Can run of ectopics last for days?

Can a run of pure ectopics last 3-4 days? And be nothing but ectopics? I ask because my my recent multi-day arrhythmia runs have felt like "lesser" Afib. Much less shortness of breath and I can move around pretty normally.

I can tell from stethoscope and fingertip pulse oximeter (which I use repeatedly throughout these episodes) that I have no NSR during the entire time. I have peaks and valleys on the waveform of the pulse oximeter, but the are highly irregular intervals and heights. And stethoscope confirms same irregularity.

But does that automatically mean it's Afib? The Afib that I was diagnosed with in ER (which also lasted 4 days) was much more debilitating - I was weaker and more SOB.

I have not felt chaotic banging palpitations in my chest since my Aflutter shifted to Afib a few months ago. So all I have to go by is my SOB and stethoscope and the waveform on the pulse oximeter.

I had PVCs everyday for 5-6 months, mostly in the end nonstop. No af. So yes it’s possible to get a run. My PVCs stopped with Tenormin 37.5mg a day.

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susan.d
I had PVCs everyday for 5-6 months, mostly in the end nonstop. No af. So yes it’s possible to get a run. My PVCs stopped with Tenormin 37.5mg a day.

Thanks for this info. This helps clarify for me what might be happening in some of my episodes.

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PoetKim
Can a run of pure ectopics last 3-4 days? And be nothing but ectopics? I ask because my my recent multi-day arrhythmia runs have felt like "lesser" Afib. Much less shortness of breath and I can move around pretty normally.

I can tell from stethoscope and fingertip pulse oximeter (which I use repeatedly throughout these episodes) that I have no NSR during the entire time. I have peaks and valleys on the waveform of the pulse oximeter, but the are highly irregular intervals and heights. And stethoscope confirms same irregularity.

But does that automatically mean it's Afib? The Afib that I was diagnosed with in ER (which also lasted 4 days) was much more debilitating - I was weaker and more SOB.

I have not felt chaotic banging palpitations in my chest since my Aflutter shifted to Afib a few months ago. So all I have to go by is my SOB and stethoscope and the waveform on the pulse oximeter.

Yes, it's possible to have ectopics for weeks, months, or even indefinitely. But what you're describing could easily be AF. Just because it isn't as debilitating as the first time doesn't mean it's not AF. When you listen with the stethoscope is it consistently irregular or does the irregularity come and go? If it's continuous, that's probably AF. The pulse ox isn't really going to tell you anything useful.

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Carey
Yes, it's possible to have ectopics for weeks, months, or even indefinitely. But what you're describing could easily be AF. Just because it isn't as debilitating as the first time doesn't mean it's not AF. When you listen with the stethoscope is it consistently irregular or does the irregularity come and go? If it's continuous, that's probably AF. The pulse ox isn't really going to tell you anything useful.

When I listen with stethoscope I might hear 2-3 in row that are sort of same, and then a rapid run and some stuff to subtle to count. Also n these episodes, I often hear individual beats that seem to have 3 sub-beats (ba-boom-ba) instead of typical 2 (ba-boom), haha! I realize this is hopeless to describe.

As for pulse oximeter... When I am in NSR, the pulse waveform across the bottom is very lovely and even with its peaks and valleys and very reassuring to see that again after a long run of the other.

This is a little experiment. I don't know if it will work. Am trying to share 2 images.

Pulse oximeter when I am arrhythmic. Actual heart rate was 95-100 bpm (w stethoscope) despite what pulse ox says.

[pigsquash.files.wordpress.com]

Pulse oximeter when I returned to NSR. Heart rate shown is correct at this point.

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Is it at all possible to tell from this whether my arrhythmia is 'just' a run of ectopics as opposed to full on afib? I realize I'm working with stone knives and bearskins here for technology.



Edited 1 time(s). Last edit at 08/09/2020 04:18PM by PoetKim.

Does the pattern in the first image repeat? With that short a series, it is hard to give any opinion.

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GeorgeN
Does the pattern in the first image repeat? With that short a series, it is hard to give any opinion.

The pattern in the first image has about that degree of erraticness continuously, usually for several days. But this last time it converted in 4 hours - maybe because I tried the conversion strategy of low-sodium V8 + 400 mg magnesium + 2 cups water immediately upon detecting it. Have never tried anything before (except metoprolol which does nothing to convert but makes me feel terrible so I don't use it now). I heard about V8 in this group. So thank you, group!

