Apple Watch ECG and pulse

I was going to write out my history and why I am asking but I'll keep it simple ...(I did search the group and read a few other posts).

does the Apple Watch do real time monitoring (can you back up and see what it was 30 seconds ago) or is it like the Kardia where you say "record now"? (I have the 6 lead Kardia).

Has anyone done match ups to real ECGs with heart rate specifically? My fitbit is a bit of a joke. It does do trends.

Is it just one point like the lower level Kardia? ( I assume b/c it is just on the wrist). Or is there somehow they are turning it into a 6 lead?

Any other cool reasons I need an Apple Watch?? LOL. I am looking for excuses!!!

It will record in real time, but what it won't do is diagnose afib if the rate is over 120. And Apple support won't assist you with anything if you tell them you've been diagnosed with afib.

Forget all the sports-type monitors (Fitbit, Garmin, Polar chest straps, etc). Not a single one of them I've ever tried could accurately count a heart rate during afib.

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Carey


Forget all the sports-type monitors (Fitbit, Garmin, Polar chest straps, etc). Not a single one of them I've ever tried could accurately count a heart rate during afib.

I have used everyone them also and totally agree!

Well booooooo I want to justify getting one LOL!! Guess I will have to think of other reasons.

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Carey
Forget all the sports-type monitors (Fitbit, Garmin, Polar chest straps, etc). Not a single one of them I've ever tried could accurately count a heart rate during afib.

I've used Polar R to R recording monitors (meaning beat to beat & almost all are not) for ~16 years for afib. The real time display is averaged over 5 or so beats, so gives a good average, but does not display the complete variability. When you record the data, upload it and examine in software, you can see everything & the Polar straps are spot on. In the last 8 or so years, I've used the Heart Rate Variability Logger app. It reads the Polar strap and will also upload the R to R data for examination. Again, the real time display is averaged. The app was built for university researchers, so is excellent & the beat rate from the strap is ECG quality (but can't read it like an ECG). On the full R to R data after the fact, I can see PAC's PVC's, afib & flutter. It is a techy solution and I would not recommend for someone who isn't comfortable in that world. An example from ~15 years ago that is stored on our site is here: [www.afibbers.org] Many different kinds of rhythms (from one person) in this file.

Even looking at the averaged real time Polar data, I can pick out afib when it starts and when it converts to NSR. I will confirm with Kardia, but have yet to be wrong.

Sure, R-R variability monitors can approximate some sort of afib detector, especially for techies like you who invest the time needed to learn to interpret them, but that's old technology that's been completely replaced at this point, and the average person here isn't into doing the analyses you like to do.

You can buy a true ECG that can actually detect afib accurately and show you a waveform recording for (reportedly) under $50 on eBay. At this point in time I see no reasonable alternatives to the Kardia if you want accurate afib detection and recording, or Apple Watch, if you want real time recording that probably won't tell you if it detects afib because afib is usually over 120 bpm, but it's convenient.

I think there's a good reason why docs will accept Kardia recordings these days but not much of anything else.

My cheap oximeter displays accurate AVG HR while in afib. Tested against my EKG monitor.
But, of course, it does not record anything.
I keep it close to me while in bed. Very convenient to count the beats in the dark if I want to.

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Pompon
My cheap oximeter displays accurate AVG HR while in afib. Tested against my EKG monitor.

That is excellent.

I've got a couple recording and non recording oximeters. Mine generally fail on counting beats as the rate gets higher. At rates <100, they are pretty good, above that, they miss a lot of beats. I notice this on plethysmograph phone apps, too (using the light and camera). The variability in the pulse wave amplitude seems to be the issue. I think this true when trying to count a radial pulse, too. Some of the very low amplitude beats are hard to feel (or be "seen" by the oximeter or plethysmograph).

Interesting.
I don't see great amplitude variations in my tracings while in afib, despite feeling stronger and weaker beats.. That's maybe why my oximeter counts the beats reliably?

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Pompon
Interesting.
I don't see great amplitude variations in my tracings while in afib, despite feeling stronger and weaker beats.. That's maybe why my oximeter counts the beats reliably?

Here is an example from 14 Jan 21. I converted an afib episode with a breath hold.

The green line is the oximeter heart rate. Blue is from a Polar H10 strap captured with the Heart Rate Variability Logger app. Red is SpO2 from the recording oximeter.

Note that when the afib rate is high on the left side, the oximeter heart rate is about 82 and the actual HR is averaging ~150 (from visual inspection). As the afib HR drops, the oximeter heart rate increases to a more real rate.

The oximeter rate is smoothed as the device records every four seconds, as opposed to the Polar, which records every beat.





Edited 2 time(s). Last edit at 07/19/2021 03:28PM by GeorgeN.

Thanks, George.
Today, after meal, as I had PACs (it's frequent for me), I took a tracing with my EKG monitor. It said 80BPM (there were 20 normal beats and 20 PACs - bigeminal pattern - on the 30s recording).
My oximeter said 42. I don't know how many seconds it takes into account, but it should be around 5. Obviously, the oximeter only counts the normal beats in this situation.
But while in afib, all beats are like PACs, so it counts accurately. As you wrote, it's obviously a matter of variation in current.

thanks for all the info George and PomPon... I think we do have an older tech polar or something like that around here. It seems. I have been using the pulse ox today.. and the battery is almost gone LOL. I have only had it like 6 months.

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Carey
Sure, R-R variability monitors can approximate some sort of afib detector, especially for techies like you who invest the time needed to learn to interpret them, but that's old technology that's been completely replaced at this point, and the average person here isn't into doing the analyses you like to do.

