Post Ablation tracking device recommendations?

Hi all,

I'm new to the forum and so grateful to find it! I'm one month post PVI ablation. I'm 65, active and I moved to Portugal a couple of years ago. What I didn't realize was that afib was also developing....in looking back, I can see there were brief, earlier episodes, and increasing difficulty living at altitude in New Mexico that I just took for age. At that point, I was already underway with my relocation and it wasn't until I experienced an increasing number of more intense episodes last fall that I took it seriously. One walks alot in Europe, and the episodes were really cutting into my quality of life. My Dr here has a very good reputation and my ablation went well, though it's taking longer to bounce back than I'd expected. I'm looking at self care and ways I can self monitor going forward, and I'd like your opinions on wearable tracking devices - I've considered smart watches and Oura rings, etc - I've also seen a Kardia device mentioned as well. Thanks for your help! Cindy

They are all adequate for what you need them to do, but some or all of the smartwatches need to be set to continuously monitor your heart, and this means heavy demand on the battery. You might need to recharge your watch twice a day! I wear two Galaxy watches in rotation, a Galaxy 4 and a newer Galaxy 6. They also can tell me what my blood pressure is, my O2 sat during sleep, etc. But you have to get the app on your phone to 'see' the results for each night. The watches will do an ECG and also do a detection of AF, but in my case, since I don't want to have to watch the battery all day long, I only do it on demand.
I have heard good things about WellU or whatever the name actually is, and about the Oura. Kardia has a solid reputation, but you'd need to carry it with you...it's not a continuous monitor either.

If you could stand some advice? Get a Kardia, but leave it at home. You do NOT want to be fretting all the time, second guessing your electrophysiologist or your own heart. Yes, I understand that this has all been a rather unpleasant and scary interlude in your life, but AF is not lethal, and you have two+ months of blanking yet. I would only focus on my rhythm if I could feel it, either through the neck or wrist, or in my chest wall due to the normal sensations of ectopy. If you feel fine, if drained still, learn to love that newfound calm that you'll sometimes feel during the day. IOW, I think you'll know instinctively, having lived through months of AF, when you go back into it or experience PACs. Wait for the Holter and deal with the outfall then.

Thanks so much for this - very reassuring. I will just try to be patient, and I'm so grateful for how quickly my afib was diagnosed and treated. My phone is a Galaxy, so the Galaxy watch may be the way to go, as measuring my sleep quality is also important to me going forward. My afib tended to occur at night or early in the morning, and alot was going on that I wasn't aware of...it's amazing to fall asleep without a bongo drum in my chest, and wake feeling rested!

From experience, I can tell you that Oura won't do a good job of picking up afib. Generally Oura won't report heart rate during afib. I also have a Wellue SpO2 ring that records heart rate every 4 seconds (Gloaming also mentioned Wellue, but in reference to a device that will measure ECG overnight). The ring with recording every 4 seconds mutes the rate increase during afib, because it is averaging the beats during the 4 seconds. The Kardia is good, but only for answering the question, "am I in afib now." Not for overnight monitoring.

With Gloaming's Galaxy watch suggestion, I assume it will measure heart rate variability (HRV) overnight. Once you get a good idea what is normal for you, you could use that to decide whether to turn on afib detection. If HRV is abnormally high, it could be a lot of ectopic beats and/or afib & afib detection the next night might make sense.

Thank you, this is so helpful! An Oura that didn't capture what I need to know would have been very frustrating and expensive!

Yes, the Galaxy measures HRV. There are two apps I use, both speaking to each other. The watch needs the 'Wear' app to adjust the watch, update it, change watch faces (you should spend 10 minutes some time and look through all the free and paid-for watch faces....astounding some of them!). So, there's 'Wear', and then the phone already comes with the Samsung 'Health' app which has been dreadfully slow to advance its utility. It deserves the current 3.8 rating IMO. But, it serves me well enough. When you sleep at night, your watch does all the right things, and then you tap on 'Health' and scroll down through the 'Wellness' section which lists HRV, avg HR, and SO2. Then the sleep section to get a breakdown of your stages of sleep and how much total time in each, with a percentage breakdown as well.

I don't know if you've ever been assessed for sleep apnea....? If not, get checked asap. My own AF came on after years of undetected OSA (obstructive sleep apnea). In fact, the diagnosis was 'severe' OSA. Almost brought me to me knees!

