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Question about A-Fib and HR monitors -

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Question about A-Fib and HR monitors -

Old 06-07-20, 02:49 PM
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Richard Cranium
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Question about A-Fib and HR monitors -

I'm a fully broken heart aging cyclist. I have several heart conditions that could become life threatening.

I am using a Wahoo fitness app and Tickr HR monitor that appears to display "jumps" in my heart rate. Since these HR spikes are not tracking my exertion level I am suspecting that they represent HR arrhythmia - most likely some sort of SVT. Since I don't feel any changes in my chest I assume these signals must be atrial in origin and not the ventricles in spasm.

My question is: Are any of you familiar with this kind of HR monitor activity? Are any of you using wearable EKG regularly? And if you are - is there a relationship between how many P wave signals there are and how the HR monitor counts actual ventricular beats? (QRS cycles)

Thanks - any conjecture welcome - I'm assuming consumer HR monitors count only ventricular depolarization as a heart beat - but I'm just guessing.
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Old 06-07-20, 04:49 PM
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A-Fib and HR monitors

I had A-Fib from about 12 years ago. It started when I passed out twice on the bike when running close to max heart rate. Both times I was taken to the hospital by ambulance and the ER Docs didn't diagnose A-Fib. About 10 years ago on fast group rides my HR would jump to 220 BPM when I was really pushing it. I have had 3 cardiac ablation surgeries with the last and most successful 2 years ago.I have an ICD and take an anti arrhythmic drug but at 77 I still ride with my 50-60 year old buddys. Ablations work if you find a qualified Electrophysiologist/ Cardiologist with access to a Hospital Catherization lab with the latest technology.
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Old 06-07-20, 06:08 PM
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Having worked with medical-grade cardiac monitors in my career as an RN, I can say that there are times when the monitor does not accurately count heart rate; I can't imagine that consumer-grade monitors are more trustworthy. Many things can cause this: e.g. motion (brushing teeth can trigger a V-TACH alarm!), hair or sweat under the electrodes can cause poor signal, dried out patches don't pick up signal well, etc. When in doubt, check the patient, not the monitor. If you see an anomalous heart rate, palpate a carotid or radial pulse to verify the reading.
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Old 06-07-20, 07:16 PM
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Have you consulted your cardiologist about an implanted monitor? I know your cardiologist could read it anytime but maybe there are products that could satisfy your need.
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Old 06-07-20, 08:45 PM
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I was diagnosed with Afib about 3 years ago. I questioned my cardiologist about my heart rate as shown on the Garmin because I was going well beyond what was supposed to be my max rate based on my age. I was told to go by perceived effort and leave the HR monitor at home. Had surgery last year to repair a leaking valve, relocate a congenital issue with a cardiac artery, and the ablation which so far all is good. Would suggest that you work with your cardiologist with any of your concerns.
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Old 06-08-20, 07:48 AM
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Over the past 25+ years, I have tried all the arrhythmic drugs with varying degrees of temporary success, 5 cardioversions, and two ablations working with a cardiologist and electrophysiologist. I now have a pacemaker, but for another reason. My advice to the OP is don’t do self-diagnosis; find a good cardiologist or electrophysiologist and work with them.
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Old 06-08-20, 08:03 AM
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Thanks for comments - I had my first episode of A fib about one year ago - and I am suspecting that warm weather exercise is about to trigger another event. I'm sure most people get pretty rattled by it - I know it made me super anxious.
I wore a "stick-on" EKG for two weeks last July. I'm not sure how much of the time I was in "classic Afib" - but I did have some really pronounced arrhythmia much of the time.

I went on Xarelto and increased beta-blockers dosing. Over the winter i discovered I could ride a trainer pretty hard without triggering any symptoms. So now I am a little depressed about discovering these HR spikes without a lot of sense of exertion.

Good to hear that 77 year olds can ride with A fib for years. I'm no where near as bad off as you were.

No doubt - that manually checking for a pulse will tell the story. My "panic" started after checking my BP and seeing a 140 HR while sitting still. At that time my pulse was so shallow that I could not detect it at my wrist - don't remember trying my neck.

Part of my question has to do with whether there is any usefulness in seeing the "extra beats." That's why I wanted to know if anyone else managed their exercise or Afib by using a device.

I do know one thing - I don't want to trigger a full blown episode because sitting around with arrhythmia is a very uncomfortable way to live.
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Old 06-08-20, 09:00 AM
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Old 06-18-20, 12:53 PM
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On bit of a heads up: I use a polar HR monitor with a chest strap ( they apparently are more accurate than the wrist sensor ones). I too need to worry about HR spikes. Early this spring (cold=no sweat) was riding on the road and a couple times when was going 20-25+ mph the HR suddenly spiked at like 200...freaked me out.

