This may be a silly question but I'm a little confused.
Whenever I see a doctor I'm often asked if I have a heart rate monitor and a blood pressure machine that can deal with AF. My BP machine can't detect AF but seems to be accurate otherwise when compared to readings at my GP.
When it comes to heart rate monitors though, I know there are monitors that can detect AF like Apple Watch and Kardia (I have the Kardia device) and thought that this is what they meant. However, when talking to a physio at the hospital about exercising with AF, he said to get a wearable one that can measure your pulse when in AF.
What is the difference between an "AF Heart Rate Monitor" and a regular heart rate monitor? I have a smart watch that measures heart rate but it can't detect AF. So would that not be able to measure my heart rate accurately when exercising?
I just can't get my head around what the difference is between an AF heart beat and a NSR heart beat and how a heart rate monitor might measure them differently.
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I would say there’s no such thing as an AF Heart Rate Monitor, just a Heart Rate Monitor, but when you do an ECG with a Kardia for example it will be over maybe 30 seconds and gives you an average heart rate over that time.
The wearables you speak of give you an instant heart rate reading based on a beat to beat measurement, ie one second beats would give you an instant reading of 60 beats per minute. The issue is when in AF the beats are not evenly spaced so the instant reading will be jumping about from beat to beat to beat and is not particularly reliable. In AF you have to count the beats over a longer time. For example count how many beats in 10 seconds and multiply by 6 to get an average beat per minute for that 10 second period.
When I was nursing ( in the Dark Ages) I found that if I was trying to hurry and count a pulse rate for only 15 secs (rather than as taught for a full minute)and then multiplied by four , it was necessary to deduct 4 to get the same result as counting for a full minute. Just tried and still true!!
I saw a heart monitor in Boots the Chemist recently and it said on the front of the box that it could detect AF. Was Just under £70 from what I can recall.
A normal BP monitor is not very good at recording AF, mine will often not work and just say 'Error'.
Yes, any good heart rate monitor should be able to accurately measure your pulse rate, both in and out of afib. It just won't be able to tell you if you're in afib, or just have a high heart rate. For that, you'd want something like the Apple Watch, or a wearable heart rate monitor for heart rate and a Kardia like device to tell if you're in afib.
Thank you all for your replies and for confirming what I thought. Thankfully I don’t need to buy anything else as I already have a Kardia and a smart watch. They just made it sound like something different.
When I had my afib attack, the regular heart rate monitors (Apple without ekg, fit bit and at the doctor's office measured 70 bpm, but the ekgs on the apple and at the doctor's measured 150-180 bpm. I think the beats from the atria were too weak to be picked up in the regular way, so there may be a difference. Maybe buy a portable device with an ekg?
Well said, the optical sensors on the back used for background Heart Rate monitoring on the wearable devices can be pretty inaccurate when you’re in AF and the electrical sensors used to do the ECG/EKG will be much more accurate in my experience as in yours.
My BP monitor will show a little heart shaking if it detects irregular heart beat, and advises that BP readings might not be accurate. It's spot on for when I have AF, and the disappearance of the shaky heart confirms I'm back in NSR. I also have an oximeter which shows a wavy line representing heartbeats. It's pretty obvious and accurate when heartbeat is irregular. Incidentally, there was a report in The Times on 20 January about Apple Watch wearers complaining of burns and blisters on the wrist. If you Google , it seems to be quite common, although Apple play it down (really?). And yet I don't recall seeing anything about it on this forum, which seems to have plenty of Apple watch users. Am I missing something?
Watches are the wearable ones. They detect heart rate continuously if you set them to (the battery life will be affected, and the watch isn;t actually continuous but checks every so many seconds). This means the watch can look for and report back on irregular heartbeats, too, and log these over time. These might be caused by ectopic beats (most commonly) or AF (much less commonly) - the watch won;t know but will report something like "irregular heartbeat" or "possible AF". All it is truly measuring is rhythm irregularity.