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gloaming
I don't know if you've ever been assessed for sleep apnea....? If not, get checked asap. My own AF came on after years of undetected OSA (obstructive sleep apnea). In fact, the diagnosis was 'severe' OSA. Almost brought me to me knees!

For some with mild to moderate sleep apnea, mouth taping at night, to encourage nasal breathing can solve sleep apnea. I've taped for something like 10 years and it did for me. Here is a post on the topic where I post images of heart rate data with and without taping. Without, the patterns are those of sleep apnea:
[www.afibbers.org]

This post goes into a bit more detail as to why CO2 is important (taping will generally increase CO2 tolerance and allow greater serum CO2).
[www.afibbers.org]

George

I have heard about this, a relatively new finding I think (last year or so that it was published). I would encourage people to try it as it may suffice. The key, though, is to be darned good 'n sure you are accurately measuring SO2 during sleep, plus HR, to see if there are coincident rises in CO2 and, after a short lag, HR. If there is a strong association, with the tape, then maybe the person needs a machine.

I think I have mentioned that I do tape, but not alone. I tape because without the barrier across my slack lips, the pressurized air just escapes through the path of least resistance, and those are my slack lips. So tape I must. My treated pressure, despite the 'severe' diagnosis, is a mild 8.5 cm H2O, but it's enough to blow out my mouth, and for those who are mouth breathers, that's a no-no. The resultant dry-mouth is very bad for oral health. Very.

Thanks for the links, George. I'll remind myself with them.

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gloaming
If there is a strong association, with the tape, then maybe the person needs a machine.

A personal friend, a 20+ year afibber and very fit, uses a CPAP. He gets a lot of data from his machine. After we talked about taping & he implemented it, he said he saw very material improvements in the metrics he tracks from the machine.

I do track SpO2. Also, with all the hypoxic training I do (I have a setup that will provide me with either 7.5% or 80% O2 during HIIT exercise and I can switch instantaneously between the settings) as well as high CO2 training (I do a lot of exercises with exhale breath holds that increase CO2 tolerance as well as with rebreather devices and devices that will mix CO2 from a tank into room air for breathing through a mask). I live at elevation, so SpO2 is naturally somewhat lower and will drop even further when I sleep at higher elevations, like 8000'/2400m or 10,500'/3200m. At sea level, I'm at 98% SpO2 all night. As I spend a lot of time training at much lower SpO2, a few minutes during the night below 90% doesn't bother me.

Yes, to answer your question on sleep apnea testing, my Dr here tested me and I was found not to have it. Thank you both GeorgeN and Gloaming for the detail in your replies, I will look more closely at my results (I had been tested long ago in the US, no apnea) because I do sometimes wake "dry mouthed". Thanks for the link!

I'll also pay attention to the type of watch face I get, Gloaming. I can't wait to be able to train again, this fatigue has been unexpected but I know part of it is the amiodarone - I can't tolerate beta blockers, so I'm not sure anything else will be an improvement.

Cindy, I forgot that there's a third app that works hand-in-hand with 'Health'. It has a ruddy orangey red disk with a yellow heart's graphic beat squiggle through it. You must use that app to take both BP and ECG, but also to calibrate the Galaxy's BP assessment every 28 days. Or so the agreement was in Canada for it to be authorized and enabled as a function. (Why it couldn't have been done on the first of every month is beyond me. At 28 days it comes up unexpectedly unless one marks it all out for the year with a reminder via their phone's calendar).

To summarize, the Galaxy will require you to download both the Wear and the ECG app. Health will already be loaded. The ECG app will take your BP and ECG on demand, and it will record your ECG continuously if you set it to do that. It is heavy on the battery if you do. The watch also records SPO2 as you sleep and will give you a graphic representation over the duration of your sleep when you look in the Health app. That app will also give you a breakdown of your stages of sleep and your percentage of time in each. It will also give you a depiction of your HRV in the night's summary stats, plus a graphic depiction of it over time. Similarly, your HR over time as you slept. It's quite useful.

