Update on wide QRS Kardia reading

[Hammerboy]

Well the arrhythmia team finally got back to me yesterday. As far as they can tell from the ECG I sent them they can see a delay in the transmission of electrical signals from the ventricles to the atrium causing my symptoms. It feels like ectopics but the rhythm is normal . They have advised me to get a 12 lead ECG done and sent over to them to examine so they can be more certain what is happening . I’ve contacted my local surgery to get an appointment which was comical as the receptionist tried to find any excuse not to make it . I kept my cool and eventually got a slot for this evening so hopefully I’ll have some more information in the next few days . I have to say apart from the delay getting a call back the arrhythmia nurse was very helpful and will be keeping me updated, she did say that it probably means my AF has changed and another ablation in the future is likely .

[Buffafly]

I asked for the ecg before contacting Cardiology. This backfired spectacularly because a few hours after having it I was called by the surgery and told to report immediately to A&E because I appeared to be having a heart attack. A&E found no evidence of an MI but did find Left Bundle Branch Block which does a lovely imitation. Since then the Kardia readings which were ‘Sinus Rhythm with wide QRS’ have morphed into ‘Unclassified ’. I’m interested to see what happens next to both of us!

[Hammerboy in reply to Buffafly]

Wow , that’s a bit scary , I’ll do an update as soon as I know more

[Ppiman in reply to Buffafly]

I have this, also (see attached). If I recall (I sold mine a while back), Kardia calls an ECG "Unclassified" when the heart rate is both "wide QRS" and the rate is above 100bpm. The tall spikes "R waves" can be seen as wider and some with a blip at the top - typical of LBBB, I gather.

Apparently an ECG when the LBBB is occurring (it is often a variable condition) is all-but uninterpretable.

Steve

Kardia ECG "Unclassified"

[Buffafly in reply to Ppiman]

Mine came up as NSR with wide QRS as it was under 100bpm but the LBBB seems to have gone. Can’t understand why it’s Unclassified unless because there’s no P wave showing. Weird.

[Hammerboy in reply to Buffafly]

Very odd 🤔

[Ppiman in reply to Buffafly]

Those P waves can be tiny and obscured by "noise" I find. I have a few Kardia ECGs that come up as "AF" but which have P waves and multiple PACs, for example.

Steve

[Hammerboy in reply to Ppiman]

All very confusing

[Ppiman in reply to Hammerboy]

Well, I guess the home ECG devices are not really ideal but, well - as a gadget person, I do like mine!

Steve

[Hammerboy in reply to Ppiman]

Yes and I wouldn’t be aware of changes without mine

[Ppiman]

The problem is from the electrical conduction between the atrium to the ventricles and creates on the ECG what is called a "Wide QRS". This is when one side of the ventricles contracts a little later than its neighbour. It's usually from a kind of usually harmless heart block in the left or right bundle branches that deliver the atrial signal to the ventricles (via the atria-ventricular / AV node). These heart blocks are quite common, with LBBB being less so (that's the one I have).

Steve

[Hammerboy in reply to Ppiman]

Thank you for that information, does it mean my AF has now changed ?

[Ppiman in reply to Hammerboy]

I don't think there's a connection. The LBBB (if that's what it is) is another conduction issue, however, so there might be a link with the cause of AF and any ectopic issues you have's I do, annoyingly (which are atrial conduction issues). In the two different kinds of bundle block, the conduction is interrupted in one side of the "wiring" only that goes from the AV node to the ventricles. This stops one ventricle from receiving the electrical signal directly, and it, instead it gets its signal a fraction later from its neighbour's contraction.

Steve