Holter monitor

[Kinfusion]

Does PAF always disappear in the days when someone has a Holter monitor? After months of having almost daily, quite long episodes (though sometimes had a few days free), and a five month wait, my husband finally got a three day monitor. None of the absolute certainty triggers over the past months - exercise, caffeine, alcohol - seem to be having the slightest effect and his heartbeat is steady as a rock. So frustrating.

[jeanjeannie50]

Yes, I understand totally.

I've had AF for 19 years and every time I've had to wear a hospital provided heart monitor I've felt fit and healthy - like I could climb mountains. The day it's returned to the department, well off it all goes again and my heart rate plays up.

This seems to tell me how much the mind has to do with creating AF. We feel secure/safe with a monitor on but not without.

Now if we could all wear one permanently, would we stay well forever?

Jean

[Peacefulneedshelp in reply to jeanjeannie50]

Jean I was thinking the same thing. it is like the body relaxes thinking brain says "help is on the way".

[BobD Volunteer]

Yep, often said the best cure for AF would be to fit Holters permanently. lol 😁

[Cavalierrubie]

Oh no! You could not make that up could you! AF is very difficult to detect because it is so unpredictable and makes us unreliable to everything going. Not a lot you can do in the circumstances only have a good grumble. I feel for you. 😫

[Linley]

It's weird you should post this today as my Holter of 4 months ago showed PAF runs and 424 ectopics, put on meds for 3 months and last weeks Holter showed only 3 ectopics, no further action to be taken, perhaps I don't understand my own body or the condition I thought I had.

[Chinkoflight]

If your husband is at risk of a stroke then he should be offered an implanted loop recorder (ILR). This is an AA battery sized ECG implanted by a nurse practitioner in the lower left breast above the heart. You have a bedside monitor that sends remote reports through the mobile signal to the hospital and records any unusual events. There has been a NICE initiative to increase the use of these devices to reduce strokes and death from strokes by 6500. Holter monitors are unreliable and too labour intensive. I had a stroke out of the blue with no obvious cause. An ILR was fitted and 3 months later it picked up a paroxysmal AFib event. My medication was changed as a consequence. I might ask the question in the absence if a formal observation how does your husband know he has Afib?

I hope this helps. You need a cardiologist to make the decision to fit an ILR. It sits there working for several years 24/7/365.

[Kinfusion in reply to Chinkoflight]

Thanks for your concern. My husband has had PAF diagnosed and is on Edoxaban to minimise stroke and MI risk. He also has a Kardia which has shown increasingly frequent episodes. We were hoping that the Halter would provide sufficient evidence to get him on the 1 year waiting list for an ablation.

[Chinkoflight in reply to Kinfusion]

I would definitely ask about an ILR. It's definitive.

[108cat in reply to Chinkoflight]

not sure what happened there ..!

Cat

[108cat in reply to Kinfusion]

Yes I had 'palpitations' for 8 months prior to diagnosis and naturally the monitor issued by GP showed absolutely nothing, so the diagnosis was 'anxiety' until I insisted on seeing a private cardio who immediately suggested Kardia or the implant ... I went for Kardia and he diagnosed PAF very quickly on the strength of the readings.

So if you have Kardia I'm surprised your medics are not accepting those readings since Kardia was approved by NICE (2018) and if you have kept the history of readings it will show them exactly what's going on.

In my experience both private and NHS cardios accept Kardia. The NICE report (mtg64) found it very accurate.

I do hope you have success ..

Cat

[108cat in reply to Kinfusion]

Yes I had 'palpitations' for 8 months prior to diagnosis and naturally the monitor issued by GP showed absolutely nothing, so the diagnosis was 'anxiety' until I insisted on seeing a private cardio who immediately suggested Kardia or the implant ... I went for Kardia and he diagnosed PAF very quickly on the strength of the readings.

So if you have Kardia I'm surprised your medics are not accepting those readings since Kardia was approved by NICE (2018) and if you have kept the history of readings it will show them exactly what's going on.

In my experience both private and NHS cardios accept Kardia. The NICE report (mtg64) found it very accurate.

I do hope you have success ..

Cat

[Desanthony in reply to Kinfusion]

Have you asked if you can e mail the Kardia results to your consultant of the nurses. I am able to do this and it saves time

[Kinfusion in reply to Desanthony]

Yes my husband has done this a lot of times. There is no question that he has PAF, but it seems that unless the Holter monitor shows that it is prolonged and frequent (which it is much of the time but the Kardia doesn't show the length of episodes) there doesn't seem to be any expectation that an ablation might be worth trying.

[Desanthony in reply to Kinfusion]

Ah right, I understand. Like taking your car to the garage with an occasional worrying fault - the garage keeps the car for a few days or in one case with us for a week and the fault never occurs. As soon as you get the car back the fault appears about 3 times in the first day! Typical!

[ozziebob in reply to Chinkoflight]

Hi,

If your husband is at risk of a stroke then he should be offered an implanted loop recorder (ILR)

I'm hoping you can clarify more precisely your statement above about who exactly is likely to be eligible for such ILRs, as well as perhaps post a link to the NICE initiative to reduce strokes you mentioned.

