Wellue's ECG Report: Page 1 Versus (?) Page 3

[Corazon17]

I have a few questions about the ECG Reports that I get from my Wellue sessions.

On Page 1 of my most recent ECG Report, I see "Percentage of Atrial Flutter and Atrial Fibrillation: 70.39."

But on Page 3 -- "Hourly Statistics Table of ECG Data" -- the numbers in the Ventricular and Atrial columns are very small. For example, for 8 hours, there are only 9 events in the Ventricular section, and only 3 events in the Atrial section.

I would expect to see huge numbers in the columns, to back up that claim of 70.39 percent.

In reading Page 3 only, a person might think that my session was just peachy-keen.

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In a previous ECG Report, on Page 1, I see "Percentage of Atrial Flutter and Atrial Fibrillation: 0.00," and then on Page 3, I see *very large* numbers (in the hundreds) in the Ventricular and Atrial columns.

For this report, I would expect to see *small* numbers in the columns.

In reading Page 1 only, a person might think that my session was just peachy-keen.

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I think I'm not understanding something fundamental. Am I wrong to look for consistency between the two portions of the ECG Reports? Can someone help?

[Ppiman]

I have used the Wellue many times, although now just use my Apple Watch and a Contec PM20 ECG monitor. It's an excellent home ECG device, unique, in fact.

The Wellue report splits AF / AFl out and reports these arrhythmias separately from non-AF atrial and ventricular conduction problems. You can have AF with few PACs for example, it seems. I don't, having many ectopics much of the time as well as during AF episodes, but a friend, for example, seems to have AF without many ectopic beats.

I attach a recent Wellue report. It shows a lot of ventricular activity as well as AF. It's incorrect on this as the issues are all "atrial" in origin. I have a bundle block (LBBB) and this makes it impossible for the Wellue AI algorithm to report correctly, sadly (hence my change to Contec).

Steve

Wellue ECG summary report

[Cliff_G in reply to Ppiman]

Interesting. I did a post-ablation 24 hour trace the other day on my Wellue. It reported anywhere from 1000 to 1500 PVCs per hour on page 3, down to 200 to 400 overnight (asleep). I went through one hour of both the daytime and nightime traces and manually counted the PVCs (which are pretty easy to spot), and the count was quite close to the Wellue count.

Now, I also have LBBB, (which may be one reason why I'm getting so many ectos, which my EP confirmed were coming from the left ventricle below the AV*). LBBB can prevent the LV from depolarising properly, hence giving an inadequate refractory period and a greater chance of local point automaticity, causing PVCs.

(* but couldn't ablate due to my mechanical AV preventing access.)

[Cliff_G in reply to Ppiman]

p.s. have you looked at the page 3 count of PVCs and compared with the ECG? I justbwondered how you know the Wellue count is incorrect.

[Ppiman in reply to Cliff_G]

I see what you mean. It wasn't so much "incorrect" but that I was told that the cause was atrial, rather than ventricular. Your doctor's explanation makes sense, however. My cardiologist didn't study the Wellue trace much at all, really, but was not too concerned by its reporting of VT, since he felt convinced this was the AI being fooled because of the effects of the LBBB. He sent me for a stress MRI just to be sure, though, but simply reported back to me that that showed my heart hadn't deteriorated since the last MRI when I had atrial flutter five years ago and that all the issues were atrial. There's certainly plenty on the internet about the difficulties of interpreting ECG traces in people with LBBB, so I just took his word for it.

It seems your cardiologist is more willing to look deeper at what the Wellue reports and explain how the PVCs form.

Regarding the LBBB, my doctor seems unconcerned about it, whereas I feel it is problematic since I can associate symptoms with the ECG showing a much wider "R" wave. The symptoms are not awful, but are trying and wearing: tiredness, slight light-head, "distanced" feeling, for example.

Steve

[Ppiman in reply to Cliff_G]

What did you mean by "mechanical AV", by the way? Was it that during the ablation, the devices or heat transfer caused AV block?

Steve

[Cliff_G in reply to Ppiman]

I had an aortic dissection in 2017 with major repair surgery including a metal aortic valve. This brought my AF back. My EP's recent conclusion that my ectopics were coming from the L ventricle was based on mapping during the ablation, not the Wellue trace.

To ablate L ventricular ectopics, they would normally go in the femoral artery, up and over the aorta, and down through the AV - but only if you have your own AV - my mechanical one prevents that 😓

[Ppiman in reply to Cliff_G]

Got you. I thought AV meant atrio-ventricular [node]. Sorry! I hadn't really considered that ablations were carried out in the left ventricle. Interesting.

Steve

[Cliff_G in reply to Ppiman]

Sorry, I should have realised the alternative meanings!