the more you can be upset by false or inaccurate readings. These are all taken from background checks with the optical sensor which we know from previous discussions can have inaccuracy for various reasons, loose fitting on the wrist or poor radial pulse for example.
They are located in the Health app, Heart Rate Variability then Show All Data to see the daily HRV records and drill in to the records another 2 steps until you see Beat-To-Beat Measurements at the bottom.
My resting HR is regularly in 40s and 50s when NSR but in AF the beat to beat will be lower and higher as the beat to beat jumps about, that’s why we’ve said before that beat to beat is meaningless in AF and you should go with the average like the ECG app does over 30 seconds.
Probably an outlier, yes on bisoprolol, seems to drop to low 40s which consultant said was ok.
I also found that. As a matter of interest, what is your average HRV? Mine is ranging from 20-30 not in AF and doubling when in AF.
Hi, have a look at this post, very similar question which I’ve replied to.
healthunlocked.com/afassoci...
Hope this helps
as I am very aware of my AF when it visits I only have my watch set in normal mode which alerts me if I am in AF. If I’m concerned at all I’ll check HR every now and then and look at HRV or do an ECG. People can become obsessed with data and what’s happening every moment, I’ve found I’m far more relaxed and get on with life when I put it into standard mode. I will add that being more relaxed and focusing on nose breathing seems to have eliminated ectopics so far!
I don't have an Apple Watch. I rely on how I feel. When I had paroxysmal AF I knew when I was in it, by an awful feel in the artery in the neck. When I was in Amiodarone I felt bad most of the time. Once put in Flecainide my episodes reduced significantly. After 12 years on Flecainide I was found to be in persistent AF, which, given I've had it for 7 years I recognise as permanent, though it's asymptomatic. I can feel my pulse if I need to double check.But what's my %burden. An Apple watch might tell me a figure but it would be wrong
I respect my permanent though asymptomatic AF, as I respect my other long term contains, asthma, Lymphoedema in my lower legs, BPH, and right Foot Drop. I try to keep healthy, having a mainly pescatarian diet. I don't walk as much as I should, though the Foot Drop doesn't help, as I need a stick for balance.
Yes, that is normal. You may have had a restless night, eg tossing and turning, and the watch algorithms have determined, because of the time (night) and temporary spike, albeit minor, constituted an “anomaly’ and reported as 3 vs 2 (which is the default for no activity). It is a weekly compilation, so hard to pin point unless you were aware of it.
I wrote the post the other day about 4% afib on my apple watch where as the two weeks prior it was 0-2%. I stopped meds two weeks ago (under the cardiologist and EP because my HR is already low, Ican't have it much lower. But since then I feel the odd one or two flutters. I don't know if it is my imagination, but I am wearing a holter monitor also so I can then let you know when I get the results in January how it correlates to the watch...I also asked my EP about the 4% and he wanted me to send the ekgs (which are normal as far as the watch goes)
I would also like to state a couple of months ago (and before I knew I had afib) I was talking to a friend in his forties who had had an ablation this summer, after he had covid. His watch kept picking up afib at night but he had a hard time convincing his doctors that he was having afib because his EKGs were coming back normal. So he wore a monitor and he was having afib at night, his watch was correct...
I’m constantly checking my heart rate on my watch 🤦♀️. I went onto the history feature when I was diagnosed but changed back to the feature that tells me immediately what my HR is going. I prefer that and feel more in control.
It won’t actually alert you immediately. It only checks periodically when you’re at rest. I only got alerted once after about 5 checks over 5 hours or so in AF. It actually misses more than it alerts you to. I still wouldn’t be without it but be aware of its limitations and don’t over obsess with it is my advice.
support.apple.com/en-gb/HT2...
From this link :- The irregular rhythm notification feature on Apple Watch is not constantly looking for AFib. This means it cannot detect all instances of AFib, and people with AFib may not get a notification.
Hope this is helpful
Just announced - Apple watch to track AF - 11/30/17
KardiaMobile and Apple Watch
AFib/Atrial Flutter Burden
Apple Watch SE ECG App