I read your Bio and your stroke history does indicate an ILR for you could be a life saver. Now I have the stroke risks of a paroxysmal AF patient with no comorbidities (and no anticoagulation), but I still cannot imagine being offered an ILR. I understand this, so I am seeking a 24/7 ECG device via the marketplace that allows me to monitor for irregular rhythms during my sleeping hours in order to include this in a more accurate assessment of my AF burden and my current choice not to start apixaban. There is the 72 hour Wellue ecg device available, but an ILR would really be much preferable.

What do you think? And hopefully you can direct me to that "NICE initiative". Thanks.

bob

[Chinkoflight in reply to ozziebob]

nice.org.uk/sharedlearning/...

One NHS trust article. There are many , a simple look up. My stroke was cryptogenic. I was on antiplatelet, but the ILR icked up Afib and meds changed to anticoagulant. One caveat, the ILR is only as good as the team monitoring it. I collapsed (SCA) while running. The ILR was still in and captured a 23 seconds LVT. It's clear from things said in hospital there had been other events not responded to or ignored in the year before this.

[ozziebob in reply to Chinkoflight]

Yes, I did already see this advice re treatment after a stroke (I did make an effort!) but my query was really about whether just paroxysmal AF (and inability to tolerate DOACs) might qualify me for an ILR, as this is my situation. I was hoping that your "NICE initiative" document had moved the use of ILRs into wider health concerns than post stroke monitoring. Alas no, and I myself haven't found anything addressing this. I have found articles about the potential inaccuracies of ILRs and their relative high cost compared to devices like watches. While I'm not yet convinced by the currently available Wellue 72 hour ecg device, I do have it under review with another member who just purchased one. Perhaps I will have to wait until the results of the REACT-AF trial appear, and if positive for the use of Apple watches as effective in 24/7 heart monitoring, just "bite the bullet" and buy an Apple product.🤔 Hopefully Apple will be then have developed a (cheaper) specialised AF watch (for AF patients) as a result of feedback from the REACT-AF trial and the requirements of Apples's participation therein.

bob

[Chinkoflight in reply to ozziebob]

ILR's are not really for post stroke monitoring. They are to detect PAF'S more efficiently and effectively than Holter monitors in order to reduce strokes. If you already have a diagnosis and management for AF or PAF then neither a Holter or ILR are needed per se. They don't drive other treatments except in my case for example when an ICD was fitted post hoc so to speak! The original post didn't.ake it clear a clinical diagnosis of PAF had already been made. I wouldn't have responded had I known. But hopefully if some use to a n other reader.

[ozziebob in reply to Chinkoflight]

I am trying to find out if I have unknown-to-me AF events at night, so I can more accurately assess my AF burden. Surely it's appropriate to search for devices that would give me this essential feedback, especially as I currently take no anticoagulation.

[Chinkoflight in reply to ozziebob]

All my AF events are unknown. My LVT and SCA event had a one second warning and lights out. I see events on my smart watch but. Ever aware of them. I would have thought any recorded PAF would trigger anti-coagulants to mitigate against stroke unless there are contra-indications.

[Ppiman]

This broadly happened to me. I bought a home AI ECG (from the Wellue web site) which runs overnight (with the new model running for up to 72hours). This helped a great deal to capture how many ectopic beats were happening and even one AF episode.

Steve

[Saltcoatslass04]

Like your husband I was suffering from what I later discovered is PAF. For years I kept describing my symptoms to various medical people and was repeatedly told , everything is fine .

Nothing ever showed on the halter.

My episodes were becoming more frequent and frightening. But never captured.

I remember once wearing the halter and trying everything I could to get things to 'kick off, ' Jumping ,bending, drinking coffee, showering.

Was like a woman possessed.

Three years ago another halter trial .

Thankfully this time I kept it on while taking it back. Luckily for me it all kicked off it recorded 220 bpm.

My memory of that day was apart from feeling awful was, Elation ,Happiness, grateful that finally it had been captured .Never was I so happy to be having an episode

Now on medication that seems to be controlling this horrible condition .

I call it my demon within me every now and again 'he' will give me a prod to let me know he is still around.

As all the lovely people here will tell you it is a very difficult thing to capture ,but the reassuring thing is we are all still around to share our experiences.

[Visigoth]

Yes! This has happened to me several times!

[Deepbreath27]

happens with me too, but last time I wore a 7 day monitor, I thought it picked nothing up, because I didn’t have my usual symptoms but apparently it did see some short bursts of AF. So perhaps a longer time with the monitor. On the strength of that and my apple watch readings I had an ablation in May. No episodes since

[FraserB]

I wore a Holter monitor for 14 days. The day I returned the holter to the clinic that night I had my longest fastest flutter episode ever. To say I was sorely disappointed this happened is putting it mildly. After this when I had my appointment with the cardiologist I told him about the flutter episode after I returned the holter. His comment was "that's not unusual". I don't want to make light of the situation but sometimes it seems that if you want to guarantee that your heart stays in perfect rhythm, just wear a Holter monitor.

[Ersilia2 in reply to FraserB]

That made me laugh, I might buy a monitor and wear it everyday.

[Tplongy]

very frustrating Kinfusion, I wish it were so for my my persistent AF which showed 100% AF with no let up every time I had a holter (3 times)… annoying though it disappeared when u need it to show!

[Ersilia2]

Yes definitely, monitor always showed NSR, it took 15 years before I was diagnosed with Afib.