Possible aFib

Getting a steady stream of “unclassified” and “possible aFib” readings today. BPMs up to about 80 from a norm of about 55. Generally feeling pretty normal. When the Kardia gives those descriptors is it more likely than not that it means one thing more than another such a pacs or pvcs? Took an extra Flecainide a few hours ago but still within dosage parameters for my weight. Don’t want to go to ER as I don’t think they would do anything. Thought I would wait it out until Monday and send Kardia strip to my EP. Anyway thats my plan unless things change. Sound OK?? I think there was a link for uploading a Kardia strip to the forum but have t been able to locate it. Not sure I could do it anyway. Am I on the right track or should I be doing more. Thanks.

A Kardia reporting "possible afib" means it's reporting what it has identified as afib. I don't think it ever gets more certain than that. Lawyers made them add the word "possible," not the doctors and engineers who built the product.

You're definitely right about not going to an ER, but you're wrong that they won't do anything. They'll do an ECG, see that it's afib, start an IV, put you on a diltiazem drip, and then park you in the corner and ignore you for hours, possibly all night. When the afib finally stops (at the same time it probably would have if you'd stayed home), they'll discharge you with instructions to see your cardiologist and send your insurance company a huge bill, which might be yours to pay if you haven't met your deductible. So yeah, they'll do something; it just won't be anything useful. In their defense, they'll do that because they know patients expect them to do something. But they also know you're at no risk of dying or suffering horrible consequences, and preventing that is really their only job, so you just won't be a priority. They have people who really are dying.

For everyone: There is almost never a reason to visit an ER with afib unless you're experiencing additional symptoms such as fainting, dizziness, chest pain/pressure, or your heart rate is extremely high (anything close to or higher than 200).

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Carey
A Kardia reporting "possible afib" means it's reporting what it has identified as afib. I don't think it ever gets more certain than that. Lawyers made them add the word "possible," not the doctors and engineers who built the product.

"Possible afib" is the terminology they use if you don't subscribe to their KardiaCare and KardiaCare Plus fee based memberships. If you do, they will report "Kardia Advanced Determination:Atrial Fibrillation." They say they use a different algorithm for Kardia Advanced Determination. Source

That being said, I don't think it is perfect. A friend with a Wolff Parkinson White (WPW) ablation sent me a number of Kardia ECGs a few days ago. She is a KardiaCare subscriber. One of hers was definitely afib with large irregularly irregular beat to beat interval times. The others weren't NSR but not afib either. With a subscription, they will provide an R to R Interval Plot (& weirdly formatted at that). On the others, the rate was high but the beat to beat variability was very regular, like a sawtooth on the graph. My friend does get strange WPW rhythms and these looked like that to me. She's going to send these over to her doc to see what he thinks. In my case, I'm grandfathered in to KardiaCare, since I've had one since 2014 & the afib determinations are pretty spot on (with both the original - non subscription or Advanced Determination algorithms), however flutter can be reported as NSR.

Unfortunately using the ED is an experience I think most patients have to learn on their own. After a few visits and doing some investigating, such as coming here, is when I realized I should ride it out at home rather than the ED. Most docs, for liability reasons, will not tell a patient not to go to the ED. In my case there was almost no patient education on how to handle Afib. I find the patient education part to afib is really lacking.

The other issue w the ED if you do go is the different approaches you encounter by the ED MD. I have had the suggestion of immediate CV to giving IV bolus and drip of Cardizem or Metoprolel. Some have kept me until conversion to NSR, one that after he got the rate below 100 discharged me while still in Afib, which I was ok with and then I went into NSR in the car 10 minutes after leaving. And another MD that I knew who was obviously annoyed w me for being there.



Edited 2 time(s). Last edit at 04/16/2023 10:10AM by JakeS.

My first round of afib started in 2001 and went for 11 years before a successful ablation. I documented over 200 episodes and only had one visit to an ER for a cardioversion. I always converted on my own in anywhere between a couple of hrs. to 72 hrs. (the longest). The ER visit was early on, and I learned it was not necessary.

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GeorgeN
That being said, I don't think it is perfect.

No, it's not perfect. I've had it give me an afib indication due to bigeminal PACs and also flutter with a variable rate. The variable rate flutter even fooled me. Looked just like afib but my EP pointed out the subtle clues. But for the most part I found Kardia to be very accurate. For most people if it says afib, it's afib.

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Mark
Getting a steady stream of “unclassified” and “possible aFib” readings today. BPMs up to about 80 from a norm of about 55. Generally feeling pretty normal. When the Kardia gives those descriptors is it more likely than not that it means one thing more than another such a pacs or pvcs? Took an extra Flecainide a few hours ago but still within dosage parameters for my weight. Don’t want to go to ER as I don’t think they would do anything. Thought I would wait it out until Monday and send Kardia strip to my EP. Anyway thats my plan unless things change. Sound OK?? I think there was a link for uploading a Kardia strip to the forum but have t been able to locate it. Not sure I could do it anyway. Am I on the right track or should I be doing more. Thanks.

