PACs or Afib? Calling all EKG experts lol

As you know, lately my PACs have been back with a vengeance, less than a yr post my Natale ablation.

My Kardia most of the times calls them Supra Ventricular Ectopies, or Unclassified, however occasionally calls them Afib, like that attached example from a few mins ago.

While the RR plot and EKG clearly show relatively "organized" PAC pattern, I do notice that for the most part my P wave is either very tiny, or at times non-existent, which I assume is what's causing Kardia to call it Afib.

So, which one is it....are these PACs with tiny P waves, or actual Afib? Thanks in advance!

The RR plot certainly does not look like afib. Looks like PAC's to me.

Pompon has some posts on ways to hold your Kardia (or other single lead device) to get better traces of p waves. See: [www.afibbers.org]

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GeorgeN
The RR plot certainly does not look like afib. Looks like PAC's to me.

Pompon has some posts on ways to hold your Kardia (or other single lead device) to get better traces of p waves. See: [www.afibbers.org]

Thank you very much for the link!

I want to see AF, but the double beats with long pauses on either side suggests bigeminy to me.

I can see a few P waves and if you ignore the PACs it's fairly regular, so PACs.

Looks like PACs, but I would try another tracing to get a better P wave.

Thanks everyone!

I wonder why is Kardia calling them Afib? You would think their algorithm would use the RR plot to distinguish between PACs and Afib. The RR plot for Afib is all over the place and easy to pinpoint, compared the RR plot for PACs.

[litfl.com]

An improved resolution might show the misshapen P wave on the OP's example.



Edited 1 time(s). Last edit at 05/28/2024 07:29PM by gloaming.

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WhyMe
Thanks everyone!

I wonder why is Kardia calling them Afib? You would think their algorithm would use the RR plot to distinguish between PACs and Afib. The RR plot for Afib is all over the place and easy to pinpoint, compared the RR plot for PACs.

I think it is a pretty simple algorithm, just looking at variability, not the variability of the variability (second derivative). I've been looking at RR plots for nearly 20 years (and continue to use them as can easily get and quickly interpret many hours worth of data from recording RR heart rate data). Sometimes I'll get a lot of PACs around what looks like a flutter/tachy baseline (high rate) during an episode. It could easily be interpreted as afib, but my eyes will pick out the consistent baseline.



Edited 1 time(s). Last edit at 05/28/2024 08:18PM by GeorgeN.

Thank you!