Long story short. If it's low humidity and you are wearing a synthetic shirt and the wind is moving it around you can get a static situation which will screw up the HR reading ( I found this the fine print on the Polar web site.) The solution is to put a bit on water on the shirt over the chest band....or sweat

and you may want to read this:
https://www.mdedge.com/cardiology/ar...y-high-af-risk

may be a reason to use HR monitor

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Old 06-19-20, 07:28 AM
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Richard C- if it’s any consolation, I have gone though all your experiences, ranging from scared, to simply frustrated, because through all these years, I have never felt really bad, but when I went into afib, I lost energy. As I mentioned earlier, I have had all the treatments with varying degrees of temporary success and now I have a pacemaker, which was inserted a a couple of years ago, not for afib, but because my resting HR went to 34 and my heart was pausing for up to 10 sec.Since having the pacemaker, I have had few afib episodes, although this is an added benefit of keeping my resting HR at 60. (I am well into my 79th year). My pacemaker transmits data to the heart clinic, so they can see what is going on. I take Eliquis, which, like Xarelto, is very important if you have afib and are over 75, as the risk of stroke increases at that age.Beware of false HRM readings: I have never had success with the Garmin chest straps. I think it must be something to do with my skin, although I use electrolyte gel. Recently I bought a Bluetooth strap and thought this would fix things. Well, at least it stayed on, but I was getting Intermittent HR which randomly increased slowly to over 150 with little exertion. When I asked my heart center to check the readings from my pacemaker, they found no erratic behavior. So much for the new strap!
In summary, don’t obsess about the arrhythmia; if you feel OK, ride, but if you feel weak or dizzy slow down or stop. It’s frustrating, I know. If the episodes last more than 48 hours, see your cardiologist and ask for a cardioversion. If there is no underlying heart defect, like ischemia, there’s probably no need to worry.
Good luck and try not to worry, as stress can bring on afib, even when you are sitting around.

Last edited by Artmo; 06-19-20 at 07:31 AM. Reason: Correction
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Old 06-21-20, 09:25 PM
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I have 3 riding buddies who, in their mid-70s, developed Afib. I was riding with a couple of them when they had an Afib event. Both were wearing Garmin straps. In both of them, their displayed HR quickly increased from about a 130 normal to over 170, and at the same time they had a very noticeable loss of power and simply didn't feel good. We stopped, and after a while their HR returned to normal. We remounted and proceeded at a much reduced place to somewhere they could wait comfortably for a pickup, without any further Afib issue. Those events were pretty much the end of spirited riding for them. They could still ride, but at a much reduced effort. I don't remember if they had ablations, but probably, and afterwards switched to e-biking. I have another buddy, an MD, my PCP in fact, who got an ablation and now rides just as hard as he ever did. Another rider, just now turning 70, developed Afib, got an ablation, got scared, still rides but never out of what would have been zone 2 for him. He was a big randonneur, wall full of distance medals, thought nothing of doing 15,000'/week. Until one day . . .

I haven't had that problem - yet. AFAIK and IME strap-type transmitters and Garmin and Polar receivers do show Afib reliably. If one wanted to take that a step further, there are HRV apps available for smartphones. I use Elite HRV. it displays veriations in R-R, not the EKG waverform at all, but is very sensitive to variation and displays it visually and real time.

With the HRV app, I use a Polar H10 Bluetooth transmitter and strap. Seems to work the best.
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Old 06-23-20, 10:15 AM
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Originally Posted by Richard Cranium View Post
I'm a fully broken heart aging cyclist. I have several heart conditions that could become life threatening.

I am using a Wahoo fitness app and Tickr HR monitor that appears to display "jumps" in my heart rate. Since these HR spikes are not tracking my exertion level I am suspecting that they represent HR arrhythmia - most likely some sort of SVT. Since I don't feel any changes in my chest I assume these signals must be atrial in origin and not the ventricles in spasm.

