latest ECG results from Cardiologist, any cooments plse?

[ainslie]

Firstly thanks to all those you replied to my original Newbie post, the quality and energy of the responses was fantastic. Certainly faast tracking my learning.

I received a letter from my Cardiologist today re results of a 24hr ECG I did about a week ago, I am seeing him tomorrow thursday at 4pm and wondered if anyone had any input on what I should ask him or suggest to him.

He reports " there were 88471 beats recorded, more than 93% were normal sinus rhythm. This is significant improvement to the ECG in Dec in Spain ( consuming 50 units week alcohol when I had 42% ectopic beats on ECG) he goes on to say "There were (this is last week) ventricular ectopic beats at 6% of all beats. There was a single short period of narrow complex tachycardia with heart rate of 160 bpm which may have been sinus tachycardia or possibly atrial flutter. Currently there is no indication for anticoagulation (CHADS Score 0)."

I caught the 160 beats on my finger oximeter, I was exercising fairly hard and was stressed with neighbour noise dispute, 160bpm while exercising is well above the 120 max I usually get to with exercise, it stayed around 160 for maybe 30 secs and then back to 80 then 62.

Doc goes on to say that I had reported to him verbally I had episodes (2 or 3)during the last 2 months of bradycardia and tachycardia where BPM were 150 for 3-4 hours until beta blocker. Peeing every 5 minutes on one episode.

Does this mean I dont have AF or it just hasnt been spotted yet, or do I have something else.?

What it does tell me very clearly my heart and excess or maybe even any alcohol dont get on too well, how boring but off it for now.

I plan to ask him re wearing a Apple watch etc.

All comments , suggestions, input welcome

Thank you

[BobD Volunteer]

Sounds like AF was not picked up but that means nothing. Flutter was posssible but that is generally easier to deal with. For now it would appear they will treat you for what they have found. If in future fibrillation is discovered then that's a different story.

From my experiecne the only boring thing about abstention is how stupid your pi**ed mates appear when you are the only sober one.

[ainslie in reply to BobD]

thanks , I agree 🙂

[pip_pip]

I don't think suggesting to him is a good idea as he is the cardiologist. You might not be too happy with what he suggests to you in the way of treatment. Hope it works out well.

Phil

[ainslie in reply to pip_pip]

thanks Phil, he is okay with my suggestions usually because they are hopefully sensible ones

[CDreamer]

Apple Watch will show quite a lot and dependent upon how you use the settings will give you alerts of High HR. The modern ones also have an ECG facility but you do need to hold the crown. The algorithm will only show NSR - normal sinus rhythm or AF though, mine has never shown AFl or ectopics whereas the Kardia has picked them up.

Most doctors accept readings from iWatch and other modern self monitoring devices. I used to email my Kardia reports to my EP ten years ago so hopefully doctors these days are more open to suggestions, mine certainly are.

Doctor/Patient relationships are important and in my view need to be collaborative so I would suggest you ask yourself - what do you want from the consultation? The clearer you can be about that, the clearer your doctor will be.

In your shoes I would want echo cardiogram to look at heart structure and the a letter to GP (copy to yourself of course) with recommendations for monitoring and advice as to possible medications/treatment options if arrythmias develop.

Maybe also advice on Lifestyle or even signposting to support services? I wouldn’t be too hopeful on that one!

[Morges in reply to CDreamer]

In your shoes I would want echo cardiogram to look at heart structure and the a letter to GP (copy to yourself of course) with recommendations for monitoring and advice as to possible medications/treatment options if arrythmias develop.I agree with CDreamer especially in the light of my first consultation with E- cardiologist (private appointment) yesterday, which was preceded by an ECG and then after speaking with the doctor, an Echo. The Echo showed cardiomyopathy, and 2 leaking valves which he hadn't picked up on his stethoscope. The ECG showed persistent AF but heart rate around 80. My B/P is ok and I have no other symptoms.

So I think it was serendipitous that I went for my pre op assessment in February where the initial problem of AF was picked up.

It rankles a bit that the NHS doctor at the Royal Berks Hospital wrote to my GP that I didn't need to be seen by a cardiologist. However the doctor yesterday also works at the RBH and will see me there for the next investigation because he wants to find out why the cardiomyopathy especially as I'm not hypertensive. And also that my LBBB diagnosed 3 years ago was not followed up at all, which apparently it should have been.

For me it was well worth getting the tests done.

