ECG need help: Began noticing "funny... - Atrial Fibrillati...

Atrial Fibrillation Support

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ECG need help

Willow55 profile image
63 Replies

Began noticing "funny" heart beats about 2 years ago. Finally went to dr last January 2024. ECG no further info. Tried Dr again, another ECG and heard nothing since.Got my ECG but can't read it. On it was "A Fib cannot be ruled out"

I was on BB for migraine had reduced dose after heart block about 4 years ago and am now taking 25ml Atenolol.

Hardly ever notice "funny beat now unless I get stressed"

Would anyone help me to read the ECG please? I am in UK

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Willow55 profile image
Willow55
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63 Replies
jeanjeannie50 profile image
jeanjeannie50

You need to put the ECG in this post so that members can see it.

Willow55 profile image
Willow55 in reply to jeanjeannie50

Thank you

Can't describe
mjames1 profile image
mjames1 in reply to Willow55

It looks somewhat regular and I see some "p" waves which does not suggest afib. That said, you only uploaded a small portion of the EKG and I am not medically trained.

Has the EKG been read by an electrophysiologist (ep)? They are the ones best equipped to read an EKG. And have more training in that regard than a regular cardiologist or a general practitioner.

Jim

Willow55 profile image
Willow55 in reply to mjames1

Thank you, I am finding it difficult to get a dr or anyone to discuss or explain. I was taking Vitd3 combined vit k2mk7 and realised that the k2mk7 was definitely aggravating the symptoms so have had improvement since I stopped those vits.

mjames1 profile image
mjames1 in reply to Willow55

Is having a private consultation with an ep an option? Taking a second look, it's really unclear what's going on and knowing whether or not you have atrial fibrillation is important for a number of reasons.

Jim

Bunkular profile image
Bunkular in reply to Willow55

I wish my waves looked as regular as yours. The problem with having an ECG / EKG done is it's only a short snapshot in time unless you go for a treadmill stress test in which case the readings are longer and during physical exercise. Next best option after that is to wear a Holter Monitor for 7 days to possibly catch any irregularities.

Willow55 profile image
Willow55

Thanks for your help, I do need to know so will possibly go private

Linley profile image
Linley in reply to Willow55

Agree with mjames1 if you can afford it a private consultation is a good investment you don't get hurried, wish you good luck

SeanJax profile image
SeanJax

your ekg is normal . All I can say. You might need an Apple Watch or Kardia to record your funny beats if it happens again. And we would go from there.

Willow55 profile image
Willow55 in reply to SeanJax

Thanks

Buffafly profile image
Buffafly

I don’t see the point of paying to see anybody unless you have an ecg of the ‘funny beats’. I’m assuming you weren’t having them during this recording? I agree that a Kardia is the way to go (and cheaper). If you can record the fbs that could confirm whether they are AF or ectopics. If they don’t go on long enough for you to set up and record then they are probably ectopics. As you say, it is important to know because of the stroke risk. A friend of mine told me she also had AF but rather in the tone that it was nothing to make a fuss about. She didn’t mention taking an anticoagulant and didn’t seem keen to discuss her medication. I recently had a message to say she had had a stroke. I suspect she might not have had AF formally diagnosed - either that or had a doctor who wasn’t up to date, mine had me on baby aspirin for years after I should have been on a real anticoagulant. It’s good your gp is still considering AF rather than diagnosing you with anxiety! Best wishes ❤️‍🩹

Willow55 profile image
Willow55 in reply to Buffafly

Thank you Buffafly, Yes this is the ECG with"AF can't be ruled out" written on the results, unable to talk to Professional to hopefully rule it out.

Buffafly profile image
Buffafly in reply to Willow55

AF can’t be ruled out because you have a ‘normal’ ECG (according to what you have posted). If it showed any AF the report would say AF.

Willow55 profile image
Willow55 in reply to Buffafly

Ah I understand it now much relieved if feeling a bit stupid. Thanks to everyone for your patience.

Buffafly profile image
Buffafly in reply to Willow55

Not stupid at all, that remark was quite cryptic so confusing to anyone not able to read an ecg. It might say NSR (Normal Sinus Rhythm) somewhere on it. If it was a Kardia recording it would say what the rhythm was so there wouldn’t be the same doubt. I do encourage you to get one to set your mind at rest x

CDreamer profile image
CDreamer in reply to Willow55

If you have paroxysmal AF unless you have an episode whilst hooked up to the ECG it will show NSR - normal sinus rhythm. If you went to the doctor because of symptoms that sounded like AF your doctor’s cryptic comment is understandable but not very helpful for the uninitiated. No such thing as a stupid question, only stupid when you don’t understand something and then not ask.