My question is: Are any of you familiar with this kind of HR monitor activity? Are any of you using wearable EKG regularly? And if you are - is there a relationship between how many P wave signals there are and how the HR monitor counts actual ventricular beats? (QRS cycles)

Thanks - any conjecture welcome - I'm assuming consumer HR monitors count only ventricular depolarization as a heart beat - but I'm just guessing.
I use a wahoo ticker run and also see jumps in heart rate coming from the ticker but my heart rate coming from my garmin smart watch shows normal heart rate and my perceived exertion level does not change. It seems to happen when the battery is getting low on the wahoo ticker. If I change the battery on the ticker and put a new one in upside down for 10 seconds to reset the ticker then put the battery in correctly it works like normal and matches my smart watch. I like to use the ticker as it is supposed to be more accurate and when working properly it will track my HR closer during interval training. It happened to me again today on my trainer so I stopped the workout - replaced the battery and reset it and the heart rate was normal for the rest of the workout.
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Old 07-10-20, 09:29 AM
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Thanks for sharing your experience. But in my case all the "jumps" in HR activity seem to coincide with real time exertion and subsequent HR response - in other word my HR was supposed to be going up - just not so much as 30 or 40 bpm.

As another really "Richard Cranium" - thing to do - set up a wahoo fitness to actually detect "extra heart beats" - at least if you have them.

Step One - use a "treadmill profile" so you don't have to mess up your cycling or running profiles.
Step Two - set an "auto lap" increment to "time" and set it to one-minute
Step Three - put on chest strap and lay down or sit comfortable and remain still for at least one minute
Step Four - start "special treadmill workout" and stay perfectly still and quiet for at least 10 minutes.
Step Five - stop the wahoo fitenss app workout and review auto lap HR averages as well HR "highs"

The app review should show whether or not you have any "extra beats" or arrhythmia. In my case my HR started at an average of 49 bpm for the first minute and lowered to 47 bpm by the 10th minute. The highest HR was 52. This is a crude but accurate way to test for arrhythmia, If you are lying still at get readings more than 6 bpm apart - I would suspect something going on. (of course I'm on beta blockers - it may have an effect)
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Old 08-24-20, 06:18 PM
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There is a big push to use the HRM as screening. Save for rare FDA approved systems it's problematic.
Don't even pretend the consumer level HRM gives you anything a physician will accept as data.
It will possibly open you to a $3K to 10K work up, with poor predictive value.
The best of them are mediocre compared to the one the doc paid $2500 for.
Rarely they find some AF, but mostly just chases errors.
Nothing better as a financial plan than making mistakes and getting paid to look into them.
Not saying AF isn't a problem, but
We are awaiting a system that out performs taking you own pulse if you feel funny, and having someone to call.
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Old 08-01-22, 02:24 AM
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Remote heart monitoring has been an effective part of heart treatment plans and has continued to grow in importance during the COVID pandemic. There are several different types of heart monitors that you can use for counting heart rate properly.
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Old 08-02-22, 09:36 PM
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I had a heart attack in 2014 and subsequently had A-Fib, and I couldn't feel a thing. I'd highly recommend contacting your cardiologist and requesting a stress test to see what, if anything, is happening with your heart during normal activity and stress. Your cardiologist should be able to recommend equipment for you to use while cycling and doing other activities. Don't depend on a forum for answers!
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Old 08-03-22, 09:24 AM
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Originally Posted by Richard Cranium View Post
I'm a fully broken heart aging cyclist. I have several heart conditions that could become life threatening.

I am using a Wahoo fitness app and Tickr HR monitor that appears to display "jumps" in my heart rate. Since these HR spikes are not tracking my exertion level I am suspecting that they represent HR arrhythmia - most likely some sort of SVT. Since I don't feel any changes in my chest I assume these signals must be atrial in origin and not the ventricles in spasm.

My question is: Are any of you familiar with this kind of HR monitor activity? Are any of you using wearable EKG regularly? And if you are - is there a relationship between how many P wave signals there are and how the HR monitor counts actual ventricular beats? (QRS cycles)

Thanks - any conjecture welcome - I'm assuming consumer HR monitors count only ventricular depolarization as a heart beat - but I'm just guessing.
Since this thread has been revived and in case the OP ever looks at it again after two years,

1. One cannot subjectively distinguish supraventricular from ventricular tachycardia and they will look the same on a HR trace. I assume by "ventricles in spasm" you mean ventricular fibrillation. Trust me, you'll know when you have that and it will show up as an HR of zero.

2. Athletic HRMs cannot see or count P waves. You need a real EKG for that.
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Old 08-04-22, 08:37 PM
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Originally Posted by MoAlpha View Post
1. One cannot subjectively distinguish supraventricular from ventricular tachycardia and they will look the same on a HR trace.
I assume you mean on an athletic heart rate monitor. On an EKG or four-lead telemetry monitor they are distinct. SVT has a narrow QRS interval, indicative of source above the ventricle. V-tach has a wide QRS characteristic of a ventricular origin.