I think you're probably experiencing AF episodes, but without an actual ECG of some sort, at least a Kardia or Apple Watch, there's no way to be sure. I don't think that pulse ox tells you anything at all other than your SpO2 levels, which aren't particularly relevant.

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Carey
I think you're probably experiencing AF episodes, but without an actual ECG of some sort, at least a Kardia or Apple Watch, there's no way to be sure. I don't think that pulse ox tells you anything at all other than your SpO2 levels, which aren't particularly relevant.

Thanks Carey. I'll see if I can get a requisition for a walk-in EKG that I can use at a lab the next time I have an episode. To pin this down better.

If you're going to be asking this question often, which seems likely, why not buy a Kardia so you can check whenever you want instead of having to requisition ECGs and drive to a clinic and all?

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Carey
If you're going to be asking this question often, which seems likely, why not buy a Kardia so you can check whenever you want instead of having to requisition ECGs and drive to a clinic and all?

I have considered that. I own no wireless devices because I am anti-wireless. so i would have to also get a smartphone or at least ipad or it's useless. and then if i had ipad, in order to save the read-out, i would have to at least email to myself... which i believe with ipad means i also need to bring a wireless router into my home... forever. all of that is really a big step backwards for me in terms of what I consider a healthy life. hence my hestiation on Kardia.

also... i keep reading here and elsewhere that people's Kardias don't really confirm if it's afib or not in many cases. the device says "possible afib" over any type of arrhythmia. in which case i would be no better off than i am right now. or the kardia flags something as afib when it is just ectopics.

i have no cardiologist i can email the kardia output to, nor am i likely to find one. have seen 2 different cardiologists now. they are each like: "you have afib. you only have 2 choices. take pills and live with it or get an ablation." I really do not accept that, based in part on the numerous case histories and anectodotal accounts i have read on this and other afib forums and in hans larsen's LAF Surveys book.

so i think i will probably just carry on as is, not knowing for sure whether my arrhythmia episodes are ectopics or afib, but deploying the same non-pharmaceutical strategies in either case in effort to reduce/eliminate. and we shall see.

If you have a Kardia, you have the option of paying $19 for someone at Kardia to diagnose your strip since you don’t have a cardiologist. Turnaround time is 24-48 hours.

I recommend if you want to be WiFi free, to buy the Afibalert device. It’s old school plug in the device to your computer and see the strips. If in af, you get a red telephone icon, if nsr, you get a green check. Their tech support is perfect. Many times I have emailed their support link and ask them to diagnose the strip. It’s a pdf file size you can print it up. If my iWatch or Kardia says nsr, I still take out my Afibalert and confirm. It’s small. I fit and protect mine in an eyeglass fabric case. I have been a beta tester for 16 years already and have had peace of mind.

Downside is you need to attach a cable to your computer to upload your strip to their server. Pro-for you is that you don’t need a smart phone or WiFi, just a PC (not Apple) computer, the PC app and an easy to get cable. The strips are saved forever on their server. I am grandfather clause in but new patient may pay a monthly subscription fee to store on their server. The device holds 30+ readings of memory before you upload. If I get a green check, I don’t bother uploading. In fact since the Kardia 6L, I have not uploaded in over a year. I just take to see the green or red icons when I have steady nsr like flutter when the Kardia and my iWatch says nsr but my Afibalert says red. That is when I use it now.

Afibalert
[www.lohmantech.com]



Edited 1 time(s). Last edit at 08/10/2020 02:12PM by susan.d.

Thanks Susan for this info and explanation of Afibalert device. i was not aware of that option. Will look into it. Sounds like it might be the best way to go in my old-school non-wifi existence.

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PoetKim
Thanks Susan for this info and explanation of Afibalert device. i was not aware of that option. Will look into it. Sounds like it might be the best way to go in my old-school non-wifi existence.

You only need the $179 basic kit. The premium includes optional wrist electrodes if you don’t like using your two thumbs. Since being a beta tester, imho the thumbs or wrists resulted in the same quality. I prefer my thumbs. Relax to not get artifact is my only suggestion. No moisture of thumbs required. If you like it, you then get the yearly or 3 year warranty and uploading privileges. The first year of uploading is free.

You don't have to pay Kardia to have the strips interpreted. The app does the interpretation for free. It's almost never necessary to pay for an interpretation.

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PoetKim
Thanks Susan for this info and explanation of Afibalert device. i was not aware of that option. Will look into it. Sounds like it might be the best way to go in my old-school non-wifi existence.