Rubymurray25 profile image
Rubymurray25

My Kardia device has truly proved its weight in gold!

Willow55 profile image
Willow55 in reply to Rubymurray25

I will look into that, thanks

MWIC profile image
MWIC in reply to Willow55

This is how I got properly diagnosed and onto a treatment path - got a Kardia, recorded lots of EKG’s then booked a private appt with an EP (£250) - saved myself at least a year - had an ablation Dec 23 and currently AFib free - good luck

Willow55 profile image
Willow55 in reply to MWIC

Truly amazing kindness and practical help ❤️ everyone

108cat profile image
108cat in reply to MWIC

After 8 months not getting a diagnosis from nhs GP I went to private cardio who offered to do an ECG implant, or suggested Kardia which I did, and two weeks later I went back with the Kardia reports on my phone, was immediately diagnosed and then taken into nhs cardiology ...

In my opinion Kardia is brilliant and I feel it's important to get clarity on our symptoms etc.

MWIC profile image
MWIC in reply to 108cat

Totally agree with you - understand some peoples concern over getting fixated on it but for me I’d rather know what’s going on and not only speeded up my diagnosis and getting treatment but post ablation was an absolute godsend as had 3 or 4 weeks of hellishnesh and kardia at this time really helped me get through it as gave me some insight as to what was going on and was able to send readings to the Arrhythmia nurses who responded - they believed what was happening was caused by an inflammation response and would go as healing progressed and exactly what happened

Willow55 profile image
Willow55 in reply to MWIC

Glad things worked out for you

MWIC profile image
MWIC in reply to Willow55

Thank you !! So far so good and hope you get yourself sorted soon - definitely recommend taking things into your own hands and getting a proper diagnosis earlier than later - very best of luck to you

Willow55 profile image
Willow55 in reply to 108cat

Yes clarity is necessary but hard to get

108cat profile image
108cat in reply to Willow55

Hi Willow yes it's hard - but important to push your GP for help and proper diagnosis, or ask for another opinion, or referral to NHS cardiologist. The GP may not want to do that - but if you can afford it you can ask the GP for a referral to private cardiologist. A lot of people have done this, just to get a diagnosis, then you're looking at a one off fee (around £200) particualrly if you can afford to get Kardia (£99) before you go, then you can show the cardiologist the readings on your mobile at the first appointment.

good luck with getting a resolution ...

Willow55 profile image
Willow55 in reply to 108cat

Thanks for that, yes I will be pushing Dr's to find out what is going on. When I got back to them after hearing nothing re first ECG I was just sent for another ECG and getting fobbed off when I try to get feedback. With all the experiences of others on here it's encouraged me to keep trying to just find out if there's a problem or not

37Polly profile image
37Polly in reply to Willow55

A kardia is a really good investment. Get one. I sent my remaining sister one and asked her to use it every day after two of our sisters died of strokes. I have afib, and two brothers had it. Women often don’t get serious check. My husband was wearing a loop recorder ( checking for afib, that never materialized) when I was admitted at hospital with high level of aflutter. Noone had ever looked at me.🤣

PICCASO profile image
PICCASO

Could be Ectopic beats , ? Maybe best to seek a Cardiologist , but waiting list is still long I paid 250 for a proper Diagnosis, and had an Ablation for Atrial Flutter 5 months later , I'm against paying so credit card it was

Willow55 profile image
Willow55 in reply to PICCASO

Hope all is well after Ablation as it doesn't seem a "nice" procedure

PICCASO profile image
PICCASO in reply to Willow55

Didn't know a thing they give you something nice lol , would recommend it if your proper diagnosed condition calls for it I'm 81 lol , evidently atrial flutter is easier to do cos only effects one side of the heart, please let us all know when your sorted, good luck

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to PICCASO

hi

um credit card is still paying for it. now they put % on that too. the rogues.

cherio joy. 75. nz

Ppiman profile image
Ppiman

The heartbeat arises from the bottom of the heart, the ventricles, and yours shows as entirely healthy and regular. This is shown on your ECG as the large spikes which are called "R waves" by doctors. Not only are these regular, they are healthily narrow and well timed, further suggesting a normal heartbeat. You have included just a few seconds of these, however, which offers little to analyse.