SVT:


V-tach:


I assume by "ventricles in spasm" you mean ventricular fibrillation. Trust me, you'll know when you have that and it will show up as an HR of zero.
More to the point, V-fib has a cardiac output of essentially zero, so you're unlikely to be conscious to evaluate your situation.

2. Athletic HRMs cannot see or count P waves. You need a real EKG for that.
Agreed.
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Old 08-04-22, 09:10 PM
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For those interested in slightly higher quality rhythm data while exercising, there are a lot of new HRM devices that actually record something akin to a single lead ECG (I believe its closest to V5?). I have an arrythmogenic cardiomyopathy and occasionally use a frontier x2 to record a continuous ECG during a ride. The quality of the data isnt all that great depending on how much youre moving around, but its interesting and helps illustrate how/why the typical heart rate strap sometimes gets very confused with anything less than perfect sinus rhythm.

Ill often have a little cluster of PVCs on a ride, and itll cause my polar HRM to cut the heart rate in half for a while - cruising along at 200+ watts at a heart rate of 55!

https://fourthfrontier.com
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Old 08-05-22, 04:59 AM
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Originally Posted by JohnDThompson View Post
I assume you mean on an athletic heart rate monitor. On an EKG or four-lead telemetry monitor they are distinct. SVT has a narrow QRS interval, indicative of source above the ventricle. V-tach has a wide QRS characteristic of a ventricular origin.

SVT:


V-tach:




More to the point, V-fib has a cardiac output of essentially zero, so you're unlikely to be conscious to evaluate your situation.



Agreed.
Agree on all points, I referred only to conventional athletic HRMs, and, by subjectively, meant how it feels to the subject. I think we will also agree that there are a few seconds of conscious terror in a VF arrest and a short run doesnt necessarily produce LOC.
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Old 08-05-22, 08:00 AM
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Originally Posted by MoAlpha View Post
Agree on all points, I referred only to conventional athletic HRMs, and, by subjectively, meant how it feels to the subject. I think we will also agree that there are a few seconds of conscious terror in a VF arrest and a short run doesnt necessarily produce LOC.
more than a few seconds, for me. the last time i had VF (many years ago, thankfully!) i was crossing a busy street on foot and had time to make it to the median island, sit on the curb, and note that i couldnt feel my pulse as everything faded! the ICD shock came just a few seconds after i actually passed out.

fingers crossed it never happens while on the bike!
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Old 08-05-22, 08:22 AM
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Originally Posted by mschwett View Post
more than a few seconds, for me. the last time i had VF (many years ago, thankfully!) i was crossing a busy street on foot and had time to make it to the median island, sit on the curb, and note that i couldn’t feel my pulse as everything faded! the ICD shock came just a few seconds after i actually passed out.

fingers crossed it never happens while on the bike!
Handy gizmo! I guess they program in a delay to avoid false alarms.
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Old 08-05-22, 08:40 AM
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Originally Posted by MoAlpha View Post
Handy gizmo! I guess they program in a delay to avoid false alarms.
yeah, depending on the type of arrythmia it may not wait at all, or it tries to pace you out of it very quickly, or for slower VT itll actually try multiple rounds of pacing for a minute or more. in a wierd way thats worse, because you sit there feeling crappy and praying it works before getting blasted 😂😂😂
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Old 08-15-22, 10:43 AM
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Yes - you did indeed answer my question.

I guess what I am now "getting" - is that I can't understand how and why and when the AV node start firing or why at some time it stays relatively quiet.

I do know that i have seen several of my EKGs over the last several years. At first, I did have the classic "shark tooth: pattern with 4 distinct, but diminished P waves.

Currently, there is little or no elevation voltage of the P wave area, just a 6 or 7 count of little bumps.
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Old 09-18-22, 11:33 AM
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I know this thread has kinda finished, but My heart skips a beat these days; pattern of 3 normal, one missed. And of late, one normal, one missed in the middle of a sequence of other stoppages.
My chest detects this, particularly when lying in bed on my stomach. I saw the doctor, got an ECG (ECK) and was told everything was OK. Mid seventies these things might be expected, but they're still not OK. Current medical advice seems to be towards HIIT activity as a treatment, almost. I was told to continue.
I always feel good doing this, and other cycling stuff on the roads. It's when I stop that the problems start. I do not get a racing pulse, but do have a lack of energy - until I get pedalling again.
I'm wondering if beer might be the answer . . . wouldn't it be good if it was?
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