zio patch report interpretation 4 months after ablation

I'm 4 months past my ablation with Dr Bode at Texas Cardiac Arrhythmia Institute in which 77 pulse field ablation lesions were delivered for paroxysmal afib.

The zio heart monitor I just wore for 8 days did not find any afib, pauses, or ventricular tachycardia but did find 19 SVTs with the fastest interval lasting 5 beats and the longest lasting 14 seconds. Junctional Rhythm was present.

Isolated SVEs were rare (<1.0%, 28 events), Isolated SVE Couplets were rare (<1.0%, 248), VE couplets were rare (<0.1%, 1), and no VE Triplets were present.

I don't have my followup with the EP for a few weeks because of travel and I'm glad that there was no afib but am not sure about the other events. Periodically I feel some arrhythmias but the kardia shows NSR or unclassified. When I send the unclassified ones to the afib nurse he says they are benign. My wellue monitor picked up atrial flutter for 4 seconds one time but it may have been a noisy signal.

I understand that only the doctor should provide a diagnosis but if anyone has thoughts on the burden of these arrhythmias I'd appreciate it. I'm not worried at the moment and am continuing to take eliquis. This forum is really helpful.

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Ablation performed Sep 2024 by Dr Bode at Texas Cardiac Arrhythmia. Grateful for my care team and the afibbers community for helping me through this journey

That's a pretty clean bill of health you got from the Zio, my friend. Those little brief runs of ectopics are pretty common and usually aren't really meaningful. I think your followup with the EP will be a positive one.

Thank you Carey. That's reassuring and I am optimistic while I wait for my EP appointment.

I see posts mentioning needing another ablation several years after having a successful one. Would you say it's common for afib to re-occur later?

I won't ignore symptoms and will continue checking with my kardia.

My mother saw the Zio report and thinks I might need another ablation and to go back on beta blockers. She's a worry wart though.

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Ablation performed Sep 2024 by Dr Bode at Texas Cardiac Arrhythmia. Grateful for my care team and the afibbers community for helping me through this journey

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rayfes
I see posts mentioning needing another ablation several years after having a successful one. Would you say it's common for afib to re-occur later?

Years later? No, that's no common. It happens on occasion because afib is a progressive disease and new sources of afib outside the isolated area can develop later, but for most people once you're at the 1-year point and you're still in normal rhythm, that's it.

I didn't see any reason to think you need another ablation or that you need to go on beta blockers.

I would look at this as benign and as normal variation...typical for a healthy heart. As far as I know, the newest thinking about 'burden' is that anything above 3%, especially for PACs and AF, are cause for intervention. Three percent seems to be the demarcation point beyond which morbidity rises sharply.

You're many times below that.

Thank you for the responses especially the 3% burden threshold. I thought I was doing well and decided to celebrate with some alcohol last night. I wore my personal wellue continuous heart monitor overnight and it showed:

Total Number of Heartbeats (beats): 10853 (2h33m)
Percentage of Atrial Flutter and Atrial Fibrillation: 9.79

Supraventricular Rhythm
Total Number of Supraventricular Heart Beats: 123
Number of PAC: 69
Couplet of PAC: 5
Supraventricular Bigeminy (Paroxysmal): 0
Supraventricular Trigeminy (Paroxysmal): 3
Supraventricular Tachycardia: 10
Maximum Duration of Supraventricular Tachycardia(s): 4.00
The Longest Time of Supraventricular Tachycardia Happened: 04:15:21

Ventricular Rhythm
Total Number of Ventricular Heart Beats: 76
Number of PVC: 67
Couplet of PVC: 0
Ventricular Bigeminy(Paroxysmal): 0
Ventricular Trigeminy(Paroxysmal): 2
Ventricular Tachycardia: 1
Maximum Duration of Ventricular Tachycardia (s): 5.00

Conclusion:
1.Normal sinus rhythm
2.Atrial fibrillation
3.Atrial flutter
4.Premature Supraventricular Contraction (PAC)
5.Counplet of PAC
6.PAC trigeminy
7.Supraventricular tachycardia
8.Premature Ventricular Contraction (PVC)
9.PVC trigeminy
10.Ventricular tachycardia

So much for thinking I was in the clear. I sent this to my EP and have my appointment in a few weeks. I'm fine with not drinking but drank 2 nights when I had the Zio a few weeks ago and I didn't have all of this happen those nights when I was wearing it. In fact I drank more those 2 nights than I did last night.

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Ablation performed Sep 2024 by Dr Bode at Texas Cardiac Arrhythmia. Grateful for my care team and the afibbers community for helping me through this journey

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rayfes
Total Number of Ventricular Heart Beats: 76

Over a span of 2.5 hours? I think not. What is that thing actually reporting?

My apologies Carey but I don't know enough to question why 76 total ventricular heart beats is implausible. Perhaps it means I had 76 of those irregular heartbeats out of the 10853 total?

I sent the full report to the afib nurse and he said, "This resembles premature atrial contractions" and that the EP will review everything with me in a few weeks so I suppose they think this isn't something that requires a change right now (I'm not taking a beta blocker but am on eliquis).

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Ablation performed Sep 2024 by Dr Bode at Texas Cardiac Arrhythmia. Grateful for my care team and the afibbers community for helping me through this journey

It's not your lack of understanding. It's just terrible reporting from the device.

The report says it recorded "Total Number of Heartbeats (beats): 10853 (2h33m)". Okay, so that's a heart rate of about 70 bpm. Perfectly normal.

But then it says "Total Number of Ventricular Heart Beats: 76". Huh? 76 heart beats in 2.5 hours is less than 1 per minute, which is dead.

So they can't possibly mean the same thing even though they use the same language. I guess what they really meant is there were 76 abnormal ventricular beats.

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Carey
So they can't possibly mean the same thing even though they use the same language. I guess what they really meant is there were 76 abnormal ventricular beats.

Same is true for "Total Number of Supraventricular Heart Beats"

I've used a Welluse SpO2 ring for years. Their tech is good, but made and designed in China. There can be language issues.

The "Percentage of Atrial Flutter and Atrial Fibrillation: 9.79" also looks very suspect. There were 123 abnormal supraventricular heart beats. That is 123/10853 or 1.1%

rayfes, if you want, I can PM you my email address & I'll can look at the full report & see I can interpret more fully (also include the PDF manual or a link to it, if you have it).

Thank you so much! I'll PM you GeorgeN

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Ablation performed Sep 2024 by Dr Bode at Texas Cardiac Arrhythmia. Grateful for my care team and the afibbers community for helping me through this journey