Palpitations and capturing/recording

what the pacer records

by Tracey_E - 2024-09-08 13:56:13

It's always a good idea to send a download when something feels off, however it probably won't catch palpitations. It can be set up to record certain events. It will record pacing. That's it. It's not like a holter or other event monitor, or an ecg. If it happens again, perhaps you can get an event monitor? 

If you were having palpitations, pvc, or pac, it's likely your rate was actually higher than what the oximeter recorded. It won't catch the little beats between the full beats. 

Yes you may still need further external monitoring to pick up "all" rhythm disturbances

by Gemita - 2024-09-08 16:28:10

Meredith, what is important is that your rhythym disturbance ended quickly without intervention. If it happens again, particularly in the absence of any trigger like a fright, then you might need further external monitoring to pick up the disturbances if your pacemaker fails to record/store these.

Unfortunately as most of us will discover, the pacemaker will only record and store what our doctors programme to be stored, important events, like high atrial or high ventricular heart rates coming from arrhythmias such as Atrial Fibrillation and Ventricular Tachycardia.  Such arrhythmias may need treating with rate control or anti arrhythmic medication or other meds, like anticoagulants in those at risk.

Slower heart rates even with symptomatic rhythm disturbances are generally of less concern to our doctors, even though as I well know, slow, irregular rhythms can cause as many symptoms for some of us as can faster ones.

What to do about this?  I try to take the evidence to my doctors by recording on my Kardia Mobile when I experience difficult symptoms, since although my pacemaker records and stores faster arrhythmia episodes over 150 bpm set by my EP, periods of slower irregular episodes of Atrial Fibrillation, for example, below 100 bpm, would not necessarily be stored.

Important issues should not be missed, but yes slow irregular rhythms may well not be stored or reported on, so this is why you may still need external holter monitoring in addition to pacemaker monitoring to capture ALL arrhythmias as a cause for any new symptoms

Thanks for your insights!

by Merriashley - 2024-09-08 17:54:14

I will definitely keep monitoring things and based on previous conversations with EP he has mentioned doing a Holter monitor if I have concerns.  Also is it safe to use the Kardia mobile and get accurate information?  If so I will totally get even just for peace of mind.  Thanks again to you both for your quick responses.

Meredith

Kardia Mobile

by Gemita - 2024-09-08 18:35:34

Meredith it is definitely safe to use Kardia.  Some successfully use the Apple Watch too to record ECGs.  I have purchased a 6 lead Kardia mobile.  Kardia clearly states it has not been tested for use with a pacemaker.  They have a legal basis to say this but that doesn’t mean it is unsafe to use with a pacemaker or incapable of recording accurately.  It gives good recordings and my EP is always happy to see them.

Many doctor’s surgeries in the UK use Kardia to monitor their patients.  A skilled doctor in reading ECGs should have no trouble interpreting any recordings you make with Kardia.   

I would just increase the time of any recording from the default 30 seconds, to 60 seconds which will give more information for accuracy.  My 6 lead Kardia mobile records several arrhythmias although I have purchased additional Kardiacare which gives the following Advanced Determinations: 

Normal Sinus Rhythm

Sinus Rhythm with Supraventricular Ectopy

Sinus Rhythm with Premature Ventricular Contractions

Bradycardia

Tachycardia

Atrial Fibrillation

Sinus Rhythm with wide QRS

Unclassified

Possibly Wenckebach?

by Rch - 2024-09-08 19:53:12

Merriashley

Sorry to hear about the scary incident. I have had many  similar episodes. Once I just bent down to look for my pen under the table and when I got up suddenly, I felt my heart racing uncomfortably with Vp sensations. I immediately sat down and checked the rhythm on Kardia 1 ( K 6 takes a little longer to stabilize the baseline) for a full 5 minutes. What I noticed was that I was tachying around 130s ( my MTR) and then suddenly the rate dropped to 85 ( Vp). After about a minute, the rate shot back again up to about 120 (Vs / Vp) alternating but I did feel better and then shorty after it was about 110 ( all Vs) and I felt great !! It then slowly settled down to my baseline. When I reviewed the rhythm, there were markedly prolonged AV intervals during the time the HR was in the 80s. So, perhaps I was in Wenckebach after a mode switch? When I transmitted my data to the clinic, the same song and dance, ' no events, PM is working fine!' So, I'm not sure whether my event didn't meet the minimum criterion for an 'event' , or the prolonged AV is part of another algorithm to search for intrinsic ventricular conduction, in which case the pm would be working fine!! So, the long and short of it is that the Kardia does give you some insight into what is going on although you would still need to discuss with your providers your symptoms to arrive at a definitive diagnosis.

Kardia

by Merriashley - 2024-09-08 22:28:25

I decided to go ahead and get the Kardia 6 lead.  I discovered I could buy it with FSA account money.  I will be interested in what it says next time I experience crazy palpitations.   Thanks again and I will definitely reach out to my doctor as needed.  

Base rate

by piglet22 - 2024-09-09 07:00:28

I don't see any figure for your IPG base rate.

This is the BPM that your device is supposed to maintain as a minimum.

Typical figures are 60 or 70 BPM though lower rates are set.

You mention 55 BPM.

If your IPG base rate was 70 BPM, then that would be a cause for concern.

It would mean that something is interfering with the device functioning.

An example would be a PVC being sensed and interpreted as a normal pulse and the device does nothing and skips the next programmed pulse.

There's nothing wrong with the device itself, just the way it reacts.

Oximeters and BP monitors will show something going on, but not necessarily accurately.

It might be a one off but you still need to contact your pacing team.

As the others suggested, keep records and if you can, do an upload via any bedside monitor you have.

Anyone try/use a non-Kardia home EKG device?

by PaceCahr - 2024-09-11 18:37:15

My issue is that I have clusters of PVC attacks, but recently I've also had sensations of irregular heartbeats, that are not the same. These seem to correspond with digestive sensations, so I'm looking for something to help me corellate the sensations to whether they are cardiac, digestive, or both, to help with my food/symptom diary. 

At my device check yesterday, they identified some short VT episodes that were recorded, and one of them fell squarely in a day when I had no idea what my torso was trying to tell me. 🤔 

I am interested in finding something that does not require a subscription to a service, and isn't part of Apple or Google.  

Did a fast search and found a couple "best of" articles.  

--  https://www.health.com/best-ecg-monitors-7487479

--  https://www.medicalnewstoday.com/articles/ecg-monitor  (dated 2023) 

I really like Omron BP machines, but their user manual clearly states: 

   "DO NOT record an EKG with a cardiac pacemaker, Implantable Cardioverter Defibrillators, or other implanted electronic devices."

The Lookee device manual is really thin on info.  <https://cdn.shopify.com/s/files/1/0011/8050/0053/files/Lookee_Pulsebit_EX_User_Manual_2.0.pdf?v=1628559661>

The health article has this paragraph: 

"Pacemakers and Personal ECGS Monitors

Using a personal ECG monitor with a pacemaker can be complicated since home ECGs may not be equipped to identify a paced rhythm. If you have a pacemaker, it's important to consult your healthcare provider for guidance in choosing a pacemaker-compatible device, advises Dr. Higgins."

I asked my EP yesterday, and they kinda shrugged and said "people use apple watches" - and I pointed out that they are charged via Qi charging, and that was something I needed to "watch" out for getting near my device (pun intended). She wasn't really interested in recommending anything.

Has anyone run across a self-declared  "pacemaker-compatible" at home EKG?  

I'm on the north american side of the pond, so pointers from US/Canada would be preferable. Thanks all!