Anyone know of an atrial flutter home monitor?

Kardia 6L and iWatch both don’t detect atrial flutter. I called up Kardia after my strips both stated normal while the 12 lead detected flutter. It’s great for AF but not flutter or PVCs even when using 6 leads, although with PVCs one can see it but the results state possible af.

Anyone know of an atrial flutter monitor that you can use Bluetooth to transfer to your phone app? George? I’m not interested in a large medical device, something portable and reliable.

I had to be ECV twice today for flutter to be successfully convert to nsr. I’m home feeling off...thinking maybe I’m back in flutter without a device to confirm. If it was af I would know in 30 seconds. Or maybe I’m off because I was zapped twice with skin burns to prove it. My flutter was regular beats that resemble nsr so taking my pulse is ineffective.

I am aware a 12 lead ekg is the best diagnostic tool in detecting flutter but that involves frequent doctor visits which is not practical and insane. I would like a portable device at home to track the amounts of events and length of time I’m in flutter to have a fuller picture when to plan my next ablation.

I don't think such a device exists. AF is unmistakable, even without a monitor if you're informed about what it is and the sensation it brings but, despite of this, most handheld devices don't say "you have afib".
AFlutter may sometimes appear clearly on a single lead tracing, the kind of tracing you'd find on tutorials about the basics of EKG reading, but it's rarely the case.
Without a 12-lead machine, I think it's hard to tell.
I think you're right about the sensation. Once you're used to, it's easier to identify with sensation. The flutter episodes I've experienced were intricated with afib, so I couldn't feel them. But I've had one some hours long I'm not ready to forget : my HR was regular, around 125bpm, but the beats were discrete and I was incredibly weak.

My flutter was in the 70s. They had to ecv me twice. When I left the hospital I just felt the flutter sensation return.

I’m sensitive to the joules voltage. 50 is fine, more than a 100 voltage of joules causes burns. When the nurse took off the back pad she commented on my burns. It still hurts. I couldn’t sleep a wink. Same thing happened during my ablation with 200, 200, 200, and 300 joules. Linocaine cream didn’t help. For those of you who have experienced burns, it’s not pleasant.

FYI I have an excellent pain tolerance. My last major surgery I refused all pain meds. I wish I could have one now.

No such device exists and probably won't anytime soon. Diagnosing AFL isn't as simple as AF. I've had multiple (non-cardiologist) doctors misdiagnose it. But in general if you have a history of flutter and your heart rate is over 100 for no reason and it's a regular rhythm then it's probably flutter. If it's under 100 then almost impossible to know without a 12-lead.

A way to tell would be by monitoring your HR as you move around. If in NSR, your HR will fluctuate gradually between around 60-100 depending upon activity. If your in AFL, there will be a static reading. The AFL rate may change, but it would be at intervals, depending upon the conduction ratio. For example, when I was in AFL, my rate varied at the following intervals:

Sleeping : HR 44-45 corresponding to a 6:1 conduction ratio. 45 X 6 = 270 Atrial Flutter Rate
Lying down : HR 58-59 corresponding to a 5:1 conduction ratio. 58 X 5 = 270
Sitting : HR 68 4:1 68 x 4 = 272
Walking : HR 88-90 3:1 90 x 3 = 270
Stressed: HR 133-135 2:1 135 x 2 = 270

I was never in-between these numbers, for example, it would shift immediately from 58 to 68, or from 58 to 88. Kind of like gears shifting. The ratios didn't always relate to the activity levels I put in the chart above, but they tended to. For example, as I was walking, the rate would jump around from 58, to 88, and back to 58, at an instance. Overall, most of the time, I was at either at 58, or 88.



Edited 2 time(s). Last edit at 07/17/2020 03:26PM by The Anti-Fib.

Mine was a steady 72-79 hr awake and in the high 60s while sleeping- both my Kardia and iWatch showing steady hr beats. Only on the tachy onset would it be super high. 205 was my recorded highest but I remember some unrecorded episodes that felt higher.

Yesterday I was hooked up to a monitor. Initially they saw flutter but right before the ecv they could not read flutter until they did a 12 lead ekg. Frustrating. How can that be? If they were not 100% sure as experienced trained professionals, how can we know as laymen to be able to self monitor our heart?

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susan.d
Yesterday I was hooked up to a monitor. Initially they saw flutter but right before the ecv they could not read flutter until they did a 12 lead ekg. Frustrating. How can that be? If they were not 100% sure as experienced trained professionals, how can we know as laymen to be able to self monitor our heart?

Hey Susan, years ago (mid 2000's), some folks here purchased their own 12 lead ECG's & 12 lead Holter monitors. One of those people was PC, MD. He got a an afib ablation in 2005 and a flutter ablation in 2011 in Bordeaux.

