I recently had a 7 day holter monitor fitted. Halfway through the monitoring period I felt the familiar "bag of frogs" in my chest and my Kardia recorded as Atrial Fibrillation.
I took my pill in the pocket meds (bisoprolol) and the episode lasted only 1 hour and 20 mins
I have received my report today from my consultant stating that out of 678060 beats 678012 were normal and the others were ectopics and that there was no AF or atrial flutter
I have always trusted my Kardia and I now wonder if some of my previous episodes were ectopics and not AF and could I have been taking meds unnecessarily.
I was initially diagnosed in hospital so I know I do have AF but maybe I have not had all of the 15 episodes that I have recorded since 2016
I know my burden is low but can anyone tell me if I can identify AF from ectopics on my Kardia
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Sandyc2705
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I do rate my Kardiamobile 6L but it is not infallible. It has been very accurate reporting actual Afib, however, I have noticed, 3 or 4 ectopics within a 30sec trace can sometimes produce a determination of ‘unclassified’ or ‘possible atrial fibrillation’.
Advanced Determinations are available on Kardia, which covers some PVCs/Ectopy but it is a fee based service. I have never subscribed.
I think i can determine ectopics on the Kardia, usually you can see a large skew of the trace on leads II & III and the resemblance of a p wave on lead I. Along with absence of other Afib symptoms, I conclude it's ectopics and not Afib. Note - I am not medically qualified to read EKG traces either, this is just personal observations and experience.
The Kardia is just one of the tools I use to monitor my state of well being. I can usually determine the difference between Afib and Ectopics myself. The former feels like the 'bag of frogs' you describe, the latter is more the skip/thud/jolt. Even in an 'ectopic storm' - multiple PVCs, I can usually distinguish between them.
Like yourself, i have to decide whether to take a PIP and I use of the inputs available (tech and self awareness) to me to make that decision.
As others have said, have you shown the Kardia traces to your consultant? Mine has always been happy to discuss them in consultations.
I’m always surprised on here when people say they know they’re in AF purely by the feel of their heart ‘movements’ or because their heart rate is fast and the feel ‘funny’.
I have all the acronyms - AF, PACs, PVCs (and I have these in bigeminy, trigeminy, triplets and couplets), NSVT, SVT and pauses too and yet I cannot tell the difference between them all. I have them daily, and have for 5 years now. They all feel different at different times.
The only true way of determining AF is to recognise what they look like on an ecg.
P WAVE
AF does not have a p wave. The p wave is the atria contracting. In AF it’s more of a wobbly baseline and is clearer in leads II and III. It’s often hard to see clearly on home devices on any lead but II and III usually have less mess.
IRREGULAR SPACING
The beat will be irregular with irregular spacing between each one - measure three or 4 in a row and see. If you can’t see a p wave but the beat is regularly spaced, it is not AF.
The devices are not always accurate and even for specialists, it can be hard to read them as they’re not hospital grade. Also, Kardia only reads lead 1 even though it gives you six leads so there is room for error.
I would've thought it speaks for itself as a description of how AF feels in the chest to the sufferer.
My analogy was always that my chest was a tumble dryer and someone had put a pair of trainers in and set it away. None of the other arrythmias are like that for me.
I was always able to differentiate between AF and any other arrythmia, it was always very recognisable. By the same token, since my ablation 3 years ago I continue to have ectopics but have had no AF.
When I used Kardia it misdiagnosed a few times but is generally accepted as accurate. My Apple Watch has never misdiagnosed, interestingly, erring more on the side of caution, I suppose.
I believe that, although generally very accurate, a problem with any finger-type contact ECG such as Kardia (or Apple) is that the quality of the trace can be degraded by electrical "noise" resulting from poor contact (perhaps because the fingers are too dry, or if there's muscle tension between the fingers and the chest) .
Unfortunately, this isn't obvious to the user of a Kardia as it is always "smoothed" out by the software (although Kardia does allow you to see the trace with its noise). The "electrical noise" can easily obscure the small signal from the heart's atrial pulse (which shows as a "P" wave - the first tiny blip before the peak of the ventricle contracting, or "R" wave). This can then fool the AI into reporting AF, when what is actually happening are ectopic beats causing irregularity in the pulse.
There are other home ECGs that have the option to use gel-type patches to get round this (I have one by Wellue, for example).
I get both ectopics and AF and take pill in the pocket Bisoprolol for both of them so I don’t think you are taking meds unnecessarily. I know I’m in AF because of the fast heart rate, with ectopics it’s not too much above my normal rate, both feel similar and are uncomfortable but also look very different on my Kardia.
I have seen afib determined by my kardia single lead. When I sent the trace to a consultant he said no afib almost certainly noise. I have had 4 week long holters and sure I have ectopics with up to 13 percent burden but no afib. Looking at the kardia trace I DO see p waves and I don't see irregularly irregular qrs complexes. I suspect that if you have really pronounced afib kardia Will detect it
FWIW, I'd say that with paroxysmal a-fib it probably makes sense to confirm the Kardia report with a trained clinician. Their algorithm is good but it's not perfect and is capable of false positives – as I've found on occasions when multiple EPs reviewed mine.
Thanks for your reply / I have paid for the Kardia clinician to review and they have confirmed AF but my consultant says the monitor only shows ectopics 🤷♀️
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