heart rate versus pulse rate

[layla3]

daft question is your heart rate rate same as pulse rate?

[Ennasti]

Yes.

[jeanjeannie50]

Yes, they're the same thing. However, once when I had a fast heart rate the pulse in my wrist said normal but my heart was actual beating abnormally high. The paramedics had never seen that before. I guess my heart was beating too fast to register in my wrist. Don't think I've ever seen anyone else on this forum say they've had the same thing.Jean

[Buffafly]

Not quite. Your pulse rate is what you can feel at your wrist or neck. Your heart rate is what an ECG says it is - the electrical impulses generated. If some of the resulting beats are very weak or close together they may not be felt as a pulse or show on an oximeter or fitness watch. Jean’s experience was an extreme example of that.

[Ennasti]

To get technical - pulse rate and heart rate are the same. The pulse is the physical manifestation of your heart beating, felt through the arteries as blood is pumped through them.

So, your pulse rate and heart rate should technically match. However, it may sometimes be difficult to accurately measure your pulse due to various factors, such as poor circulation or weak pulses, but they both reflect the same underlying heart activity.

[Buzby62]

My understanding is that they are the same, your HR is your pulse. The discrepancies come in how you detect it. Electrically with an ECG is the most accurate way. Feeling your pulse can be inaccurate when in AF and some people, even with no AF, apparently don’t have a detectable radial pulse in their wrist. Also as others have said, wearable HR monitors with instantaneous readings are pretty much useless when in AF and you need the average electrically from an ECG device.

Best wishes

[30912]

My thoughts are that modern sensitive ECG devices used in hospitals will measure those chaotic rogue electrical impulses and alert accordingly but wich may not result in a corresponding defined detectable physical heart beat.

[oscarfox49]

Not sure I completely understand (or agree) with the comments here. Surely beta blockers work by slowing the heart rate and the beats but when I have a ECG I am always told I have permanent AF despite the fact my pulse rate is anywhere between 60 and 80 normally. The actually beats mask the missing or extra beats which are incomplete ones.

Does anybody have a link to a paper that explains what is happening in these circumstances?

[Buffafly in reply to oscarfox49]

Not sure what your question is but you can have AF at 60 to 80 bpm, I think that is fairly common in permanent AF whether natural or achieved by meds.

[Ennasti in reply to oscarfox49]

I think you’re confusing AF with ectopic beats. Atrial fibrillation (AF) is not about missing or extra beats. In AF, the atria don’t contract normally—they quiver instead. A normal heartbeat starts in the sinus node, which sends an electrical signal that causes the atria to contract, followed by the ventricles, creating the typical boom-boom sound of a heartbeat. The first boom is the atria contracting, and the second ‘boom’ is the ventricles contracting. Boom (atria) - boom (ventricles).

In AF, the electrical signal doesn’t start in the sinus node but in multiple places in the atria, causing disorganised, rapid electrical activity. This results in the atria quivering instead of contracting properly, so the rhythm becomes irregular. Instead of a boom-boom heartbeat, you may get something like quiver-boom, quiver-boom, with the atrial contraction being ineffective.

The rapid or irregular heart rate in AF is often due to the ventricles trying to keep up with the erratic signals from the atria, leading to a fast heart rate. However, some people, like me, can have a lower heart rate even with AF, such as an average of about 67 bpm.

[oscarfox49 in reply to Ennasti]

Thanks for such a clear and detailed explanation. It' s interesting that not one cardiologist or doctor has managed to explain it as clearly to me in around 30 years of suffering from AF and the last four years since my stroke and diagnosis with permanent AF.

I now understand better why I am always tired and a bit breathless when my pulse rate seems to be strong and regular with my beta blockers but I am never up to doing what I used to be able to do.

[Ennasti in reply to oscarfox49]

It must be hard for you. Your heart is really inefficiently trying to pump while in AF. The beta blockers are helping to slow the beat but also to reduce the force so as to protect the heart as much as possible.

I think sometimes that doctors are so across the academic side to heart function they forget we’re just every day people who need it explained in a way that we can absorb. They also often forget we don’t even know the basics and this is needed as a platform to build up understanding on.

[Ppiman]

They are the same. The pulse is usually taken a long way from the heart, on the radial artery in the wrist. The pulse waves themselves that are felt are caused by the opening and shutting of the valves which happens with each ventricular contraction. I have read that the pulse waves when we are in AF might, in a few cases, not always be strong enough to transmit to the wrist, and if this happens, there is what is called a "pulse deficit". In these few cases, the pulse or heart rate needs to be measured nearer to the heart using a larger artery (e.g. carotid pulse).

Steve

[Ilovedogs12]

Not always. Mine isn't, and like Jean I baffled the paramedics and the nurses at my GP surgery.

My cardiologist explained it to me - I have bigeminy, and my heart rate can be high because of this, two beats for every normal one, but my pulse is slower because it doesn't register the extra beat.

[John3333333 in reply to Ilovedogs12]

That's not what bigeminy is.

[Ilovedogs12 in reply to John3333333]

That's what I have been told by my cardiologist. He says it's where the name bigeminy comes from. Each time my heart beats it is followed by a second beat, it's a different kind of beat but it's still a beat. I have it constantly. However, if you know better than my cardiologist I will bow to your superior knowledge and tell him he is wrong.

[John3333333 in reply to Ilovedogs12]

'I have bigeminy, and my heart rate can be high because of this, two beats for every normal one...'

If this is what your cardiologist told you, then he is indeed wrong.

[John3333333 in reply to John3333333]

Your second explanation is certainly more accurate. Simply explained, bigeminy is a continuous pattern of a single sinus beat followed by a single ectopic beat (either a PAC or PVC). If you had 'two beats for every normal one', you would most likely be experiencing an atrial or ventricular couplet followed by a sinus beat.

[Desertflowerchild]

I was wearing a heart rate monitor for 30 days mid summer. I always wear my Garmin on my wrist. I learned very clearly that, when in afib and tachycardic, what the Garmin measures at my wrist does not equal the rate of my ventricular contractions. During the 30 days, I had about a 3% burden of afib; my highest radial pulse measurement was about 120, while my ventricular contractions were about 170 on one day and 150 on a couple of other days (these high rates occurred while exercising during afib).

[JOY2THEWORLD49]

Hi

YES.

Taken by stethoscope or physically (wrist) or carotid on neck better is you have

AF.

cheri JOY. 75 (NZ)

[ajaxaf]

I use a Kardia mobile ecg device regularly, taking a 60sec trace. The resulting pdf gives a heart rate figure. But I always do a manual count of the pulses and without exception this results in a lower value over the one minute trace period. Eg heart rate 98bpm manual count 83. I asked Kardia about this and got a lot of waffle in reply. So I remain puzzled as to how the ecg figures out the heart rate, and does this also happen with a full ecg done by the medics?