You might check this website too :[www.ndsu.edu]

Keep in mind that no single lead handheld home monitor, being it a Kardia or anything else, will never say "you have afib". At best, they'll say "suspected afib" or things like this. They're not made for self-diagnosis, but to show your recordings to qualified people.
If you don't like wireless devices, there are some models having their own display and memory, allowing to record hundreds of 30-sec tracings and more if you download them (by wire) to your computer. They often come with a software allowing to print or send your tracings (see the link above).
I've my own monitor, like many people here, and I'm doing this, since my afib episodes are short and nearly never show up when I've an appointment with my cardiologist or EP.

Thanks Pompon. That is indeed what would interest me - a model with its own display and memory, and downloadable to my computer by wire. However, like you have mentioned, if it will only say "suspected afib" or "possible afib"... well really I have not gained much. I am already able to clearly detect when I am arrhythmic and when I am NSR. I just wasn't sure all these arrhythmia runs were afib. And I don't currently have a cardiologist who would be interested in seeing this output. The 2 cardiologists I have met with so far... and I think I will leave it at that... are each of the mind: you have afib, either take pills or get an ablation, period, end of discussion. They don't seem to think further documentation of my heart rhythm has any relevance.

But I am hanging on to these links that you and susan.d have each supplied Thanks!



Edited 1 time(s). Last edit at 08/11/2020 04:47PM by PoetKim.

If you find a device that gives a definitive diagnosis of AF, you've found an unlicensed device of doubtful value that will probably be yanked from the markets as soon as regulators become aware of it.

The Kardia does everything you're asking for, is FDA approved, and does NOT require payment for interpretations.

Yes it can be "just" ectopics...or mostly ectopics. I get "runs" of ectopics that last between 10 - 30 hours...most of it is NOT afib but mostly loads of ectopics/tachycardia...with a small portion of short afib runs. The longer I deal with these "runs"... at least for me, it becomes easier to handle. Part of the reason is psychological, part is that we just adapt to it physically I think. There can be a strong mental component to this, managing stress can really help in more than one way. Once you know it is not going to kill you, mentally it becomes easier to deal with. Good luck, you're not alone.

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Carey
The Kardia does everything you're asking for, is FDA approved, and does NOT require payment for interpretations.

Just to clarify-
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If you are new don’t know how to read the strips —if for example you are having low hr flutter that the Kardia detects as nsr, or if you don’t have a cardiologist and want the added security and peace of mind of knowing if the Kardia interpretation is correct because it’s based on algorithm and close but not 100%, you have the option to pay for a professional interpretation.

I know now that my steady flutter doesn’t have P waves, but a medical person in the cardiac field told me that a 12 lead Ekg is the ultimate tool in detecting flutter-in my case the Cath lab’s monitors couldn’t see the flutter—but sometimes if one looks for my nsr Kardia strip’s P wave to aid in a flutter diagnoses. I was told based on Kardia’s algorithm, it doesn’t base its findings on P waves.

Detecing AF is actually quite easy. Any irregularly irregular rhythm that has a narrow QRS width is almost certainly AF, and that's largely what Kardia, Apple Watch, etc, detect. They can't rely on P waves because P waves are difficult to see from a single lead taken from the fingers, which are far from the heart. Fact is, you can detect AF with nothing more than three fingers on your wrist. Where I think PoetKim is going off track is thinking they have an unusual rhythm that a cardiologist needs to see or that a more sophisticated device will detect. That's really unlikely. If you have a pulse that's irregularly irregular, there's a 99.9% chance you're in AF.

Detecting flutter is much more difficult because flutter is a regular rhythm. Using a single lead, there's no visible difference between flutter and normal sinus tachycardia (from exercise, for example). So even if you pay for an expert interpretation, it's unlikely the expert will be able to tell you it's flutter with any degree of confidence.

But detecting flutter is rarely necessary if your problem is AF. If all you need to know is whether you're in a normal rhythm or AF, then a Kardia is by far the best choice. After the initial cost it's free unless you want to sign up for their premium package, which I frankly think is overpriced.

True true true Carey. But what do you do if you are only in flutter and are symptomatic and not af because your hr is regular with your finger on your pulse but still feel like garbage and don’t want to ignore it because it’s creating pathways? I’m told to look for a P wave because a missing P wave suggests flutter. I suggested to PoetKim an option of paying for peace of mind since he doesn’t know how to read an ekg and look for P waves.

You're mingling your problems with PoetKim's problems. PoetKim doesn't have flutter and doesn't have to worry about distinguishing between the two. Let's focus on what she actually has going on rather than what's going on with you, and that's pretty simply uncomplicated AF.