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gloaming
I wear two Galaxy watches in rotation, a Galaxy 4 and a newer Galaxy 6. They also can tell me what my blood pressure is, my O2 sat during sleep, etc. But you have to get the app on your phone to 'see' the results for each night. The watches will do an ECG and also do a detection of AF, but in my case, since I don't want to have to watch the battery all day long, I only do it on demand. .

Hi Gloaming, do you know how often the galaxy 6 looks for Afib?

I have the apple watch but it has never notified me that I was in Afib.

I'm looking for something that continuously monitors and will alert me, if possible.

The Galaxy 4 had to receive a firmware update after some department in Canada approved the function. From then on, I must direct it to perform an ECG, so it's only on demand for me. I just refreshed my memory; I forgot that you must complete a circuit by touching the master button on the side of the watch body. I haven't taken an ECG for many months, so I got rusty. But you can scroll through the app section on the watch face, tap the tile/icon for Heart Monitor, and then select from BP or ECG. From there, when you activate the ECG function, you must immediately place the tip of a finger against the master button and sit very still so as not to move the watch and change its attitude against the skin on the back of the wrist. So, seated with arms supported would be the way to go. Not in a moving vehicle, not in a small watercraft on a choppy lake, aircraft should be fine.

Ahh ok thanks. That's the same as an apple watch.

I have a Wellue 24-hour heart rate monitor that I’ve found to be very useful. You can wear it on your chest with stick-on electrodes or on a chest strap (which I prefer). It records a 1-lead ECG, which you can upload to their AI for interpretation. The AI is not perfect, and can interpret SVT as AF, or undercount SVTs. With their older models, you download the data to a computer via USB. I think their newer models allow you to view your ecg on your phone. Disclaimer: Wellue monitors are not FDA approved and their website will tell you that the monitor is not a medical device. Still, until a better option for recording comes on the consumer market, I’ve found it to be very helpful in catching brief arrythmias that my Apple Watch misses. If you do decide to get one, I would also suggest treating it gently. The usb cable clip breaks easily, and the snaps on the device can detach too. The customer support has been good, but bear in mind that they are a Chinese company, so there may be a language issue.

Thanks, I'll look into this Nancy!

I've been using straps for tracking PACs, PVCs & afib for 20+ years (note, though the strap devices will generate an ECG, I generally just use them to generate beat length, AKA RR time in ms and analyze this). They work well IF you are still. Movement can degrade data quality dramatically. Though I've not used, I know the Wellue devices can use stick on electrodes, instead of a strap for the device to connect to. That might provide less of an issue. However, years ago I had an MD friend who lent me his Holter monitor for a few weeks. It connected to the body with the stick on electrodes and it could also have data quality issues with movement. For strap use during sleep, I sleep on a recliner couch so my body is semi sitting up and doesn't move much. If I use it sleeping in bed, I get quite a bit of data artefact & is pointless for me.

One of our members who has a Wellue sent me their complete data for a sleep session. I would say about 40% of the data were corrupted from movement during sleep. Obviously this will vary by person & how much you move during sleep.

Years ago, when titrating electrolytes for my afib remission protocol, I decided to use minimizing PAC counts/hour as my metric (I get very few PVCs). I would put the strap on record during meditation so as to minimize movement & data artefact.

Here's the latest on the Galaxy Watch family:

[www.tomsguide.com]

Note that the sensor has been allowed to measure cutaneous free radicals which will allow the Health app to suggest dietary changes to improve anti-oxidant consumption. This is high tech in the strictest sense! I just hope it doesn't turn out to be a thud.

Thank you GeorgeN, that's so interesting about the effects of movement on the readings. Since my episodes and irregularities are mostly in my sleep, that's where it would show up first. I just had a normal EKG yesterday, and am receiving a followup appointment with labs and dynamic ECG next week and a Holter in another month. The attention and quality of care here continues to be phenomenal. I've resumed hypnosis (deeper rest state for me than meditation) which has been beneficial. In my pre afib days, I moved very little in my sleep.

Thanks for the link, Gloaming, I'll look at these options!

Thanks to you both for your help!

@Glenn
I have a Galaxy Watch 7 and it automatically notifies me if I go into AFIB (I believe rhythm must be irregular for more than 1 hour) . The thing woke me up this morning with a vibration saying that AFIB was detected. :-( I checked my pulse and, sure enough, it's back.
My NP recommended using it for that very reason.
Battery life is about two days