Thanks to all for the information.by Searching9 - AFIBBERS FORUM
Daisy said "Can you question your EP as to why, in particular, he wants your wife to discontinue Tikosyn?" I've already sent him a message to the effect of : Is there more of an issue with taking Tikosyn beyond that just 'it's not doing any good'. Just to be clear it was the Valve replacement doc that suggested stopping the Tikosyn, and he asked the Clevelandby Searching9 - AFIBBERS FORUM
Dear wife's journey thru Afib just became a bit more complicated of late. Multaq treatment (for paraox afib) began failing about a year ago and became persistant afib with rapid ventricular response. Local Cardo sent us to local EP who pushed very hard for immediate ablation. Acquaintances had had successes with Tikosyn so we opted for that route. (We had also been warned by other local MDby Searching9 - AFIBBERS FORUM
Incidentially, found that Apple watch also has a utility to "Track one's AFb history and log triggers". @ cary, thanks for the well wishes. The Dear Wife is trying to get another cardioversion while we wait for Cleveland to schedule a catheter ablation (two to three months). We met with Dr. Wazni, who trained under Dr. Natale when he was at Cleveland.by Searching9 - AFIBBERS FORUM
I could be incorrect on this but I believe that Federal law requires hospitals to give you (at least) an estimate, unfortunately many hospitals just ignore that requirement.by Searching9 - AFIBBERS FORUM
Dear Wife recently had Tikosyn induction, and did not self-convert. 36 hours later a 200 joule electrocardioversion brought her right into NSR. Unfortunately that lasted only 56 hours. There is no question here, but I thought I share the rather dramatic shift in the Heart Rate Variation. Each data point represents the variation in R-R intervals over a sixty second observation period, taken aboutby Searching9 - AFIBBERS FORUM
Very useful tip, I'll try it out Thanksby Searching9 - AFIBBERS FORUM
Thanks Jake, that exactly what I wanted, how to navigate to the details for each HRV. So what I learned was that the observation period is ~60 seconds. Looking further, I see a table of BPM at various times, for example: So I'm assuming that the time associated with each BPM data is the time at which a QRS occurred (because the time are not equally spaced), and that the BPM reported is tby Searching9 - AFIBBERS FORUM
Before spouting off on this (and making a complete fool of myself), I wanted to ask a question about Apple Watch Series 9 and how they determine a value for heart rate variability. My impression is that the watch measures the interval (in milliseconds) between each heart beat over some time period (anyone know the time period?), then calculates the mean or average interval. Subsequently the chby Searching9 - AFIBBERS FORUM
I asked part of this question previously, but wanted to see if the reply was still valid. We live midway between Cleveland and Pittsburgh, so going to either location is not a problem. Previously Cary had recommended asking for Dr Santangli at Cleveland for a second opinion before going an ablation route. Is that still the recommendation, and is there any recommendation at UPMC in Pittsburgh asby Searching9 - AFIBBERS FORUM
@ Carey, Dear wife does have an EP, and is an established patient with him. After it was apparent ( inferred from Fitbit and reinforced by Kardia) that the frequency of her afib episodes had increased dramatically, the cardio prescribed the ZIO monitor (which confirmed her 100% burden) and then subsequent chem induced stress test. Presumably this was all in preparation for dear wife's nextby Searching9 - AFIBBERS FORUM
@Carey, In answer to your question, my wife's cardio is not an EP. As to the Fitbit, no need to apologize for any bias. I've come to be relatively trusting of the Heart Rate as a preliminary tool as it has been a reasonable predictor of heart rate over a 5 minute span. For a closer look I'd be much more confident with the Kardia. As to some of the other Fitbit functions, the Oby Searching9 - AFIBBERS FORUM
@ Carey, Why use the Fitbit as the first device? I actually have found that the Fitbit is essentially as accurate as the Kardia rate determinations. In the example I gave above, Kardia reported a HR of 74 (over 60 seconds) and the Fitbit reported HR of 73 (over 300 seconds) , with the Fitbit observation period overlapping the Kardia. But more to the point is that the Fitbit is recording 24/7by Searching9 - AFIBBERS FORUM
@ Daisy Thank you for your remarks. As I hopefully said previously my present principle concern at the moment is what to do while awaiting the office visit with the EP. Previously we had been told that if her AFIB was persistent for 12 hours or longer she should go to the emergency room. This advice was given by her cardiologist and prior to a ZIO determination that she was in AFIB 100% of theby Searching9 - AFIBBERS FORUM
To recap from the original post it would seem that the advice/thoughts are: 1) continue her present meds ( 75 mg metopropanol BID & 400 mg Multaq BID) 2) observe for cardiac pain/discomfort 3) watch her recorded heart rate via Fitbit for extended periods of "resting" ventricular rate in excess of 100 bpm (Fitbit records the average of the previous 5 minutes) 4) relax the aby Searching9 - AFIBBERS FORUM
