Heart Rate Measurement by Apple Watch with AFib

[Buffy49]

I am 75, and have exercised regularly for many years. My resting heart rate has always been very low (typically around 45 bpm) , which I thought was because I was fit. In September my Apple Watch picked up AFib and this has been persistent ever since. However, the only symptom has been that my resting heart rate rose over a couple of weeks and has now settled around 70 - 75 bpm. Of course, this is 'normal' for many people. I have had an ECG and Echo and my heart has been assessed as in good condition, bar an enlarged left atrium.

My questions are:

1. is a heart rate measurement likely to be accurate if done on an Apple Watch, given that Afib means that the different chambers of the heart are no longer in sync?

2. Is it likely that the enlarged atrium has caused the AFib, or vice versa?

Thank you.

[Borderterriorist]

I'm not a doctor but 45bpm for a 75 year old is probably not because you are super fit. Instead of relying on an apple watch it's more reliable to do it manually (IMO). I think the AFib is more likely a response to the same thing that's caused your enlarged left atrium, possibly high BP or a number of other things related to heart damage. However, if you did high impact endurance sports it's possible that this has had consequences for your heart. I think these are questions for your doctors who have access to all your medical records.

[Buffy49 in reply to Borderterriorist]

Thank you! I should say that I am still an active member of a local gym and do regular spin and other CVand weights classes. The only problem is that my heart rate is now a lot higher, starting from a baseline of mid 70s, rathern an 45, which is rather alarming! My Dr said I should go by how I feel, rather than worrying too much about the numbers.

[Steve0114 in reply to Borderterriorist]

HI I was thinking about getting an apple watch to monitor atrial fib and or atrial flutter. Does your GP take it as a serious reading and act on it

Thanks

Steve

[Buffy49 in reply to Steve0114]

Yes, mine certainly did , although he also took my pulse the old-fashioned way, which confirmed that I had an irregular heartbeat.

[DWizza]

You know your own heart rates , you know the watch is consistent even if it’s not medically accurate ( don’t know if Apple claim it to be ). If you’ve had a lifetime of training /sport and your resting heart rate has now increased ( significantly to your normal numbers) I’d lean to getting further advice. Maybe the British Heart Foundation nurses online could give you a fairly swift reply on Monday on how to proceed?

[Buffy49 in reply to DWizza]

Yes, I will talk to someone on Monday, thank you.

[Blackknight57]

Apple Watch surveys claim it’s 91% accurate, it also depends a lot on shin condition. Just putting it on can cause high readings.

I don’t always trust readings, according to the watch my resting rate is around 50. Walking around the house 79-120.

It takes a bit of time settling down to normal levels went putting it on.

[Buffy49 in reply to Blackknight57]

Thank you. I sometimes feel that just thinking about the watch and readings makes your heart go up!

[Blackknight57 in reply to Buffy49]

So far today my range is 53-89.up and down stairsfor drinks etc. it peaked at 79 when i put it on then went to 59.

[Buffy49 in reply to Blackknight57]

Interesting that it goes up when you put it on. I noticed this morning that the red heart logo started flashing as soon as I started fastening it on. I do wonder sometimes if using the watch causes as many negative effects as positive!

[Blackknight57 in reply to Buffy49]

Ditto, that is usually when I get a high blip. 79 yesterday.

[honeybubs]

Hi I’ve always used an Apple Watch and was getting very paranoid with it. Since having my device fitted (CRT-D) my cardiologist has checked with the device team who continually check them and says that I haven’t got AF but my watch was saying I had so I don’t take any notice of it now. I’m not saying that’s the same in your case but it proved that the Apple Watches aren’t always accurate. X

[Buffy49 in reply to honeybubs]

Fascinating, thank you! It is easy to get too obsessed over the numbers etc. My blood pressure monitor is also picking up an irregular heart beat sometimes, but apart from this, I don't have any symptoms.

[richard_jw]

I believe that afib causes problems with many heart rate measurement devices because the atria beat irregularly and potentially fast.

Manual measurement of heart rate may work more reliably. Don't know about the cause in your case , but a doctor may well recommend that you take a blood thinner like apixaban since AFIB is a major cause of stroke.

With AFIB blood can pool inside the heart, and clot. The clot can move through arteries, and if it ends up in the brain, it can cause a stroke.

There is a formula called CHA2DS2-VASc used to predict the likelihood of stroke for those who have AFIB, and therefore the desirability of taking blood thinners. the formula takes into account age, history of heart problems, M or F etc.

[Buffy49 in reply to richard_jw]

Thank you very much. Yes, part of my original question was about how pulse can be measured if the top and bottom chambers of the heart are not in unison. Apixaban was the one thing. that has been prescribed and I have been taking it since September. And I have a feeling that my initial GP consultation did look at my propensity for strokes, which, given my age is probably high. I wondered whether regular, vigorous workouts to get the heart beating faster, might help flush out any clots that might be gathering in the lower chambers, rather like a Dynorod treatment!

[Dannysdad in reply to Buffy49]

Yes, I wondered whether vigorous excercise would help flush my arteries, or if it puts me in danger of heart attack. Having lifted weights every day for the last 20 + years I've reduced the reps & await a date with the Cardiologist. Echocardiogram showed some mitral regurgitation, hence GP's referral after he put me on Apixaban & statins for intermittent AF. I'm 76 and had no symptoms before routine BP check picked it up.

[Buffy49 in reply to Dannysdad]

Thank you! I had no symptoms before AF was picked up by my watch and BP monitor. Would be very interested in what you learn. I am seeing my cardiologist early in March and will ask the same question. I have reduced the intensity of workouts , but then I don’t even get breathless, which can’t be good for maintaining fitness. Seems like a Catch22!

[richard_jw]

BTW it could be that your doctor would want you to wear a Holter heart monitor for a few days. The holter reliably picks up AFIB and other arrhythmias. You wear it, and it records. Then its output is analysed to determine whether you have any heart rhythm problems

[BlueDouble007]

KardiaCare 6L is recognised by NICE and is fairly accurate at measuring heart rate and assessing heart conditions. You can subscribe to an online service with it as well for extra diagnosis. I have used the device for the last two years.Fibricheck is another online service as well that is chargeable. It uses the camera of your phone to assess your heart rate. I have used this as well, and found it to be fairly accurate.

The Apple watch is also fairly accurate, but I find it is let down by its battery capacity.

Whatever health tech is used, dont let it become obsessive, as this will cause anxiety.

I hope this helps.

[Buffy49 in reply to BlueDouble007]

Thank you, that's really helpful. I haven't heard of either of those and will look into them.

[JohnWesterdale]

I picked up a kardia ECG checker. Get a chance to look at the PQRST stuff when you're feeling off. I like to check after rowing, or as needed. Not obsessing, just want to monitor PVC frequency. Some think it's ok to have 1:6 to 1/10 PVC ratio. That's what I use it for. ST wave stuff - not sure if I can see that, but... Better to know?

[Buffy49 in reply to JohnWesterdale]

Certainly better to keep an eye on these things as long as you are clear on the implications and what to do about them.

[JohnWesterdale in reply to Buffy49]

Awareness is good. No one cares more about me than me. If I feel off and my Dr says I'll see you next week, I'll have something to fall back on. Pm me if Interested in the device. Happy to share.

[Buffy49 in reply to JohnWesterdale]

Thanks. I may well get a Kardia - it would be a lot cheaper than even one private ECG test. I am not that confident about my GP. I had to wait 5 weeks for a phone conversation. after my initial diagnosis was confirmed and am now 'discharged'. I guess this is because I don't really have any symptoms to report and they are waiting for me to have some!