This healthy heartbeat will have been triggered by the slightly earlier beat of the top of the heart, the two-chambered atrium. Like the ventricles, this, too, contracts rhythmically with the beat beginning in the heart's natural pacemaker, a bundle of cells situated at the top right of the atrium, called the sino-atrial (SA) node. This should show on your ECG as a very tiny bump just to the left of the R wave. However, as easily happened, these “P” waves are all-but hidden owing to "electrical noise" caused by body movement or natural "electricity" from the muscles. A genuinely missing P wave suggests atrial fibrillation (AF / Afib), but this would also cause an irregular R wave, which you haven't got. Thus, this is likely to be a run of entirely normal heartbeats.

AF itself can feel entirely normal and be missed, or feel like palpitations, racing, or "missed beats" with physical sensations in the chest and throat, even a pulsing headache. Anxiety often accompanies it. There can be slight breathlessness and exercise can make these symptoms feel worse and create more racing. A very few people get a severe response and their heart struggles to pump well while the AF lasts. This latter requires emergency treatment but is very unusual. Most often the AF comes and goes in bursts, called "paroxysmal AF". Some people have very few episodes; some have many and frequent episodes; some have it all the time ("persistent AF). It always causes an irregular beat. Mine is about every week or two but with regular and hard to cope with daily “pre-AF” ectopic beats or palpitations most days.

You can rest easy with yours. However, because AF comes and goes with a will of its own, you could still have it, so the report will say only "no evidence of AF" or, in your case, "AF cannot be ruled out".

If you feel symptoms of AF, then you can buy a home ECG to use when you have these. The most likely way to catch them is with an Apple Watch or similar as this is on the wrist and handy to use when the feelings occur. It's also very useful for all sorts of things, making it, overall, good value, even if pricey. Alternatively, and if money is tight, the cheapest current option is a Wellue AI Touchscreen home ECG, which works very well indeed (I have one, as well as one called a Contec PM20, also, excellent). Many recommend a Kardia, which is easily good, but that does need a smart phone to see the trace as it has no screen, and you are encouraged to pay an extra £9.99/month for their so-called "Advanced Determinations" which is annoying.

Steve

Willow55 profile image
Willow55 in reply to Ppiman

What a brilliant very informative post, thank you very much for your time. This is a great and helpful site: I am beginning to learn a little. All of you have helped me

Ppiman profile image
Ppiman in reply to Willow55

Thank you, too. My troubles began in earnest in 2019 and this forum has proven so very useful and, unlike a US-based Facebook one I also used to belong to, is altogether friendlier and more helpful!

Steve

Singwell profile image
Singwell in reply to Ppiman

Hijacking moment- YES very informative Steve. Thanks so much. So on my ECG posted last Friday the shape of the R wave is an important indicator as to what's happening at the ventricle. Without knowing a thing about it my gut told me 'this looks wrong'. I compared it with sinus tachycardia and AF readings on my Kardiamobile history and then started googling. Needless to say i frightened myself to bits but - being forwarned is to be forearmed.

Ppiman profile image
Ppiman in reply to Singwell

It was wider (like mine often are thanks to my bundle block) and fast. The trouble with home ECGs is that they don’t tell what a 12-lead can, partly also since the finger tip electrodes aren’t as good as gel electrodes.

Are you taking flecainide at all?

Steve

Singwell profile image
Singwell in reply to Ppiman

Hi, thanks for this. As far as I know I don't have any structural issues, at least if those would show on an echocardiogram. I do agree that a 2 lead isn't gold standard but I can tell you I really felt whatever it was kicking in - like a tug from the inside of the chest. Not at all like AF. I do have Flecainide but have only been using as PiP. Clearly cardiology think my reading was worth noting as lead consultant is writing to me. I don't want to resume Flecainide unless I've had medical advice but obviously would have no objection if it's a protective factor. We'll have to see. I've pushed PALS for renewed access to the Arrythmia Nurse and also put a date in place for the end of the month to see my EP privately if needed. Not sitting back on this one!

Ppiman profile image
Ppiman in reply to Singwell

I think these odd runs are likely of little consequence but since you felt it and managed to record one of them, I would be acting much as you are and finding out more. Flecainide can cause odd arrhythmias of its own, I gather, hence my asking.

