been getting this most of the afternoon and evening. HR has been between 64 and 84 but very uncomfortable. Is this just ectopics as watch saying NSR. Had ablation back in July
unusual rhythm today any tips - Atrial Fibrillati...
unusual rhythm today any tips
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Nantoone
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Consult your cardiologist. Do not listen to clueless, faceless forum users when it comes to health matters, but since you asked... These irregular beats look like they have ST segment distortion, a wide QRS, and are followed by a compensatory pause. This is suggestive of PVCs.
Thank you John. I’m hoping these are the benign non harmful type. I just read your posts and funnily enough had a coffee today which is something I haven’t done in quite a while. I did ask for decaf but unsure if that was what I was given or whether decaf can still do this to me. I was rushing doing last minute shopping. I am actually on a seven day heart monitor this week so it will be interesting to see what tge EP nurses make of all this and whether I might need medicating.
Many people think it's the caffeine in coffee which causes arrhythmias. In my case it was not the caffeine, but the coffee itself. So I've had no coffee for the last 16 years.
😮 wow. I really did wonder Thomas if that was the case. Coffee and bananas are now off my shopping list for good. I hope you are keeping well and wish you a happy Christmas
I realise responses to coffee/caffeine are individual, but you might like to read this interesting recent research ...
"Association of Coffee Consumption and Caffeine Metabolism With Arrhythmias and Cardiac Morphology"
... and here's an abstract of the article with it's surprising(?) conclusions ...
I cut out coffee but sadly no difference. Now caffeine keeps me awake because I’ve lost my tolerance through avoiding it. A lose-lose situation! Don’t cut out foods unless you really have to. If you must, cut out one at a time (and no more) for 2-3 weeks and try introducing them in incremental doses. You may find it’s not the food. If you try to pin every symptom to a food, your life will probably become increasingly miserable. You’re always going to get symptoms like ectopics whether you can feel them or not, and you’re always going to have just eaten something in the past couple of hours. One doesn’t necessarily cause the other. Coincidence is thing.
I totally agree Today I am having a far better day. Perhaps I got it all out of my system yesterday.
A wide QRS? There is no wide QRS.
Oh, geez. I must not know what I'm talking about.
ECG
A wide QRS is a minimum of 120ms or more on an ecg. 120ms is three small boxes. If these are wide, which isn’t easy to tell due to the low res of the trace, they’re only just.
Cool. Thanks for educating me but I already know how to use Google. These ectopics clearly gave a wider QRS complex than than the sinus beats. PVCs do not always fit nicely into boxes (literally and figuratively).
It does appear to be ectopics. I know from experience how unsettling they can make you feel. I guess the positive is that you’re not in AF. It’s probably worthwhile reaching out to your doc if the ectopics continue.
Re the wide QRS - I have a very wide QRS as I have a left bundle branch block (LBBB) so am used to spotting it. I also regularly have both PVCs and PACs. The LBBB causes some breathlessness for me.
This is a screenshot of an ecg yesterday from my watch. It shows the LBBB in the beginning two or three beats, then it settles again. The QRS is very wide with the LBBB and only barely, if at all, with the rest. My cardiologist has never been concerned with the width of the settled beats.
Screenshot of ecg trace
yep. Look like atrial rather than ventricular ectopics to me. Agree that too many of them can make you feel as bad as AF. Have you tried magnesium? I found it massively reduced ectopics.
I do have a magnesium spray. If it starts again I might give that a go. It’s very odd. A little After that episode my watch then said AF but only for thirty seconds but the reading looked almost normal. Then this morning everything is back to NSR.
0
I buy some tablets from Amazon. I was much troubled by ectopics last year and the tablets massively reduced them.
As your first respondent said - were not experts! Two people have already opined two different ectopic types - premature ventricular ectopics and premature atrial ectopics. I've experienced both and usually notice the atrial type more - quite uncomfortable. If you toggled into AF it might make sense that you had these PACs because they are precursors of AF. Or - as my EP puts it - that's your heart trying to go into AF. Slow breathing helps - slow down to 6 breaths or less a minute.
It’s reassuring knowing you’re not alone and others give their advice. I’m still trying to find the trigger if there is one. I had a coffee but also thinking back had a fresh banana at around the same time. This really is a minefield to walk through. Is it AF. Is it atrial ectopics or ventricular ectopics. Is it stress related or food or drink related. Had I drunk enough water. This then creates stress and off we go again. I’m really hoping today will be a better day. Thank you singwell for tips. It is appreciated
"Clueless and faceless" writes John... my goodness, that was unnecessary, unwelcome and not remotely helpful. We are all in the same boat, after all.
Your strip shows what look like ectopic beats arising from the normal place - the SA node in the atrium; there is a tiny P wave prior to the big R peak to suggest this. I could show you many similar ECG strips of my own (one attached). If these worry you, send an email with a PDF version to your GP (the Apple app allows this easily) or to your specialist's secretary for them to comment.
Mine can feel uncomfortable even at a low-ish rate as you are experiencing. The "ST" segment seems a touch prominent but, as on mine, is likely no more than an artefact and of no consequence. They can show on an ECG if you have a slightly wider QRS, which might be the case. This can occur with runs of ectopics and it might be that, like me, you have some degree of left-branch bundle block (LBBB). Have you been told this by your doctor, ever? It's generally of no consequence and often not communicated as a result. It is more common as we get older and can easily fool some home ECG AI determinations, although the Apple ECG rightly ignores them.
