Hi,I have a 2 lead pacemaker for total heart block following AV ablation and 2yrs later since the procedure I'm in heart failure & afib and take ramipril, bisoprolol, dapagliflozin and having a few issues, which has resulted in me having to attend the pacemaker clinic 3x in last 3 weeks.
I struggled under exertion as I was paced at 70bpm and my heart rate wouldn't go any higher.
Pacing clinic then made adjustments to the rate response on my pacemaker which has made a difference to my heart rate and now goes above 70bpm but this has made my AFib worse and I'm struggling throughout the day
I was also told this may make HF worse so I'm going to phone the pacing clinic tomorrow as they suggested to revert the settings back.
I have an appointment in July to see the consultant and it's been suggested I may need 3 lead pacing for better cardiac output.
The pacing technician asked if I had a heart rate monitor like a smart watch to monitor my HR which I don't so looking for advice and suggestions on a mid priced smart watch that can record a ECG and track HR.
Thanks
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Nomis21
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Good morning. Several points - first the 3 lead pacing makes a HUGE difference and has stopped my AF so that I now only have very occasional episodes that I hardly notice. It will also help some types of HF so do some research.
As to monitoring - questions first - is the smart watch for an app to monitor your pacemaker? I have a Medtronic RST 3 lead pacemaker which reports to an app on my phone which then sends reports straight to the Pacing Clinic. It does mean I need to keep the phone within a metre most of the time.
If the technician is looking for just HR monitoring most modern phones will have one and/or watch which I would have thought much more useful as the watch will monitor HR whilst you are walking and out and about.
The difficulty is if you have absolutely no experience of the tech then you will need some help and support to get set up as a smart watch reports to a smart phone or other mobile device so go with one that fits with your existing smart phone eg: if Apple - Apple Watch etc.
Probably the most used are Apple, FitBit, Samsung and Garmin. I’ve tagged BenHall1 as he has recently bought one so maybe he can give his experience of it.
I’m firmly in the Apple camp but you do need other Apple devices to sync.
I have had issues with my 2 lead pacemaker since insertion, it's been mentioned that the pacing side of the heart is not in sync with the unpaced ventricular side.
I believe the consultant is favouring the additional lead. Hopefully things will improve.
Was your HR monitoring set up via the pacing clinic? How was it set up?
Exactly right about the ventricles not syncing with 2 lead - which can lead to Heart Failure symptoms which is why my EP recommended.
Monitoring is via an App on my phone which downloads result about every 24-48 hours. The Pacing Clinic algorithm's pick up anything dire, otherwise I have regular -6 monthly - telephone consult with the Cardiac Physiologist. It is always the Pacing Clinic who monitor, cardiology will only get involved if the Physiologist see something they are concerned about so no news is always good news.
To answer your question ........... Withings Scan Watch 2 Horizon- Hybrid at £268. Does quite a range of stuff including ECG, HR and Oxygen Saturation (Spo2 ). When I'm home I use Kardia 6L, buit I'm not always at home, still working part time and it is becoming more necessary to know what is happening when asleep and when I'm actually working. Cheaper than Apple products.
I have taken readings at home with this watch and Kardia and the two sets of readings ( given they are quite different devices ) are very close.
I have a Google pixel 8 pro phone and was thing about the pixel watch which has HR monitoring and ECG but if there is better recommendations I'm happy to keep my options open.
Where did you buy the withings watch at that price?
I have a Fitbit charge 6, I like that it's slim, more like a bracelet than a chunky watch and wear it almost 24hr. I have a pixel 8 phone. Does ECG, heart rate and tracks exercise etc.
I bought it off Amazon UK. However I also researched around first and checked the various specifications of various bits of kit I was attracted to. TBH, Which? have reviewed it and not rated it more than 44% but then reading the Which? write up I felt they were talking about a totally different watch ! Not much of their write up I agreed with. The point is I didn't buy it because I wanted hospital grade kit, I bought it because it gave me a broadbrush view of what was going on in my chest. Withings also market a more expensive model but I just wasn't prepared to pay the asking price. Sometimes Which? get carried away with the science in their testings.
If I get a continuous run of data which looks ominous then I'll get in touch with my GP ( although very little chance of seeing her ) or direct with a Consultant ( as I have done at the moment ).