[ainslie in reply to CDreamer]

Thanks, I had the Echo Cardiogram and heart is alleg in spanking condition apart from the electrics

[richard_jw]

0I was told by my cardiologist that a Holter may not pick up AF. He meant Atrial fibrillation. Indeed I have had several Holters done from 3 days to 7 days, and none have recorded any AF of either sort.

My Kardia has recorded AF on several occasions but the ones seen by a cardiologist are deemed not to be AF, and are noise because of external factors.

At least 2 cardiologists (one an electrophysiologist have said "no AF".

The only way (which I am aware of) to determine if you have AF is to wear an implantable loop recorder. I am told that this will produce a reliable diagnosis.

[Mugsy15 in reply to richard_jw]

A Holter monitor will always pick up AF. The problem is not with the sensitivity or accuracy of the device, it lies in the fact that the patient often does not have any bouts of AF to record during the monitored period. This is very common and numerous posters on this forum have told of how they were monitored several times before an episode was finally captured. It is true that an implantable loop recorder is more likely to pick up AF, but only because it will monitor for a much longer period of time.

[ian16527 in reply to Mugsy15]

My loop recorder will pick up any AF event over a certain duration automatically,so the technician informed me, but you need to record an event to get the full tracking. It just tells them how long it went on for, start and stop time etc. It will only store 3 events then overwrite them.

Previous to my Ablation, the EP letters always state AF confirmed by ECG on a certain date

[Mugsy15 in reply to ian16527]

That's interesting and adds some knowledge thanks. I certainly wasn't aware that episodes are overwritten! How do you go about 'recording' an episode? I thought the whole point of the device was to continually record.

[ian16527 in reply to Mugsy15]

It does but hence the name, loop.To record an event I have a sender with a button which you press and hold over the recorder in your chest.

It beeps when connected. This stores some minutes before the press and after

But they told me it will only store 3 events

I also have the base station to send events realtime

[Mugsy15 in reply to ian16527]

Thank you, I didn't know any of that. 👍

[Ppiman]

No AF so I’d wait to see what he says. Have you had an echocardiogram?

Steve

[ainslie in reply to Ppiman]

yes thanks Steve , echo all very good, just the electrics

[Hidden]

Hi,

Just speaking from my own experience and noticing that none of the other replies made mention of the “50 units week” of alcohol, I think it important to note that alcohol and AF do NOT mix. I had episodes of AF for a number of years, years during which I drank wine daily, and didn’t know it. I did, however, recognize the connection between drinking and my heart acting “funny.” Now, with documented AF and two ablations, I wouldn’t dream of touching alcohol. And indeed, I love being alcohol free for any number of reasons, but one really important reason is my heart health. Enjoy Spain when there’s a next time and leave the “units” to others. You’ll have a wonderful time—especially if your heart is healthy!

[Mugsy15 in reply to Hidden]

I think it's good advice to suggest abstaining from alcohol, although I personally still enjoy a few beers at the rugby club and it doesn't seem to affect me much unless I allow it to cause dehydration.

Wine is a no-no though, especially red. I've read on here that the sulphites are the culprit rather than the alcohol, but I have no idea how accurate that is. I also seem to invite arrythmia (the next day) if I have a whisky, which is a shame for me as I do enjoy a single malt.

[Hidden in reply to Mugsy15]

I sympathize. But I’ve found being alcohol free to be the cat’s meow. Regular, solid sleep is one of the best benefits. But the biggest benefit by far is protecting my heart health. If my heart isn’t right, my world isn’t right physically, emotionally. I feel “off.” In Chinese medicine, they call the heart “The Queen,” the center of our life’s blood serving every tiny cell in our body so that all systems work as they’re supposed to for our health. This queen doesn’t like alcohol; it interferes with her job. (-:

[Mugsy15 in reply to Hidden]

Good for you; whatever makes you happy! ☺️

[ainslie in reply to Mugsy15]

i read about one guy maybe on this forum who found whisky didnt work but Spanish Brandy was fine, I dont think I will run that by my cardiologist 🙂

[ainslie in reply to Hidden]

thanks , yes sadly that penny is dropping, im on the wagon, apparently its called Holiday Heart, very common according to my Cardiologist

[Iamfuzzyduck]

My EPs will look at the apple watch recordings and encourage me to send in any thing funny. The apple watch won't analyze the EKGs unless it is Afib. I will upload my EKG from a couple of nights ago when I was awoken suddenly. This is a series of PVCs in bigeminy but the apple watch called it inconclusive. However it did diagnose my afib runs in November.

Apple watch pvcs