deteremining afib status

Having recently visited my cardiologist for my post-op pacemaker replacement, I was told that I’ve been going in and out of afib.

The pacemaker I have came a cell phone transmitter, a “Latitude” from Boston Scientific, that sends the data every night.

It used to be they would call me when I went into afib. Now I’m told because of my pacemaker, and that it’s controlling my heart beat at 98% (I’m assuming they mean the ventricles), that persistent afib is okay.

Well, I’m not okay with that. I had a Pulse ablation about a year and a half ago that went well. It was only after I got tested for my ejection fraction that they discovered I needed a 3 lead pacemaker – the one that just got installed.

On the post-op of the pacemaker surgery, I was told I’d been in afib for 18 days a few months back, and then another time for a few days.

I asked why I wasn’t being told, the Dr. said the fibrillation didn’t reach a high enough threshold. Also, when I was there in the post op, I was told I was in afib. AND since it had only been less that 24 hours I was “eligible” for the cardio version- which they did. That was 3 months ago.

So I have NO idea if I’m in afib or not.

The EP who did the ablation and new pacemaker said there could be “gaps” between where between where it the ablation was done.. Said he could see them if he went in again.

I don’t want to be in persistent afib. But how am I to tell if I should get another ablation if I having frequent episodes and they will not tell me.

Any ideas on how deal with this would be appreciated.

Since your episodes seem to be fairly long, can you tell if you are in afib by checking your pulse? If not how about a Kardia monitor? I've used a Kardia for 12 years and when I break them by dropping on a hard floor like tile or concrete I can get new ones (single lead models) off ebay for $30 [www.ebay.com] With either method you could test morning and evening and get a reasonable idea of how much time you are in afib.

I don’t want to be in persistent afib. But how am I to tell if I should get another ablation if I having frequent episodes and they will not tell me.

Any ideas on how deal with this would be appreciated.

You already have all the information an EP needs to help you make a decision. Just ask for the written pacemaker report, including all data related to AF, such as overall burden, frequency, duration, heart rates, and any stored recordings. Then bring that data to one or more EPs at a high-volume ablation center and ask if you're a good candidate for another ablation. Kardia is usually great, but their website suggest unreliable with a pacemaker.

Jim



Edited 1 time(s). Last edit at 05/11/2026 06:40PM by mjamesone.

I realize everyone is different, but I can check my pulse in 5 seconds by touching my carotid artery in my neck right next to my windpipe (trachea). I have issues with a slow pulse and often check. Two successful ablations, but when I went into afib, it was obvious and checking my pulse was a confirmation. I know there are some of you that don't feel the afib, which would never be the situation for me.

Frequent self-monitoring, or insisting that you be informed via the monitoring system that comes with your pacemaker, are about all that you have left to ensure you know your overall burden. From there, with proof of the arrhythmia in graphic form and your medical records, a competent electrophysiologist would form an opinion and tell you whether-or-not you are a good candidate for an attempt to correct your rhythm.

Modern pacemakers can over-pace a heart in AF which sort of works like a cardioversion. But no pacemakers can keep a heart out of AF by themselves. They can only control a rapid ventricular response.

I've heard of that and wondered if it could separate the atrial beats from the ventricle beats. My heart beat, even before the ablation (and it was persistent) was normal.

Thanks. Great advise asking for all that data. I have an appointment tomorrow with a "regular" cardio dr.
It will be interesting to see what he says.

It's weird. I think that's why the EP told me it was okay to be in persistent afib, BUT i balked and he said he would agree to do another pulse. But now the center I go to is moving from the hospital they've used for years to a university hospital in another city. Go figure.

Frequent self-monitoring, or insisting that you be informed via the monitoring system that comes with your pacemaker, are about all that you have left to ensure you know your overall burden.

If there are devices that can separate the upper an lower chambers, that would be great.

When I talked with the doc who did my ablation and pacemaker, he blew a gasket when I told him they used to call me when I went into afib. He said if he had to do that he'd be 24/7 making calls. I said, "sir" I've NEVER had a doctor call me when I was in afib, it been a PA, nurse, or ARNP.

I've love to self monitor.

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acantha
I've heard of that and wondered if it could separate the atrial beats from the ventricle beats. My heart beat, even before the ablation (and it was persistent) was normal.

Possibly flutter?

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acantha
If there are devices that can separate the upper an lower chambers, that would be great.

Sure, it's called a 12-lead EKG. And among consumer devices there's the Kardia 6L. However, neither one is going to show you separate recordings for atrial and ventricular beats. You'll have to learn some EKG interpretation to understand that information.

Thanks. I was referring to something like the Kardia 6L, which I didn't think would do that.

It does, but like I said, it will require some EKG interpretation skills to know if what you're looking at is of atrial or ventricular origin. But even without those skills, it will identify afib for you. But it won't identify things like flutter, SVT, etc, which often go hand in hand with afib, and that's where the EKG interpretation comes in. You can pay Kardia to have a cardiologist interpret a reading for you, or you can just post it here for free and probably get an equally correct answer.

My former EP had a Kardia program. He had his patients buy from him a Kardia 6L and blood pressure kit at a discount amount (New) and pay $30 a year (insurance reimbursed me) fee. What I got was sending him an unlimited amount of Kardia ekgs and someone (him or a EP partner) would review and call me back. It was the best $30. However once I got my pacemaker, my insurance didn’t pickup the Kardia program.

You may want to call up kardia and ask about this program.