That said, detecting flutter isn't a matter of missing P waves. Quite the opposite. The hallmark of flutter is extra P waves, which generally can't be seen with anything short of a 12-lead ECG, though the Kardia can sometimes see them if you use the lead II configuration (one electrode on left knee, other on right finger).

Well, if it's 99.9% certain that my periodic episodes of irregularly irregular pulse lasting 3-4 days are Afib and not ectopics, then I don't really need any device. And I don't particularly want a device that requires me to add wireless technology to my life in form of smart phone and/or wifi router in home, hence my interest in devices that didn't require wireless technology. But really, if it's virtually guaranteed that my arrhythmia (which is always irregularly irregular) is Afib, then I don't need a device.

However, at lest 2 people have responded here saying that they experience multi-day runs of ectopics alone, without afib. So I don't really see how we know I am not experiencing ectopics only.

Also, I think for first 5 years I may have been experiencing aflutter but not afib. And was diagnosed with aflutter in January (then afib later in May). The aflutter on ekg in hospital was not constant rapid rate. It was constantly jumping all over from 120-160 bpm. And it had always felt irregularly irregular for 5 years. And my aflutter had always been accompanied by chaotic and highly irregular banging around in my chest.

The afib that I seem to now have (since about March, but first diagnosed on EKG in May) is almost asymptomatic, which is why I rely on pulse oximeter each morning and throughout day to ensure my rhythm is still NSR.

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Carey
PoetKim doesn't have flutter and doesn't have to worry about distinguishing between the two. Let's focus on what she actually has going on rather than what's going on with you, and that's pretty simply uncomplicated AF.

I’m sorry. I thought multiple people including lurkers and those in this forum with a broad range of various arrhythmia issues may be interested instead of focusing a reply on one person’s AF speculation. Regarding the P wave or lack of one, a professional told me that AF and flutter are cousins and both cause fibrillation and lack a P wave, treatable with an ablation. Thanks for the info. I’ll correct this person the next time we have a visit. Sorry for posting incorrectly.

I was actually happy for your info susan, because I learned there are devices that don't require wireless equipment. and although i may not go out and buy a device at this point - i am glad to know there are devices I can buy that fit into my non-wireless lifestyle... even if they might not be as detailed as Kardia 6L.

Thank you Kim.

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PoetKim
Well, if it's 99.9% certain that my periodic episodes of irregularly irregular pulse lasting 3-4 days are Afib and not ectopics, then I don't really need any device. [...]

However, at lest 2 people have responded here saying that they experience multi-day runs of ectopics alone, without afib. So I don't really see how we know I am not experiencing ectopics only.

I agree you don't need a device, and I've said so. Where I think we're not communicating well here is that there's really no difference between sustained runs of ectopics and AF. That's exactly what AF is. You can only call it ectopics if there are breaks and the ectopics aren't continuous. If they're continuous, then that's AF and what you call it is just semantics.

Kim, I've been where you are, I've experienced multi-day (multi-week, actually) runs of ectopics that I didn't call AF, but my EP pointed out that it was an irrelevant distinction. They both come from the same malfunctioning atrial cells and the treatments are the same for both.

Let's talk about this offline, okay?

PoetKim, I agree with Carey about afib or runs of ectopics, because it's what I'm living with.
Afib is unmistakable, once you're used to the sensation under your fingers : irregularly irregular, as said.
My handheld ECG device is not to say if I've afib or ectopics. I'm used to that and I can say without a tracing if I'm in afib or if I'm just having ectopics. Bigeminal and trigeminal ectopics are unmistakable, as well as those appearing randomly. The most resembling to afib, as Carey explained, are runs of ectopics with short moments in NSR in between. It's what I'm used to name "unsustained afib". In my case, It usually doesn't last more than a couple minutes, then it turns to full afib or to NSR.
My handeld ECG device main purpose is the recording of some events I'll show later to my cardiologist and EP, which is crucial because those events nearly never happen while I'm in their office.

Are you sure about that? So afib is "sustained runs of ectopic beats"? I know "ectopics" is a blanket term...but I'm not sure a cardiologist would describe afib in this way or agree wiht this? I can get ectopics in "sessions"... they start instantly, last many hours or even days....and then instantly stop. I caught this "pattern" on a 1 week holter monitor....was almost no afib at all, but I had VERY LITTLE runs of consistent beats during it.

I'd have to see a recording of what you're describing, but I think the difference between constant ectopics and AF is the difference between VERY LITTLE runs of normal beats and none.

Does your recording look like this ?