Back then the machines were quite pricey - in the $4000-$5000 range. Today you can buy a Contec Chinese Holter off eBay for ~$500 (since my afib is very rare these days, I've not done this). The key is the analysis software. If you get one, make sure it comes with software (most of the software only runs on Windows, not Mac). You'd also need to teach yourself how to read a 12 lead.

PC's posts are difficult to search on since he reregistered as PC, MD - the comma throws off our search software. However, you could send him a PM here, if you wanted to ask how easy it was for him to identify flutter. He's a pathologist, not a cardio.



Edited 2 time(s). Last edit at 07/17/2020 04:18PM by GeorgeN.

You can buy used professional-grade 12-leads on eBay for under $1000. I've got one I'm going to put up for sale soon. I'll probably ask about $500. But a 12-lead isn't much use if you don't know how to interpret the results, and relying on the machine's interpretation is unwise.

Placing the leads correctly would be a challenge. When I am ECV, they move my leads around the pad and I get artifact.

Right now I speculate I’m back in flutter. I felt that way once after the ecv and I sat up. Kardia says possible AF while my afibalert and iWatch says nsr.

Placing the leads is trivially simple. Remember, there won't be a big ECV pad in the way. I could teach anyone how in less than 5 minutes and there are instructions and diagrams all over the web.

I use an app on my iPhone called Cardiio. I have learned to identify the trace, it is obvious when you are in NSR and like me this morning starting out in AF and progressing into flutter. Not ideal but it is a reasonable aid, and very cheap.

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John S
I use an app on my iPhone called Cardiio. I have learned to identify the trace, it is obvious when you are in NSR and like me this morning starting out in AF and progressing into flutter. Not ideal but it is a reasonable aid, and very cheap.

Thanks. Kardia and iWatch doesn’t have a physical strip to identify atrial flutter. Not enough leads.

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John S
I use an app on my iPhone called Cardiio. I have learned to identify the trace, it is obvious when you are in NSR and like me this morning starting out in AF and progressing into flutter. Not ideal but it is a reasonable aid, and very cheap.

I assume you are looking at the pulse waveform.

I've noticed, using other waveform apps that use the camera & light as a plethysmograph, that the waveform changes in afib. Not just the fact that the characteristic distance between peaks (or BPM) is highly variable, but the amplitude of the waveform is also variable. I can also feel this variability in my radial pulse. What characteristics do you notice in atrial flutter? Did you purchase the waveform pack?

Thanks John. I did download the app but I read the privacy and I may not be comfortable using it so I deleted it for now. See below just some of the 3rd party sites they sell your data to:

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You're never going to identify flutter with any device that only has lead I, which would be all devices that read from the fingers or wrist. You need to be able to see flutter waves and that requires leads II, III, and/or aVF. Flutter waves are really just extra P waves in between each beat, and P waves are nearly impossible to see on devices that measure from the hand or wrist. Using the Kardia in lead II mode (left knee, right thumb) is the closest you'll get, but I experienced a hell of a lot of flutter and was never able to reliably spot it using that method.

Flutter is most often seen with a 2:1 block producing a HR near 150, so if you've got a history of flutter and a HR near 150 that's a regular rhythm, you're probably in flutter. You don't need any device at all to make that judgement. But if you've got flutter with a 4:1 block that produces a heart rate of about 75, there's just no way to identify it without at least one of the other three leads I mentioned above.

And just to complicate matters, flutter can have a variable block, which produces an irregular pulse that looks just like AF. That one fooled me even with a 12-lead until my EP pointed it out.

Thanks Carey. You are referring to the 2 lead Kardia? The 6 lead Kardia has a knee or ankle contact behind the device plus two thumb contacts on the front. It does show lead III.

My flutter starts out for a couple of minutes over 200 and then drops to the 70s-high 80s which resembles a regular rhythm. You may ask why don’t I live with it instead of camping out at Los Robles hospital parking lot to be tested one day only to return the following day to rid the flutter by ECV? Simple. I am symptomatic. If I want to sit on my couch all day watching Netflix then I can remain in flutter. But once I stand, walk, bending over which starts flutter tachy- or gardening in the early morning when it isn’t hot, carpentry hobby, daily clean out my koi pond or other low impact activities—then living a life of flutter would be an issue. I might as well then move to a nursing home and sit with the other decrepit and waste my life watching tv to avoid getting AF and flutter which starts up my symptoms that makes the quality of daily living limited.

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susan.d
My flutter starts out for a couple of minutes over 200 and then drops to the 70s-high 80s which resembles a regular rhythm. You may ask why don’t I live with it instead of camping out at Los Robles hospital parking lot to be tested one day only to return the following day to rid the flutter by ECV? Simple. I am symptomatic.

Doesn't really sound like you need a monitor, your symptoms tell you what you need to know.