The Dear Wife has had paroxysmal afib for about ten years. She would have symptoms (pain/discomfort) about 10-15% of the time. Her measured burden (by Holter) was 3%. However lately ( 4-5 months) she has had many more episodes (as detected by smart watch) - albeit without any overt symptoms. Over the past several months she and I have met with her cardiologist and he he put her on a 14 day moby Searching9 - AFIBBERS FORUM
QuotePavanPharter Measuring HRV works. When you see you have elite athlete status you're probably in AFIB. Hint - afib is HRV HRV is the acronym for Heart Rate Variability. Correct? Is heart rate variability based on beat to beat (R to R) variability?by Searching9 - AFIBBERS FORUM
Quotegloaming There is a syndrome known as 'rapid ventricular response syndrome' where the ventricle is compelled to beat in concert with a fibrillating atrium - So what I'm likely observing is RVR in response to atrial fib. (see the example fitbit graphic above). I think I understand that this RVR has the capacity to do more damage to the heart then Afib without RVR. (by Searching9 - AFIBBERS FORUM
@Daisy, That's interesting, I purchased a Kardia 6 lead about 2 years ago. When I use it during a AFIB episode, the Kardi determination is "Possible Atrial Fibrillation. BTW, contrary to what Jake was saying (above) I can print out the strips (4 pages for all 30 seconds), and the all strips are on my phone for the past 18 months (and all can be printed for a physician to review).by Searching9 - AFIBBERS FORUM
I suppose that I failed to make it clear, that I am interested in long(ish) history of Afib. For example, I (and my doctors) are interested in seeing if any of the therapy efforts are effective in suppressing episodes (frequency & duration). I've had paroxysmal Afib for 10+ years, following a cardiac cath. I have been on Multaq for 10+years. Recently (18 months) my cardiologist-EPby Searching9 - AFIBBERS FORUM
@Pompon, I'm not aware of any "personal" devices that declare: "it's AFIB". The personal devices I'm aware of may say "suspected" or "possible" AFIB. I could be wrong about this next statement, but I believe that the diagnosis of AFIB is actually made by a physician, rather than an algorithm.by Searching9 - AFIBBERS FORUM
So the sleep doc wants to know if most of my episodes occur during "sleeping hours". The PCP wants to know if the episodes are more frequent during high-pollen periods of the year. The cardiologist wants to know "how often", how many hours per month. To attempt to provide some information, I have recorded the "episodes" by reviewing the fitbit daily record of heby Searching9 - AFIBBERS FORUM
Is anyone here using Fitbit (or similar) heartrate to monitor Afib episodes. Is this a reasonable method to track the history of episodes? Any pitfalls to be aware of?by Searching9 - AFIBBERS FORUM
To close out this topic: Wife had a 14 day Holter monitor while she was monitoring her HR with a Fitbit. Here is the comparison: During the 14 day observation period, her Fitbit HR data was suggestive of Afib for a period of 11 hours beginning at 4:45 pm and ending at 3:30am. Her Holter (same observation period) reported detected Afib for a period of 11.5 hours beginning at 4:50 pm and endingby Searching9 - AFIBBERS FORUM
QuoteGeorgeN So, and finally, does the community see any flaws in that DIY approach to tracking her Afib burden? Since you've checked the heart rate signature with the Kardia, this would work. If your wife does a workout, I assume this looks different and you don't count it? Thanks, Actually she had a 14 day Holter while she was using the Fitbit. I've asked for the Holterby Searching9 - AFIBBERS FORUM
Workout ? What's that? Extra heavy knitting? We are both in our late 70sby Searching9 - AFIBBERS FORUM
Newbie here, so be patient with me if my question was covered previously. My wife has been treated with Multaq for ten years. (last Holter in July '21 reported a 3% Afib burden). The overwhelming majority of her Afib episodes are "silent" (no pain) and about half have no sense of flutter or palpitations (her descriptive words). Seven months ago she was prescribed a CPAP for herby Searching9 - AFIBBERS FORUM
QuoteCarey Feel your pulse for 30 seconds. Is it an irregularly irregular rhythm? By that I mean there's no pattern or predictability to the pulse at all. If so, it's almost certainly afib. Easier solution: Buy a Kardia. You don't need the more expensive 6L and you don't need to sign up for their plan. You can get one for $69 on Amazon. Newbie here, so be patient if my qby Searching9 - AFIBBERS FORUM
QuoteGeorgeN However, regarding the original post, I would hypothesize this reduced cardiac output would likely not be noticed when at rest. Its effect would be experienced during material exertion. In other words, it would limit your top end, not decrease SpO2 during rest. The medical studies cited above are silent on if the patients observed were at rest or were undergoing material exertiby Searching9 - AFIBBERS FORUM
Actually I finally found the reference (re reduced cardiac output); From the abstract: QuoteThe presence of chronic or paroxysmal atrial fibrillation places the patient at increased risk for embolic stroke and/or death. When atrial fibrillation develops, there is loss of the atrial transport factor ("atrial kick"), with consequent decrease of cardiac output. Stroke output declines byby Searching9 - AFIBBERS FORUM