Apple watch ecg - advice if possible

[Spudly22]

I am currently on monitoring for very occasional AF maybe once or twice a year. Taking 1.25 bisoprolol at night for 6 months to see if improves.

on occasion I get these odd flutter feelings and makes me feel quite anxious and a little sick - I managed to capture it tonight on my watch but it says Sinus so what could it be? Just a flutter or Ectpic beats.. anyone have an idea from my recording attached .. due to see the cardiologist in May but I could go sooner if I felt it was necessary - he has always assured me my heart is good structure but we need to investigate these odd episodes

[John3333333]

Please get clarification from your cardiologist but here is what I can see:

Top - single atrial ectopic

Middle - atrial salvo (4 beats) and, after a few sinus beats, a single atrial ectopic

Bottom - atrial ectopic immediately followed by ventricular ectopic and, after a few sinus beats , an atrial couplet

Overall, mostly sinus rhythm.

[Spudly22 in reply to John3333333]

Wow Thank you! What’s the difference between ectopics ( different ones ) and AF?

[BobD Volunteer in reply to Spudly22]

Ectopic just means out of place. i.e. missed or wrongly timed. Everybody has them but only we stupid AFers notice.

[GoodHearty in reply to John3333333]

John, how does one recognise the ventricular ectopic? Is it that the p wave is inverted?

[Drone01]

Not sure what you expect Bisoprolol to do for you at night. It may lower your bpm and blood pressure whilst sleeping but won’t stop AF recurrence. I’d be questioning the need for a regular betablocker given the negative experience reported by many on this forum.

[Spudly22 in reply to Drone01]

hi - I took them at night as they made me feel so tired and dizzy in the mornings and I also had most of my previous episodes or noticed them overnight .. I have thought about switching back to mornings and may do that in my 6 month trial of taking them before changing back to pill in pocket .

We also discussed taking Proparanol as that is a beta blocker that would help with anxiety I believe ..

[Vonnegut in reply to Spudly22]

As bisoprolol only reduces heart rate and does nothing for the irregularity which is part of our problem, it would only deal with part of any AF episodes you may experience. And don’t get into medications for anxiety if you can help it- gentle breathing, mindfulness, meditation are preferable and less harmful.

[Drone01]

I stopped betablockers altogether once an echocardiogram showed my heart was in good shape, and I felt much better as a result. I prefer to put up with the very occasional short (<30 min) episode of 180-200 bpm PAF. It’s not long enough to make a PIP worthwhile because I revert naturally to NSR.