I hope you solve the riddle soon!

Steve

Singwell profile image
Singwell in reply to Ppiman

Thank you. You've been very kind and helpful. I appreciate it. Meant to share your comment on yesterday's post re social media - I commend to you the 1st of the 2022 Reith Lectures on Freedom of Speech. Well worth your niece reading it. Plus a new book by Africa Brooke - The Third Perspective - Brave Expression in an age of intolerance. I think the book is useful for people who are 40 or younger. The Reith lecture for anyone.

Ppiman profile image
Ppiman in reply to Singwell

I’ll look into those. They sound very interesting.

I started on flecainide yesterday and had a day of no ectopic beats for the first time in weeks. But I also had some worrying powerful heartbeats on and off which caused me to phone my GP this morning who told me to stop the flecainide and go back to the bisoprolol (which doesn’t work…). The Apple Watch ECG I took while on flecainide was NSR but with very wide peaks.

This evening the cardiologist/EP phoned to say the ECG was normal with flecainide and not to worry but it is only for symptom relief. I’m on the list for an ablation.

What a life!

Steve

Singwell profile image
Singwell in reply to Ppiman

Oh interesting. I don't THINK I had a wide QRS when on Flecainide initially but hey - what do I know? It does take getting used to though. But if you can, it's pretty effective. I chose to stay on 50mg X 2 pre ablation even though I had breakthroughs every 2 months. I'd then take extra PiP. It's when you take 150 that you realise how powerful it is. GPs usually don't know about Flecainide unless they have an interest in arrhythmia- some do. Do I'm not surprised yours suggested coming off it - safety first when you don't know I guess. Are you worried about having an ablation? I'm still glad I had mine.

Ppiman profile image
Ppiman in reply to Singwell

After my atrial flutter ablation in 2019, I said that I wouldn't want to go through that again but now, well - it has to be. I am going to try to see how I cope again just on bisoprolol for now. My AF (it's happening now, as I type) seems to have slowed from around 150+bpm in the past, to 85-110 now. The main sensation is in my sternum and throat, really, a kind of hotness, with some palpitations and mild breathlessness. In many ways, the ectopic beats I get daily are more wearing and harder to cope with. It all limits what you can or dare do.

Steve

Singwell profile image
Singwell in reply to Ppiman

If you get supraventricular ectopics you have my sympathies - they can be blooming uncomfortable!

Ppiman profile image
Ppiman in reply to Singwell

Do you suffer with them. In their way, i find them worse than AF. They catch you out in a way and cause chest “aches” and slight breathlessness. I think the LBBB makes them worse, but can’t be sure.

Steve

Singwell profile image
Singwell in reply to Ppiman

Not very often thank goodness. But when my thyroid got out of whack - my TSH had doubled even though technically within range - I had a 20 hour on and off run of them. And the thwack when the beat in time comes after the premature one was really disturbing. And I couldn't sleep. I will say though - 20 minutes after 50mg of Flecainide and I was a happy bunny. But if you have a branch block maybe it doesn't suit you. It's blooming complex stuff this arrhythmia!

Ppiman profile image
Ppiman in reply to Singwell

My first and only day with flecainide was Monday and my heart was very calm throughout AF/ectopic-wise but I had some really heavy beats without any ectopics and the Apple ECG had strange and worrying looking wide peaks.

My GP next morning said to stop the flecainide - but then the consultant rang in the evening to say not to worry as all was fine with the ECG and my MRI was so good that he was confident to prescribe it without issue. I hate phone calls from doctors though so I emailed him this morning to ask if he would confirm in writing to my GP before starting again. I hope he didn’t mind my doing that but my GP was definitely not so keen.

It’s hard to decide what to do as I am just about coping with the long ectopic runs and more frequent AF but that’s easy to write when all is calm, as now. I have a strangely poor memory for remembering what symptoms are like when they are gone!

Your symptoms seem directly related to your thyroid issues. I didn’t realise there was such a “trigger” as that?

Steve

Singwell profile image
Singwell in reply to Ppiman

Well, there is definitely a link. The cardiologists acknowledge it too. I think it's linked with T3 conversion- if that is poor or hypothyroidism is untreated then you can develop heart problems. I left my subclinical hypothyroidism untreated for 5 years. Then hello AFib!