Nothing wrong with this watch, depends on your expectations. For me ... value for money and a good looking dress watch to boot.
I don't know ............ I mean I tend to be asympomatic anyway so I'm on a hiding to nothing. More to the point, I only ordered it on 4 May 2024 and just haven't had the experience with it in all its glory and functions. I'm also under the care of a Consultant Cardiologist and ( sods law ) my heart hasn't misbehaved very much. I'm not an exercise freak so I ignore the workout bit anyway. That said I suppose I could activate walking.
The one thing I would say though it does give a very good summary/overview printout of the various areas of activity. Also I did have a bit of heart activity going on which my Kardia ECG device produced a printout result of "UNREADABLE". I took a Withings reading at around the same time of day and got a reading. The ECG printout gives a summary of the following data on the ECG printout itself ..... QRS; PR; QT; and QTc. and NRS ( as it was at the time of testing).
The pacing technician asked if I had a heart rate monitor like a smart watch to monitor my HR
If all you need is heart rate monitoring. an inexpensive sport watch or basic Fitbit type device will would do the trick. But if they want you to take EKGs, the Apple Watch is a good choice but requires an Iphone. If you're in the Android universe, Samsung and others offer smart watches that take ekgs.
But again, the ekg function may not be needed. so maybe first get clarification from your pacing tech.
My Apple Watch may not be clinically accurate, but is more than good enough to notice patterns and spikes in heart rate. I had a couple of blackouts due to arrhythmia, and the watch captured the spikes perfectly.
Beware going down the bargain route of cheap smart watches on the Internet. I made this mistake, it offered to do all sorts of things, including reading blood glucose level and doing ecg. It does what it says, but none of them are remotely accurate. I read somewhere that the supposed "readings" are really produced by algorithms. That says it all. (It does tell the time ok.)
Beware of battery life of most smart watches. It's the price you pay for being full of features and processes you might not need. The Withings scanwatch is a hybrid watch with HR and ECG functions and claims of up to 30 days battery life. However, like more featured watches, the more you use it features the more battery you consume.
I have a Withings and a Samsung smart watch. The Withings is topped up to 100% charge each night while I'm showering. My Samsung Galaxy Watch 4 cellular normally needs at least an hour or 2 on charge daily, even with minimal use.
My wife's Apple Watch is a great device but it also struggles to get through a full day at times without charging.
For your needs I'd look at something like the Withings I.e. a something that has the features you are chasing and a battery life measured in days or weeks rather than hours. YMMV.
Have you had AV node ablation and now reliant on pacemaker full time ? I had a 2 lead Biotronik pm implanted but never had the node ablation. At first the rate sensor was on for a few weeks but technician turned that feature off as i was getting lots of uncomfortable palpitations. Now 3 yrs later I am getting almost intolerable heavy thumps in my ticker. I have started the conversation again with the possibility of doing the node ablation. Quite frankly i have had 3 years of misery since the pm was put in as i have become quite intolerant of drugs and excersise.Colin.
Yes had AV node ablation anlong with an ablation of an extra electrical pathway, I have total heart block and fully reliant on the pacemaker.
Struggled every day since surgery, I have a two lead pacemaker and it's looking like it's put me into heart failure due to due to the synchronization of the ventricles.
Had problems with the PM rate response for months, my heart rate wouldn't go above 70bpm and I really struggled on exertion, even walking up stairs and slight incline and I could feel the energy being zapped out of me along with lightheaded, dizzy and breathless.
I get thumps in the chest, erratic beats and frequent dizzy lightheaded spells but Iam also in AFib.
Pacing clinic last Friday changed some settings and now my heart rate does go above 70bpm however it's made my A Fib episodes twice as bad.
Thanks for reply Nivis21. Its Colin here from NZ. 53 ,thats kj da young for a AV Node ablation Im just on 82 and want to spend a bit of the youth i have lrft lol.Now seriously from what ive been told an AV node ablation plus Pacemaker leaves you totally reliant on the PM but supposedly the afib and palpitation are no longer felt. No more drugs required except anticoagulant.
The pacemaker i have is a Biotronic 2 lead ,rate sensitive model. Had it put in 3 years ago so all they got to fo is yhe ablation
Can you commentcause it doesnt seem to add up with your experiences.
