Occasional fast rate

Hello everyone,

I decided to wear my iWatch to sleep last night and was surprised to see that I had 2 readings of a fast rate of 138bpm while sleeping. The watch takes a measurement every 10 minutes and my each reading only accounted for one of those 10 minutes readings. So it appears there was a brief moment of fast pace.

I guess my question is: is this anything to be concerned about?

All the best,
Q

Sleep Apnea can cause the HR to increase. The less oxygen taken in means the faster the Heart will beat to try to keep the body Oxygenated. But you would probably not get just an isolated reading like that if you Sleep Apnea all the time.
Was the HR 138 averaged over 10 minutes, or just for just for a brief moment within that 10 minute timeframe? I used to just stop breathing in my sleep altogether, don't know why, but that cause my HR to spike, and the Sleep Dr. was really concerned that I was stopping breathing like that.

Thanks, that's an interesting perspective. I had a sleep test done a couple of weeks ago at Stanford and am awaiting the results. It's certainly something that I should discuss with the doc there. I'm not sure how long the duration was since the iWatch takes 1 reading every 10 minutes. It's my guess that when it took that reading I was at 138, then it took the next reading 10 minutes later and I was back to normal.

Actually, this might be a good thing... It might just be one of the consequences of being in the REM state.

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While you sleep, you go through a cycle of sleep phases. The first phase is light sleep, followed by deep sleep and a dream state referred to as REM-sleep. A full sleep cycle lasts about 90 minutes and is normally repeated several times each night.

...
Rapid eye movement sleep (REM sleep) is a unique phase of mammalian sleep characterized by random movement of the eyes, low muscle tone throughout the body, and the propensity of the sleeper to dream vividly.

-Ted

Very short term and very sporadic is no problem Que, I also don't know how well I would trust the IWatch yet as the last word in personal HR monitoring accuracy with the relatively short experience we have so far with the new product, but keep a log of these and if it starts to increase at all let your assigned nurse or Salwa know at CPMC. And have them check your monitoring they are doing (you still have the event monitor they gave you??).

It's not uncommon at all to get brief higher rate runs from bursts of adrenaline, even in sleep, or spikes of rapid conversion of the thyroid storage hormone T4 into the bioactive thyroid hormone sudden spikes of T3, and either of those short term variations in hormone function can cause a brief HR elevation without exercise. And not surprisingly if those two often related hormonal scenarios occur often it can signal a problem with your adrenal glad function , but let's not go there yet based on just these two short little blood.

Do you have an Alivecor? If not Que, I highly recommend you pick up one for just $75.00 to be able to quickly keep tabs on many of these type of blips.

Shannon

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Do you have an Alivecor? If not Que, I highly recommend you pick up one for just $75.00 to be able to quickly keep tabs on many of these type of blips.

Thanks for the head's up, Shannon - I was not aware of the Alivecor until you mentioned it just now.

The Alivecor product does look very well designed, but looking at the Alivecor youtube videos... and the videos on the Alivecor site... it seems like there's quite a bit of artifact in the typical Alivecor ECG waveform recording. Does this present a problem when looking for a p-wave? Or do you diagnoses afib vs NSR via an alternate method (eg, checking for regular R-R spacing, or relying on the Alivecor waveform analysis sw?)

You can clear up the noise to a degree by using their averaging method or 'enhanced filter' mode and you can invert the waveform
too. They have four decent algorthims that give a general, but not infallible indication if you are in NSR or Normal , AFIB, Too much noise detected ( make sure your two index finger tips are moistened and don't squeeze too hard or it will increase noise), and 4th it will say something like indeterminate result which mostly means another arrhythmia like SVT or atrial flutter..

You can pay a few bucks to have a cm scan interpreted by a cardio tech or full Cardio I for a bit more within 24 hours or faster for more money. You can often see se degree of P wave but this is not a 12 lead ECG it's a single lead device that is FDA approved for detecting AFIB. You can see PAC and PVC ectopy as well and the 30 second strips can be converted into a PDF for emailing to anyone.

Just be very careful about not inundating any doctors with a flood of ECG strips asking what they mean... That is the biggest complaint physicians have about empowering patients with these ECG devices is having their full
Staffs and themselves overwhelmed by largely redundant strips when everyone knows what the patient has already. In other words only send them to your actual EPs office once you are an established patient and something about your heart rhythm changes significant and for more than a few minutes. Don't want to wear out your welcome. But they are very handy devices for an active Afibber.

Also in an earlier post Apache about the duration of your AF episodes, those are some considerable durations and the odds are high you could have a significantly more significant case of paroxysmal leaning toward persistent than you might expect. Again just underscores to do all that you can both diet and nurmtritionally and make sure any ablation is with the best possible EP you can set up.

Shannon

Hi, Ted,

Alivecor now has a pretty good algorithm for detecting what may be AF. In my case, it was always right. And it also has an algorithm for determining a normal ECG, which I think is OK, too. In my case,the strips are quite clean. I think you have to experiment with contact with the Alivecor module. If you press too hard, I think you can get noise. Using the lightest touch that indicates full contact, I usually get something very clean unless I move my hands. Even then, Alivecor adjusts in a few beats. For the money, it can't be beat. And you can definitely see a P wave. At least this has been my experience. It's not substitute for multiple leads and a doc, but it can be reassuring when you don't have those options and it's also a way to show your doc what happened, since you can capture problems when you are awake if you have the monitor around.

Rob

Hi Shannon and Rob,

Thanks, gentlemen, for the excellent Alivecor tips and anecdotes.

Cheers,
-Ted

I've found that with my alivecor, any readings above 100 bpm are considered indeterminate. Just a general FYI.

Thanks Shannon. Yes, I do have the AliveCor. I have the same good impression of it so far. I'll keep an eye on the night measurements. Agree with you on the iWatch. It's early technology but helpful still.

All the best,
Q

Pretty sure that this is my sleep apnea kicking in during the night. Spoke with the sleep doc and he seems to agree. Of course, there's no way to tell with an iWatch reading. Would need full EKG.

r