Chronic afib, oximeter and rate control

Since I'm in chronic afib, the pulse rate on the oximeter changes almost constantly.
I'm playing with jotting down the whole series over a minute, for example, adding it up and then averaging by dividing by the number of readings. They run from 15 to 25 readings. I'm guessing it is mathematically incorrect as the figures change irregularly. How close or far off the mark could these averages be to get a general picture?
I need some backup for my next appointment to argue in favor of the series of tests recommended here and help in following the Protocol. I live in Buenos Aires, Argentina and the magnesium available OTC is usually Mg oxide or Mg chloride.
And another question: when a ECG is taken in the doctor's office, (white coat syndrome?) is the 100 bpm they use as a standard to then prescribe "rate control" drugs an "average" or just the highest rate reached?
Thanks,
ginny

Ginny,

I'm pretty sure it is an average. You might try manually taking your pulse and counting beats for a minute. This could understate the actual rate as sometimes it is hard to feel some "soft" beats with your fingers. I have a pulse point a little in front of and just above the tragus of my ear lobe. I find this pulse point is very easy to feel.

I'd worry that your BP machine is not sampling every beat, if it were, 15 to 25 readings would indicate a very slow heart rate. So are those readings averages of the rate since the last reading or just the rate for the latest beat. Of course the average would give you an indication of rate.

Though people denigrate the effectiveness of both mag oxide and chloride, I've found them both to be effective. No harm in trying them. However it is unlikely they will magically return you to NSR. They are more likely to be effective keeping a person in NSR than converting someone in chronic afib.

George

Have you ever considered purchasing an alivecor monitor for your phone. This would give you a more accurate reading.

The best way to measure HR in AFIB is by ECG. The rate given is an average, but that is an average only for several seconds while they did the ECG. On your own your idea is good. I agree with what George said, but you are using a Pulse Oxymeter, not a BP machine. BP machines also give HR readings, but are not accurate, as George indicated.

What is this DR place talking about that there is a 100bpm threshold in order to implement Rate control Therapy? This is foolish. Weather to treat depends on your normal NSR rate. If you normally are at 90+, then this might make sense, but not if you are normally much lower.

Your objective in AFIB, is to get your HR as close to possible, as your normal NSR rate. The higher your AFIB rate over your normal rate, the more symptoms you will have. If your Normal NSR is 70, then your should try to get your AFIB HR down to at least in the 80's. To not treat with Rate Control unless HR is over 100 risks causing Tachy-cardia induced Cardiomyothapy, it the episode goes on for longer than 24 hours. >100 is the threshold to start worrying about Cardiomyothapy.

Thanks George and Lynn,
George, I appreciate what you said in an earlier post and am keeping in mind the need for having a plan before attempting anything:
"If you do try conversion, you do need a plan (like my flecainide) to deal with a reversion to afib."
Trying to recover my digestive regularity after stopping some capsules I was given by my "digoxin pushing" MD, before I take on any magnesium.
I've managed to make Waller Water but approaching it with caution.
For some humor, I tried counting my pulse at my throat, watching a minute hand on the computer screen and kept ending up counting the seconds and not the pulses!
On the oximeter, which shows a pulsating, throbbing and very *uneven* bar, it's also hard to follow and count each beat. Averaging the numbers seems to be easier.

Lynn, Thanks, I'll put it on my wish list, I need a new cell phone first.

Anti-Fib:
Thank you! How foolish fixating on a number (100) really is, to then prescribe dangerous drugs (digoxin) is exactly what I'm trying to prove to myself before I go out into the wild world of cardiologists again.
My experience both with a cardiologist and a clinician has been that they both read "100" on the ECG (or the BP, a mistake, but he held his ground, when I objected) and then handed me a prescription for Bisoprolol, the cardiologist and Digoxin the Clinician (ironically he promotes his experience in "Natural approaches" to arrhythmia!)
I've read a little on Lenient vs. Strict Rate Control in permanent afib trying to find some ground to stand on as regards the numbers.
"... lenient rate-control strategy (resting heart rate <110 beats per minute) or a strict rate-control strategy (resting heart rate <80 beats per minute and heart rate during moderate exercise <110 beats per minute). ..." Conclusions: In patients with permanent atrial fibrillation, lenient rate control is as effective as strict rate control and is easier to achieve. "
[www.nejm.org]
and
"2010 Journal of Family Practice
A-fib and rate control: Don’t go too low
Practice Changer
Aim for a heart rate of <110 beats per minute (bpm) in patients with permanent atrial fibrillation. Maintaining this rate requires less medication than more stringent rate control, resulting in fewer side effects and no increased risk of cardiovascular events."
[www.ncbi.nlm.nih.gov]

Unfortunately I don't have a reference mark for my Normal NSR, I'm in chronic afib since February and have had these 2 bad MD experiences. I don't question the Bisoprolol, I haven't a clue, I question the cardiologist's attitude: "If this doesn't work, we'll try something more drastic." No further explanations, etc.
I don't have symptoms beyond breathlessness, after climbing stairs, nor distinguishable "events" beyond "throbbing and thumping" vs. "a calm heart" but which don't necessarily translate into a *higher* heart rate as seen on the oximeter.

I find chronic afib confusing to post about as there are no triggers, no events, no vagal, adrenergic, etc.
Many thanks, will keep struggling to understand.
ginny

Ginny your normal NSR rate would have been in your past medical records prior to your AFIB.

The throbbing of your Heart (palpitations), and breathlessness, are symptoms of your Heart beating too fast in AFIB.
Since the Atria are in Fibrillation, they don't push Blood down into the Ventricles like on a normally beating Heart.
Sounds like your Ventricles are not filling up with enough Blood prior to the next Heartbeat.

Have you had an Echo? If so,what was your Ejection Fraction?

Thanks for posting those studies. In reality each patient is different, These studies help the Doctors treat more than the Patients cope.

You will probably need to experiment some with finding the right medication to lower your HR.
If you can determine your approximate NSR HR, then you can adjust your AFIB HR down closeer to it, by increasing your Medication dosages, to see how you feel. These numbers like 80 and 110, are not precise, one Patient might do best at 75, while another at 90.

Thank you Anti-fib.

24 hr. Holters (April 2013):
HR: Mean: 91 bpm / Min: 64 / Max: 136
"Normal Sinus Rhythm with high average heart rate."
and
Echo (April 2016) in afib:
Ejection Fraction: 69% (Ref: >55%)
Left Atrium: 49 (Ref: 19-40 mm)
and of course a whole lot of other data, very much abbreviated and in Spanish.
I'm a professional translator, I can handle it, but it takes some time, since it is so specific.

I'm currently not taking any medication.
I hope to find an MD who will go beyond: "100? Take this. See you in a month".

"Left Atrium: 49 (Ref: 19-40 mm) "

Not an expert, but this sticks out to me.