Ambulatory BP monitor

First of all I have been usually diagnosed as having White Coat Syndrone when I get my BP checked at the Doctors as my Systolic is usually on the high side. When I take it at home I get low readings and sometimes its higher. So my cardio wants me to get a 24 hr ambulatory BP monitor and has scheduled me to get this done in about a week. I got a "after visit Summary" paper and on it I read that a 24 hr BP monitoring cannot be performed on patients with Atrial Fib. because the monitor has a difficult time taking the BP if the pulse is irregular.

I sent a message to my doc. in my Portal and have not received a reply as yet , appt. is towards the end of next week, so I need to know if I should do this, it is a long drive to the facility to get this done. So anybody have you got any answers for me? Oh, I don't take any BP meds and have never taken any.

Liz

My Life Scource UA-767 is not a 24 hour machine, it's a 'desktop'. But it's also over ten years old. It can record BP and pulse at the same time. I have used it to confirm my Galaxy Watch's HR, which it usually matches. It always...but ALWAYS...records a BP, even when I am in AF.

Still, what the Summary paper indicates might be the case for the device they're contemplating giving you.

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Elizabeth
I got a "after visit Summary" paper and on it I read that a 24 hr BP monitoring cannot be performed on patients with Atrial Fib. because the monitor has a difficult time taking the BP if the pulse is irregular.

Liz, what I've noticed is that in afib, the amplitude of the pulse wave as well as the beat to beat timing are irregular in afib. I'm guessing the pulse wave amplitude may be the issue. I've noticed that the amplitude can be quite low on some beats. If I use a device that shows pulse wave, this irregularity is very visually apparent. I can also feel it when taking my pulse at my wrist with my fingers. Since you are in afib 24x7 and your rate is < 100 BPM, maybe this amplitude variability is lower. You could try feeling your pulse with your fingers and see how much pulse wave variability there is.

George:

When you say Pulse wave variability do you mean the pauses between some of the beats? So this 24 hr. BP monitoring isn't really too accurate? Then what about if my BP is taken in the doctors office is that accurate?

Liz

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Elizabeth
When you say Pulse wave variability do you mean the pauses between some of the beats? So this 24 hr. BP monitoring isn't really too accurate? Then what about if my BP is taken in the doctors office is that accurate?

Below is a graph of pulse waves in afib & NSR from this paper. As your ventricles contract, it pushes blood through your blood vessels. When you feel your pulse you can feel these peaks with each beat. These peaks are sampled for the systolic blood pressure. In afib the "height" of these peaks is variable. Though you don't feel them, the depth of the troughs are sampled for the diastolic blood pressure. I can't answer how accurate the BP would be in afib. I'm guessing if it is taken manually, the person taking the reading could possibly adjust their technique for someone in afib. This is not something I have experience with. I discovered my first ever afib episode while taking my BP manually over 18.75 years ago.. It sounded very unusual, though, as I recall it was normal. Since then, I haven't taken my BP during afib.

If you feel the pulse of someone in NSR, the height or amplitude of these peaks will feel the same. In my experience, in afib, some of the peaks are very hard to feel as they are so small, others are very strong.

Thanks George, I am doubtful now after reading that an Ambulatory BP monitor would be completely accurate. I am taking my BP at home, it isn't the same all the time, sometimes a little high and sometimes in a good range, so the one time my BP is taken at the doctors office could be high and they go by that.

Liz