You can buy a true ECG that can actually detect afib accurately and show you a waveform recording for (reportedly) under $50 on eBay. At this point in time I see no reasonable alternatives to the Kardia if you want accurate afib detection and recording, or Apple Watch, if you want real time recording that probably won't tell you if it detects afib because afib is usually over 120 bpm, but it's convenient.

I think there's a good reason why docs will accept Kardia recordings these days but not much of anything else.

Carey, just saw this. I have a Kardia, too (and have had one since about 2014). Both the Kardia and the Polar RR data have their uses, IMO. The Kardia will take a 30 second reading, that I think can be extended to 5 minutes. It answers the am I in afib question nicely. The Polar, especially with the Heart Rate Variability Logger app I use, can record almost indefinitely. I use it to see how my heart responds to many different situations. For example the with & without mouth tape during sleep I posted. If I'm in afib, I use it when I'm trying different things to accelerate conversion during afib, including breath holds. But I've also done head stands and successfully converted after. I've also held myself inverted with my DIY gymnastic rings & watched what my afib rate did. . I've done 60 or so hyperventilation breaths & then done pushups during an exhaled breath hold. I've done fast walking and jumping rope as long as I can stand it during exhaled breath holds. I've pushed my heart rate to 220 and then dropped it during some of these exercises. I don't think these experiments are appropriate for all, so I don't write about them. I'm very fit and take no other meds except PIP flec. I have great BP (many evenings 100/60) and weigh what I did in Grade 10, now at age 66. I think the Polar is a great tool for both immediate real time feedback as well as later analysis, but not for a non technical user I also do not think many of my experiments are appropriate for many afibbers. Not all of these attempts have converted me, but many will change the rhythm, say from flutter back to afib. I can also get my rate down into the 70's or 80's, where I will convert, at times.



Edited 1 time(s). Last edit at 07/22/2021 09:22AM by GeorgeN.

Oh, don't get me wrong. I think some of the stuff you do is fascinating, but I agree it's not the thing for most people here. You're an analyst by nature, I think, and you dig doing all these experiments and stuff. But most people aren't willing to go as far, and probably don't have the tech knowledge you do. Hell, even my eyes glaze over sometimes when I'm reading your experiments and analyses.

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Carey
You're an analyst by nature, I think, and you dig doing all these experiments and stuff.

This is certainly true. I've made a career of analyzing things for people. I look at afib, as well as my genetic risk for Alzheimer's as challenges to be solved.

I know that many say that they see no trends in triggers for afib. I can empathize as I experience the same when my electrolytes are not balanced, which can and does happen. When they are balanced, then the triggers are much easier to see. The Polar has been an invaluable tool to get feedback. Sort of a poor man's Holter. In some regards, much better. Years ago, I borrowed a Holter from a friend here for a while. Having all the pads on was a pain. As well, analyzing hours and days of ECG data was very time consuming. I can look at 8 hours of Polar data in a few minutes. Early on, I constructed a DIY ECG device. I ran it in parallel with the Polar to make sure of what I was seeing in the tachogram data (heart rate vs. time). It was how I learned that the Polar did not "see" the malformed PVC beats, which were reported by the Polar as half speed beats. When I started trying to construct my afib remission program, there were hints as to what might work, but certainly no roadmap. I would use the Polar during meditation to minimize artifact and count PVC's and PAC's/hour. I used this as a heart "happiness" gauge. PVC's don't initiate afib, but I figured their existence was an indication of some kind of electrolyte imbalance. I would test various agents at different levels to minimize the ectopics. As mentioned above, having real time feedback when in afib was also crucial in seeing whether what I was trying was having an impact.

In this graph of just the Polar data from the episode above, clearly the character of the heart rate pattern changes when I initiate the exhale breath hold. Unfortunately, I can't see this display format in real time, only after I download the data. However I can see the heart rate level drop as well as the variability get smaller. This tells me I'm on the right track.

You don't need an excuse to get one, or justify it. My hub has the Galaxy 3.. it's invaluable. It's a tool that helps you learn you! So quit making up excuses to not buy one :-P

I appreciate GN's posts.. I learn from them. Electrolytes, keep them up. Pay attention to the small signals.

Keep posting.

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unangan
You don't need an excuse to get one, or justify it. My hub has the Galaxy 3.. it's invaluable. It's a tool that helps you learn you! So quit making up excuses to not buy one :-P

I appreciate GN's posts.. I learn from them. Electrolytes, keep them up. Pay attention to the small signals.

Keep posting.

I like your way of thinking. LOL. I think I will try to go to Costo- you get an extra year of warranty that way.. just see how it goes

George- continue sharing your experiments. I, along with others appreciate your contributions. Thank you!

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unangan
I appreciate GN's posts.. I learn from them. Electrolytes, keep them up. Pay attention to the small signals.

Keep posting.

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susan.d
George- continue sharing your experiments. I, along with others appreciate your contributions. Thank you!

Thanks for the feedback!

I get a fair number of PM's from people who rarely or never post who appreciate my posts and have gotten benefit from them.

Sooo, did you get the watch? :-)

George, I bet you do! That reminds me, I keep looking into mineral waters.... off to search. (Remember you commenting on something-Adobe spring- or something.

I like my IWatch for hr. I’m at cardiac rehab and the hr monitor is spot on with the holter monitor I wear during exercise. The O2 function is Jack. Worthless isn’t a strong enough word. It can work (rarely accurate with my oximeter) and then the next 10 times day it can’t get a reading at all-just an error. Google. Lots of similar complaints. I even called up Apple. They agree.