Recording AF with LBBB

[MyCloud]

I suffer from pAF and left bundle branch block. I would like to record an episode of AF on a personal ECG . I know many of you use Kardia but some reviews say it will not record AF if you have lbbb. I contacted Kardia and they confirmed it may record an af episode as unclassified. My Fitbit records when I have an af episode but I would like to keep an ecg record for my consultant. Does anyone on the forum have lbbb and successfully use a device to record an episode of af. Many thanks.

[Buffafly]

I have LBBB and can record Atrial Fibrillation on a Kardia. However I often get ‘Sinus rhythm with wide QRS’ or ‘Unclassified’ when not in AF.

[30912]

Yes. I have LBBB and PAF. My Kardia correctly records AF. Sometimes, when I revert to NSR it records unclassified though but no problem with it picking up AF.

[Ppiman]

I have LBBB (bear in mind this is an intermittent condition in most people, or so I have read). When I owned one, my Kardia was fine for picking up AF when the LBBB was happening, but was not helpful for diagnosing ectopic beats, especially when tachycardia was present at the same time, diagnosing this unhelpfully only as "NSR with wide QRS" rather than as PACs or PVCs (despite the extra monthly fee, annoyingly). Best of all has been my Apple Watch which has never let me down or misdiagnosed AF yet but that also does not label PACs or PVCs either but does show them and the LBBB well.

I now use a device from EMay / Contec that is working very well. It's their new 6-lead ECG (PM20 / 6L) but I had to get it from their European branch as it's not in the UK yet. That shows the LBBB well although does not label it as such, and it always picks up what it calls "arrhythmia" as well as any actual AF when the LBBB is present

Steve

[MyCloud in reply to Ppiman]

Many thanks for reply. Interesting that some people have found that Kardia did not pick up AF with LBBB yet others have not found it a problem. Even Kardia themselves say it may record as unclassified. Will look into the EMAY device.

[Ppiman in reply to MyCloud]

Here is a trace from my Kardia that shows a wide QRS from LBBB and several ectopic beats. The Kardia is limited to calling this "NSR with wide QRS". This is technically correct, but it ignores the ectopic beats.

Steve

Kardia - NSR with Wide QRS

[Ppiman in reply to Ppiman]

And this is a Kardia trace determined as "Unclassified". It seems that this is because it is >100bpm as well as having a wide QRS (from LBBB).

Kardia trace "Unclassified"

[MyCloud in reply to Ppiman]

Thanks for these. Kardia have confirmed that their devices will not record a reading as LBBB.

[Ppiman in reply to MyCloud]

Do you get any symptoms that you feel are from the LBBB? I think mine creates a kind of shortness of breath like a need to take a deeper breath.

Steve

[MyCloud in reply to Ppiman]

Steve - no shortage of breath or obvious symptoms apart from fatigue - but have lived with it for a long time!

[tcpace in reply to Ppiman]

Didn't know LBBB was intermittent. My wife has it and it shows up every time she does an ECG (i.e. M-shaped peaks). She uses a Prince 180 monitor.

[Ppiman in reply to tcpace]

I think it can become permanent - mine seems to be becoming so. I gather that it's caused by a conduction problem (i.e. in that sense, like AF and other arrhythmias). This is in the left-side "wiring" of the bottom of the heart following on from the node above the ventricles (the AV node). This node fires after receiving an impulse from the primary "pacemaker" node that causes the atrium to contract (I.E. the SA node). The left-side wiring somehow becomes inactivated or damaged and fails to conduct. This means that the left ventricle now needs to take its cue (and a little late, hence the "wide" peak) from the contraction of the right ventricle.

It's said to be no problem in many, but I do feel mine when it is "on".

Steve

[tcpace in reply to Ppiman]

Thanks - that's my understanding. About 10 years ago, my wife's EP told her that her LBBB is nothing to worry about. I never cease to be amazed at what the human body can do to overcome problems.

[Ppiman in reply to tcpace]

Thank goodness it can. Does your wife feel any symptoms related to it?

Steve

[tcpace in reply to Ppiman]

Difficult to say. She is easily fatigued but we've tended to put that down to problems with hypothyroidism (Hashimoto's).

[Ppiman in reply to tcpace]

When there is more than one health issue it is hard to untangle what is what.

Steve

[Buffafly in reply to tcpace]

I understood that it was generally permanent. Mine varies in the width of the QRS but doesn’t seem to totally go away.

[MaryCa]

Regardless of what title the ECG has, the spacing will be irregular and there will be no P wave in afibYou'll see it yourself. And you can download and print off anything unclassified or afib, I use a photo booth to print them for my EP, and let the EP see all ECGs, he'll fly through them as he knows exactly what he's looking for.