Having taken that extra dose earlier, when it came time for my regular Flecainide dose, I crushed it and took it with a glass of warm water. I think I read on this forum ( don’t know who to give credit to) that by doing that it helps to get the meds into the system faster in a more concentrated form. . I think the OP mentioned that technique was particularly helpful when using it for PIP. Probably should have done that with my earlier extra dose. In any event, returned to NSR about an hour later. Maybe just the luck of the draw, maybe not. Thanks for reminding me that on the Kardia “possible aFib” means aFib. Think I knew that but forgot. Interesting comments about the ER. I’m kinda curious now what would have happened if I had trudged over there. Thanks for the help.

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Mark
I’m kinda curious now what would have happened if I had trudged over there.

Six hours of boredom lying in an ED with an IV in your arm.

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Mark
Having taken that extra dose earlier, when it came time for my regular Flecainide dose, I crushed it and took it with a glass of warm water. I think I read on this forum ( don’t know who to give credit to) that by doing that it helps to get the meds into the system faster in a more concentrated form. . I think the OP mentioned that technique was particularly helpful when using it for PIP.

Yes, this is a good plan. For many years I've chewed any PIP flec doses for just the reason you state.

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Ken
My first round of afib started in 2001 and went for 11 years before a successful ablation. I documented over 200 episodes and only had one visit to an ER for a cardioversion. I always converted on my own in anywhere between a couple of hrs. to 72 hrs. (the longest). The ER visit was early on, and I learned it was not necessary.

Ken, when you say you always converted on your own, do you mean you did it without medication?

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Carey

I’m kinda curious now what would have happened if I had trudged over there.

Six hours of boredom lying in an ED with an IV in your arm.

At least you were laying down. My past two in CA I only had a chair. I’ve been to the ER recently (non Afib) two-three weeks ago by ambulance just to get a gurney. Walk in’s only got a chair. Laid there in the hallway for 3 days until I self discharged myself because I was hungry after 3 days and being gluten and dairy free, I was given the choice of staying and getting treated but no food or self discharge and eat at home. Unfortunately I had nobody who visited with food. Patients were allowed to take the elevator to the plaza level where there were restaurants and a market but I was too sick to leave my gurney to buy water or a banana. Still waiting for a follow up dr appointment because I’m not better. Still laying around weak but at least I’m eating.

And this was not an isolated event. Once at Cedar Sinai they had nothing to feed me because CatScan iodine was listed as an allergy so the kitchen didn’t offer food because all cooked food contained iodinated salt. But before with >150hr I thought it was necessary to visit the ER to be treated with a drip. My hr doesn’t get that high anymore. I think if one has problematic symptoms and super high flutter for days then it’s understandable to go to the ER. Best of luck.

I cured myself from ever considering going to the ER again.

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Yuxi

My first round of afib started in 2001 and went for 11 years before a successful ablation. I documented over 200 episodes and only had one visit to an ER for a cardioversion. I always converted on my own in anywhere between a couple of hrs. to 72 hrs. (the longest). The ER visit was early on, and I learned it was not necessary.

Ken, when you say you always converted on your own, do you mean you did it without medication?

The first 5 years was a misdiagnosis (mitral valve prolapse causing an irregular heartbeat) and I did convert without meds. Then caught on an ECG and I went on meds, but still converted much like I did without meds for the next 6 years.

Susan, Hope you are feeling better.

I think it’s wise to go to the ER if you feel unsure. You can always get up and leave after they have checked you out. I’ve lost a couple of friends who decided not to go, and while I don’t always go myself, I have been living with it (AF) for decades so am fairly astute about when I need to. That said, I have passed out when I thought I was fine.
Just be aware of how you feel in general. We only get one shot at this life so take good care of it

Along with a lowered quality of life and the psychological effects that can effect one’s sense of well-being, AFib puts people at an increased risk for stroke, which can be both deadly and costly. Medicare alone is estimated to pay . 7 billion per year to treat newly diagnosed atrial fibrillation patients. Stroke is the 5th leading cause of death in the U.S. and kills more than 129,000 people each year.

We each tolerate the uncertainty and 'bother' of AF differently. As some of you are aware, I'm a timid one who needs hand-holding when my AF lasts more than an hour or more. I have learned about my timidity, and that I'm every bit as likely to self-convert, which is my history, at home as I am lying on a gurney and having strangers walk past me wondering if their day is going better'n mine.

But, I have pointedly asked my nurses several times if I am imposing an unreasonable burden on them after they have performed all their investigations and received a physician's final instructions. They have all emphatically assured me that I must go to the ER when my AF seems like it wants to run on and on, especially if the lower limit to the AF runs in the 120 range and higher, which mine does.

We get to know ourselves best when we are in adversity. Others learn more about us at the same times. The secret is to profit from what we learn, as I have done here and through self-education, and try to find an acceptable balance in anxiety, uncertainty, empirical knowledge, and the capacity of the systems upon which we rely to stay healthy.