RR chart questions KardiaMobile Card

[davephx]

Kardia question

Background: I am 78 years old and live in the US. I have had some A-fib for brief times, but not recently. I have had all sorts of tests, including a bike stress test at the Cardio doctor over the years, and I have no physical issues with my heart. In A-fib, my HR has never been above the 70s.

For over a decade, PVCs per KardiaMobile Card were normal for me. NSR was rare, but over the last few months, it has been mostly NSR, which has been a pleasant surprise. I take Metoprolol, which is probably keeping my heart rate down in Afib and Xarelto. I also take magnesium and potassium supplements and have been on a Keto diet for decades (I went from a 46-inch waist to a 36-inch waist).

Questions (finally)

I know Kardia only records as PVC if there are three or more PVCs in the 30-second period. I sometimes see a PVC or two on the strip, but it still says NSR, so I understand why, but most of the time, I see none. Lucky me

What I am trying to learn is the R-R interval.

1) I am confused because the right side of the plot is BPM, and the left is RR seconds. So, which is the line graph showing? The BPM seems to be about what the chart shows, but the blips seem to be the RR interval. How can one line be both?

2) I am looking at an R-R interval chart I just did where Kardia shows NSR but I see 1 PVC on the main chart. Normally the line is almost straight across with no PAC's. With this on where I see 1 PVC, the left side of the R-R Interval chart starts at about 0.8 . When it spikes to 1.2 followed by a big dip to 0.55, this represents the PVC. I think?

However, I also have unsteady lines that gradually go up and down (no sharp spikes like for, I assume, the PVC) and end up at 1.2. I am totally confused about what this is measuring since the strip chart seems normal other than the one PC, but I didn't exactly measure the wave intervals.

On the average beat chart, as I understand it, this has nothing to do with PVC etc., only the amplitude of the average beat. It shows all the time 1 strong spike up from 0.0 to a peak of about 0.6 as well as the normal minor tiny waves in a normal beat. Is a 0.6 amplitude about normal? I have done tons of Dr Google research to learn about EKG graphs, including nursing texts, etc, and I can not find anything on average amplitude.

Notes: I have been reading the mail here for many years and appreciate all the different experiences. I realize I am lucky not to have some of the more significant issues many folks here, and it's excellent support.

Your drug names are different, and I have no long delays to see my Cardio Doc, a week or two maybe. I am on Medicare and going to specialist like Cardio is a $20 cost and regular Dr, blood tests every 6-months no cost, only the Xarelto costs much of anything about $320 for 9 months worth.

Our Medicare fund will be going broke in a few years with our high costs but other than drugs it is excellent from my perspective. I am also surprised by how low the reimbursement rate is for Drs and hospitals vs. the huge uninsured retail prices that drive many to bankruptcy, especially if they are under age 65 and don't have Medicare or an employer plan or good rates under the Affordable Care Act of Obama. Middle-income folks are most at risk until they qualify at 65 for Medicare. Starting in 2025, Medicare will limit out-of-pocket expenses to $2000/yr. Fortunately, I have never been close to that.

[Desanthony]

I think you need to be a cardiologist or electrophysiologist to read these charts correctly and they spend a long time in training. I can only presume you are correct in what you say. I can easily see that I am still in AF - I am in permanent low rate AF with rare short episodes of NSR which have lasted at longest a couple of days - wouldn't have caught that had I not been using Kardia for another reason as I had had a fall and wanted to check it at that time - maybe the fall put me back into NSR for those few days? As far as I know I get no other problems but expect my Kardia to show if I do or feel poorly and that is when I shall take further action, make an appointment to see my GP and email the Kardia trace to him so that he can look at it beforehand. Should that happen I would generally expect him to say it is either nothing too unusual or refer me back to my Electrophysiologist for further investigation.