Ppiman profile image
Ppiman in reply to Singwell

I was once tested carefully for possible thyroid issues and there’s a good deal online about what are safe limits. It’s not at all clear cut, it seems.

Steve

Singwell profile image
Singwell in reply to Ppiman

It's one of the most neglected conditions in the UK Steve. The range of norms for the various hormones is wide, to allow for individual variation, but many GPs and even endocrinologists just insist that within range is within range and wont allow patients to move to the outer edges. They all need to understand a bit more about stats! Additionally in the UK the path labs are under a directive to not bother with checking T3 if TSH is within range. But conversion of T4 to T3 is critical for the the thyroid to do its job. Which impacts on most of our organs and systems- heart, digestion, blood pressure, cholesterol absorption etc etc. I was shocked when I found out. Everyone should be better informed about thyroid health.

Ppiman profile image
Ppiman in reply to Singwell

I have read this. It must be mightily frustrating as the thyroid affects so much of the body by directly impacting the metabolism. It was once thought I might have hypothyroidism, and that is similarly difficult to diagnose, I gather. Luckily, all was well.

Steve

JOY2THEWORLD49 profile image
JOY2THEWORLD49

hi

after ECG done in my clinic I ask for a copy.

it reads abnormal ECG atrial fibrillation.

gives me BP , H/Rate

I take it to dr and she reads it.

Best is 24hr heart monitor. I had one before and after each med change. your h/specialist should be doing this.

you need to express your requirements to get answers asap.

cherio joy. 75. NZ

ian16527 profile image
ian16527

Maybe ask your GP for a holter test which will monitor your HR for however long they decide, usually 24 hours or better still 72 hours. And you can press a button to highlight when you are having symptoms This is part of the NICE guidelines.

But, in my case, and I had several over the years never showed up anything but ectopics.

The other way to get diagnosed is go to A&E when you are having symptoms and get an ECG there and then

Nightmare2 profile image
Nightmare2

Hi, i dont understand why you are asking on here, suely this was done via your GP or Consultant, it is up to them to read this, as the public can only guess as we are not trained to read these. Suggest you take this to whoever arranged your test for you.

Willow55 profile image
Willow55 in reply to Nightmare2

It's OK I'm well aware of what you say.

LindyMc profile image
LindyMc

I would say a Kardia 6L would be well worth investing in. I was diagnosed with AF by GP but when this was referred to the cardiologist with my original ECG they said I had no AF but AVNRT was present and sent me to the back of the list for an appointment estimated to be 18 months away, and by the way make sure she stops taking the anticoagulans. I had been using a phone app that dealt in scatter plots and thus no use to the medical profession and getting frequent AF messages. I also read up on the difference between AVNRT and AF and found a delightful piece of wide-ranging research that had been looking at patients with a primary diagnoses of AVNRT, and within this, took a look at checking them for undiagnosed AF, and lo! they found 48% had undiagnosed AF. So when my GP gleefully told me what the consultant had said about the blood thinners ( as she knows my attitude to meds in general), you can imagine my reply! Anyway a rapid purchase of a Kardia, and a printout of AF recorded response, a locum GP used on an line referral service to confirm I did indeed have AF. So get a Kardia and have your own evidence before evening thing about a private appointment. Catch the beast when it is playing up. If GP contact is hard to come by, attach the offending article to an email to the practice manager and wait for sh*t to hit fan!

Willow55 profile image
Willow55 in reply to LindyMc

Thank you, I will look into that

Marymara profile image
Marymara

These people here are not trained, you need to listen to a cardiologist.

Willow55 profile image
Willow55 in reply to Marymara

I have already replied to another person that I am fully aware that people here are not trained. I was looking for people's experiences. I am waiting to talk to Professionals and just getting some comfort in the meantime from those who have been through similar.

Marymara profile image
Marymara in reply to Willow55

I get that, but sometimes a little knowledge is dangerous.

Singwell profile image
Singwell in reply to Willow55

Comfort is good. I think we have the right to ask questions and ask about people's experiences. Patient experience is valuable. I hope you've got some comfort. And I apologise for a little bit of hijacking further up the thread. Some of the responses helped me too.

Willow55 profile image
Willow55 in reply to Singwell

No problem re "hijacking" lol glad some responses were helpful for you also.Good to share abd help each other

Palpman profile image
Palpman

I'm not trained but savvy enough to compare this ECG to a normal ECG. Your ECG looks the same as a normal one.

Albeit short duration.

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