The strip I attach shows a run of ectopic beats returning to NSR. The R waves (the big ventricular peaks) on mine are wider than yours as I have a pronounced wide QSR from my own LBBB.
I am looking out of my window at heavy snow as I write. What a wonderful wintry surprise!
Steve
Apple Watch ECG showing ectopic beats and return to NSR
Thank you Steve. No LBBB has ever been noted. I am currently on a seven day monitor from the hospital so will no doubt find out soon what is going on. I’m hoping that the ablation is still holding off the af and that this is just a blip period. Wow snow. How nice
I feel sure that’s all it is. You’ll be fine. These really do look like innocent ectopic beats. Whether they are premonitory of some future return of AF, only time will tell, but the Holter will be a good guide and calm the anxiety I feel sure. Once the atrium becomes sensitised, I have a feeling it often stays so.
Steve
As my EP says, it’s all on a spectrum. He insists ectopics are “harmless” and that he has about the same number as I had on my most recent 24h ECG, but the big difference is that I feel every one. He says he can’t feel his ectopics. He’s very much of the opinion that we should live our lives and not be obsessing over it, even if we have AF. But if you feel every ectopic never mind the AF episodes then that’s easier said than done.
On Mg supplements, I thought they made my ectopics worse so I consider them a bit pointless. I tried coconut water and that made no difference, but coconut water can be a nice drink or a nice culinary ingredient. I get my magnesium from nuts and seeds, leafy greens, beans and pulses and whole grains, so very much into the whole food plant based dietary pattern rather than supplements.
Agree. Best advice here is to email the reading to the GP or arrhythmia nurses where the ablation was done for a professional opinion and possibly a referral for a 24h ECG.
As much as I love my watch and find it very useful, it’s not a full 12 lead ECG which can give a lot more information. The watch algorithm isn’t that sophistication either so it’s “diagnosis” isn’t particularly reliable.
None of us here are experts. We may be familiar with our own watch readings and what our arrhythmias look like but I don’t think any of us are in a position to read anyone else’s ECG and tell them what’s going on with any certainty. We are just “clueless and faceless” as some would put it! 😂
Well - one person put it! Tactful, eh?
Steve
I’m obviously one of them! 😂
I have found through others sharing their ECGs for whatever reason, we all seem to have our own characteristic pattern. There seems to be many variations of “normal”. My husband’s looks like the perfect textbook ECG. I’m so jealous! But there was one occasion some months ago when he was having a lot of ectopics. I think that was stress at work that did it. Otherwise he’s like “oh. I had an ectopic today” — once every two years. If that! Some people don’t know when they’re lucky! 😂
Mine can be unhealthily wide looking to my eyes, thanks to my LBBB. When I took my once-and-only flecainide tablet, although I had a day free of all ectopic beats and AF, the R waves were wide and it put me off using it again - even though the specialist said it was perfectly safe for me (oddly if I ask Dr Google its AI tells me not to use it with LBBB!). My wife's are perfect narrow peaks. Lucky lady.
Steve
Do you ever get ectopics with the LBBB? I’m assuming this one is a PAC but not 100% sure. At least I think they’re ectopics. Here’s an example of one and I’ll adid another after. The first I think is definitely ectopic, the second maybe the ventricles doing somewhere weird when depolarising. Interested to hear what you think.
Screenshot of ecg
And this which at first I thought was interference but I’ve concluded it’s not.
Screenshot of ecg
I have many traces that are similar. I attach one that wrongly suggests ventricular premature beats - but they are all atrial in origin, I am assured. The AI is simply flummoxed by LBBB.
Yours seems to me to be classic atrial ectopics with LBBB (well, that's what the specialist I see tells me mine is). He blames my atrial issues for my symptoms (which aren't too bad overall, I suppose - judging from what some here report of their own AF). I remain convinced it's the LBBB that gives me most grief, though.
Steve
ECG showing ectopic beats with LBBB
Wow. Yes, I’d imagine you would have possibly felt breathless with that? I personally think my LBBB is also one of mg biggest issues. I’m amazed that people can live it and not have symptoms! Not many I know, but when I have read such comments it amazes me.
It’s not often that bad, thankfully. I think it’s a kind of “pre-AF” in a way, though - an atrial arrhythmia overlaid with LBBB. It amazes me that I don't feel worse. I never feel breathless as such, only an odd feeling of needing to breathe more deeply. Tiredness, sometimes a light-head, also, can be symptoms - and a strange chest “ache”. There are a few others on the forum with it.
Steve
Ache? I have recently been getting chest tightness at the top middle. They did what is called a provocative angio and I’ve been diagnosed with coronary artery spasms. My cardiologist, whom I’m yet to speak to in great detail yet, feels it’s the spasms restricting blood flow to the heart which is making my LBBB worse. My LBBB is evident every time I get the chest tightness.
That’s interesting. What is disappointing to me is that doctors rarely seem able to feel certainty about what is happening. My chest aching seems to start lower left and can feel more gastric.
Steve
I'd go for PACs too.
Looks like NSR with a trial ectopic beats.
there is an app called ECG+ which analyses ECGs done on a watch and tells you if they are indicative of PAC or PVC plus a load of other info about the ECG - I have it on an Apple Watch gives you the kind of info in the picture. Picked up the PACs which I could feel and were disconcerting.
ECG analysis
Thank you. I will take a look.
hi as others have said talk to your cardiologist.
If in the meantime you want your ECG analysed you can use the app Qaly which can diagnose 30 different type of arrhythmia.
It can use either AI or you can pay a bit more for analysis by a human.
Best wishes
Jezza
looks like ectopics to me x
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