Secondly the Apple Watch and some other makes such as Fitbit and Samsung can perform an actual ECG and check for AF, but now the watch must be held with the opposite hand from the wrist it is on for 30 seconds while it checks for this. This works in tandem with a matching mobile phone. and the resultant ECG is analysed by the phone's app and can, reasonably accurately, determine whether AF occurred in that 30 second period, or whether the heart was in NSR. Sometimes, multiple ectopic beats can fool the app into reporting AF when it isn't, but my Apple Watch has, so far, been accurate.
Next, there are the separate hand held devices that also needs an app, such as on an iPhone. I have tried three of these: the Kardia 6L, the Wellue AI and the Wellue 24-hour AI. I still own and use the latter two. I sole my Kardia as I was having to pay £10.00 extra per month as I have a "wide QRS" as well as irregularity, and Kardia like to make extra profit from people like me!
The Wellue 24-hour AI device is unique for home use as it can be worn for from 5 minutes to a full day, including in bed and while active, and it produces, using gel chest electrodes, noise-free excellent ECG graphs and very detailed AI analyses that are not too far different from those your doctor would produce, although those use twelve leads and can detect more heart abnormalities. The Kardia 6L is limited to 30 second detection periods, but can run for up to 5 minutes; the Watch runs for 30 seconds. The problems with short run times is that for many people their AF or other heart irregularities occur fleetingly and can be missed. That's why the 24-hour Wellue comes in and can be very helpful for both you and your doctor.
Finally, most blood pressure machines can detect an irregular heartbeat, with just a handful. now also checking for AF, too (Moron and Withings have a model). These are pricey and less convenient. Also,, when the heart is in AF, no home machine can accurately check BP wing to the way they work. To measure BP with any hope of accuracy during AF requires a stethoscope and traditional sphygmomanometer.
The Apple Watch can and does report Afib. (Not sure which release of watch and watchOS is needed.)
Fine to question its accuracy - I'm not here to defend it. But to point out that this is not just seeing tachycardia in the heart rate section.
Insofar I am able to recognise anything, when I do an ECG with it, that shows disturbed rhythms. So this could be a genuine assessment. And it does not need me to touch the watch with my opposite hand for Afib - as it does for ECG.
I think you’ll find it actually reports irregular heart rate or possible AF or Indication of AF (Shows signs of AF) when you have the alerts set up as Ppiman says.
Without the electrical circuit using your other hand/finger then you are relying on the optical sensor LED reflecting blood movement under the skin and not the electrical activity from your heart. In AF some of the beats can be weak enough to be missed by the optical sensor and I have experienced this, it will still report irregular but the rate might not be accurate.
You can switch from using the optical sensor to electrical sensor using your finger on Apple Watch series 4 onwards (not SE model) while using the Heart Rate app and is the only way to use the ECG app. When you use your finger on the Heart Rate app you will see the rate change from beat to beat if you are in AF but in NSR it will not change so much unless you cause an increase by doing something. The electrical readings are much more reliable but the optical sensor can give you good indications that something is not right, but it will miss some AF.
I suspect your doctor is asking whether you have a HRM or BPM device that can detect AF. This goes beyond a HRM or BPM that can detect arrythmia as these can be tiggered by ectopic beats and other forms of arrythmia . Obviously your Kardia fits the description of a HRM which can detect AF. There's at least one BPM I'm aware of that can detect AF and if you have that, I'm sure you'd know.
I presume you are aware your BPM won't accurately measure your blood pressure during an episode of AF. I believe the only medically accepted method for checking your blood pressure when you're in AF is the traditional manual method.
I have been using the wellue 24 hr ecg monitor, and well worth the purchase cost. I generally now wear the monitor for a 10 hr period, and this is when I would be most active
Since Xmas i have been in tachycardia rhythms when walking at a slow pace, and the monitor has picked them up, and also in a 10 hr period tells me how many beats in a 10 hr period = 58,000 beats. Been told by my Gp that is kind of high, and should be more like 38,000 in a 10 hr period
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