Hi Col,Was at pacing clinic yesterday, AF was confirmed and the higher heart I was set at on rate response made the AF worse so the technician reverted back to previous setting of 70bpm until further investigation with consultant which I have an appointment in July.
The AF isn't currently managed with meds (this might change in July when I see consultant)
The AF has been confirmed also with my Heart Failure nurse and another consultant I seen previously (long story)
The issue with me is that I'm totally dependent on my 2 lead PM following AV node ablation which is also causing my ventricles to be out of synchronization which may be the cause of my heart failure plus being in AF which also can make Heart Failure worse (so I've been told)
No idea if AV node ablation is believed to stop AF but but in my case I'm being told I am in constant AF even after my AV node and extra electrical pathway ablations.
It's been suggested I may need a 3rd lead added to my PM to synchronize the ventricles.
Current meds, ramipril, bisoprolol and dapagliflozin, all prescribed by heart failure specialist nurse.
I was a sufferer from Wolff parkinson white syndrome all my life which caused intense palpations episodes after trying various meds (which didn't work) and being informed I was 5x more at risk of a stroke or blood clot, I was offered an ablation to rid me of the extra electrical pathway that was causing the problem however the extra pathway was to close to the AV node and the ablation procedure had a high risk of AV node damage....both were ablated during the procedure hence the pacemaker.
I know have HF and in AF and feel more at risk now at 53 than I did before I hade my ablations, unlucky I suppose!
I have a Fitbit Charge 6. For heart rate measurements, it does not seem so accurate when my HR fluctuates. If you are in NSR, it works fine. For example, a Kardia 6L ECG can show a heart rate of over 100 while the Fitbit shows a heart rate of 60 during periods of fluctuating heart rates. I find the Fitbit cannot keep up with the fast heart rate fluctuations during times when the heart exhibits irregular rhythm.
There are reports that say watch heart rate monitors lack the accuracy of a chest strap, which is the gold standard in measuring heart rate and used by many athletes. I am currently testing a Polar H10 chest strap to see whether it is more accurate than my Fitbit Charge 6 for continuously monitoring my irregular heart rate.
The downside of the Polar H10 is the hassle of wearing a chest strap and the need to pair the H10 with a phone app or a Polar watch. Since accurate tracking of my heart rate fluctuations is important to me, I am willing to tradeoff some inconvenience for more accuracy.
I have a Samsung6. Watch. I chose it in the end because my phone is android, a Samsung and there can be compatibility issues so be careful. I found choosing a smart watch choosing more complex than I first thought it would be. If you don't have apple mob the Samsung smart watches did well in reviews. Its really useful as it keeps a constant track and record of my HR as well as steps etc..... And when out walking ir exercise I can monitor hr levels more accurately. It does need charging most days. Takes about 40mins.
I use my Kardia 6L for ECGs. I've found it useful post heart op. I hadn't realised how much my heart rate varies during sleep!
Hi I agree, It's a bit confusing, I've looked at withings, Garmin, polar, Samsung, fitbit and Google pixel.
I know there all aimed at activity and fitness exercise tracking mainly but Iam not sure which is best mainly for HR monitoring and ECG which is what I'm looking for.
Personally I'm getting the feeling that the apple watch is coming out on top for heart monitoring but I use a Google pixel 8 phone.
Maybe the ones I have mentioned all just as good as each other? Who knows?
I use the Garmin Vivosmart 5 as I wanted to keep an eye on my heart rate. I’ve had two Fitbits in the past and find the Garmin much better. The technology behind it is first class and information included with the Garmin has to be paid for with a Fitbit.
You also need to check on which ones are compatible with your phone. Bit of a mindfield. Why I chose Samsung watch as have Samsung phone. They are not totally accurate for HR....but very good. Kardia is probably the most accurate......unfortunately you have to be sat still. I wanted something to track my heart rate as walking sleeping...... If I compare readings from Kardia and Samsung watch when sat quietly (needed for Kardia) they are very simular.
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Heart rate post exercise. 
Heart rate monitor watch
Heart rate still high after exercise 
Heart rate shoots up when exercising
Afib/Irregular heart rate.
