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Bit of a niche question here, perhaps one for a cardiologist or wearable expert. But STW has never let me down before...
My dad has now had three small strokes. We want to monitor for paroxysmal AF as this is a leading cause of stroke. He had a 48hr ECG but nothing picked up, which isn't all together surprising. My understanding is that pAF could happen any time and no reason to think it would happen during the monitored 48hrs.
Apple watch seems to be better than other ECG watches as, according to British Cardiovascular Society...
Currently, ECG watches still require patients to manually create an ECG. However, Apple® ECG watches have an algorithm that identifies an irregular pulse automatically. For 1 minute every 2 hours, the watch will create a tachogram (a graphical recording of blood flow). If background noise is minimal, and the peak to peak intervals on the tachogram are irregular, a Poincare plot is generated, and dispersion analysed. Through this the irregularity of the pulse is assessed in greater detail. If the pulse is deemed to be irregular, the watch will then sample up to every 15 minutes for 48 hours. If 5 of 6 consecutive tachograms are found to be irregular, the watch will notify the user, an ECG can be taken, and AF potentially identified16. From this design the algorithm will not detect short episodes of AF, and acts to minimise false positives
I can't find a date on that article though and struggling to find any reference to whether other devices have now caught up. Apple watches are spendy, ECG isn't available on the affordable SE model and Dad doesn't have an iPhone. So whilst we are willing to invest if needed, it would be great if we could go down a non Apple route if it works the same way.
Cheers
the Fitbit charge 5 apparently has ecg functionality at a fraction of the cost of an Apple Watch and apparently gives alerts if an abnormal rhythm is detected. You can then take an ecg by sticking 2 fingers on the device
im no cardiologist but don’t you need to be in AF for a significant time for clots to form? (Ie 5 hrs +). So if concerned he could do an ecg a few times a day even if he isn’t getting notifications which should provide reassurance
I have a charge 5, only used the ecg once out of interest but apparently it’s medically certified
That's good, I had a look and it does look like fitbit are upping their game slightly. Does their hardware still fall apart after a few months of use though?
Will the cardiologist treat on the findings of a watch?
I assume he's already on anticoagulants - what do you want to achieve?
He isn't being seen by cardiologist, just stroke nurse. My understanding is that if they see evidence of pAF they will likely give him warfarin and another med to reduce occurrence. Finding of a watch could be enough to trigger this, or trigger further investigation.
Samsung watch does ECG and AF monitoring - you pop a finger on one button, but they won't do the detail the apple does, and the Samsung warns you it doesn't look for signs of heart attack, but will tell you if in AF or Sinus.
Have you considered CEX for a used Smart watch - saved a fortune with my Samsung Watch 4 classic - and you get a no quibble two year guarantee.
Does their hardware still fall apart after a few months of use though?
I’ve not had it long enough. Was a pain in bum to set up with numerous resets and app reloads but working now from what I can tell
costs about 120 quid
Mate of mine has ParAF, but was already apple through and through and had iphone/ipad/iwatch already. Initial diagnosis and follow ups have all taken account of the watch findings, cardiologist regards them as reliable and useful. I can ask her for more info this evening if you like.
I can't comment directly on how good the Apple watch is for the ECG as any sort of medical expert, but having owned Wahoo, Garmin and Whoop wearable HR systems, my Apple watch is by far the most accurate for HR readings.
When i really struggled with COVID, the ECG on that picked up heart data of enough concern i went to Doctors, one GP was really dismissive of any wearable, the second was a runner and agreed with me, that he felt it was surprisingly accurate for a watch!
I am holding out for them bringing out one shortly with non invasive blood glucose readings.
Interesting to read, as I'm currently wearing a monitor for a week, having been GP-diagnosed with pAF a couple of months ago.
He specifically referred to an Apple watch as monitoring for this, but I just have a Garmin, which has no such functionality.
Interested to see what other watches could do similar on-going monitoring, as I'm all about the androids, so reluctant to buy Apple which I'd miss out on loads of the usefulness...
Daft question perhaps, but can’t you feel when you get AF? I am always getting ectopic beats, never had more than about 10 in succession lasting 15 sec max, but even then I know all about it, it’s a horrible sensation. If my heart beat was all over the place for a few hours like that, never mind using my Fitbit watch, I’d be straight down to A&E!
Check out Kardia, which I believe is an app which communicates with a set of sensors fixed to the back of a smart phone. During suspected arrhythmia, a couple of fingers or thumbs are placed on the pads and it detects the rhythm/arrhythm of the heart. I have no idea of the cost or practicalities, but something else to consider.
Best of luck to your father.
I have a Kardia ECG thing. It doesn't have to be mounted on the back of a phone, it's just a dinky device. It's definitely good enough to be useful (one GP and two different cardiologists have been happy to look at its output), but of course it only takes a 30s reading when you choose to do it. The potential advantage to wearables is that (a) you always have it with/on you so can trigger a measurement any time you feel funny, and (b) they can detect things even when you haven't noticed anything. It sounds like the Apple watch may be best for that at the moment. The only Garmin with ECG function currently is the Venu 2+ I think, but I think it only takes a measurement when you ask it to. Maybe they'll catch up with time.
Thanks for all the feedback. We ordered a reconditioned Apple Watch Series 5 and I've dug out an old iPhone for him to use. He'll stick to his Android phone for now and just use the iPhone to manage the watch.
Perhaps after a few weeks of use he'll realise that Apple is best and just migrate his Android over and go all in on the iPhone.
The only Garmin with ECG function currently is the Venu 2+ I think, but I think it only takes a measurement when you ask it to
pretty sure no watch provides an ecg without asking it to, ie even if you get a dodgy heart alert you still have to manually take an ecg reading. So if you sleep through an episode you’ll maybe get a notification waiting for you in the morning but you won’t get an ecg read out.
Why don't you for a 7 day monitoring device from GP? (They're available..I've been offered one)
Interesting topic…
I’d deffo listen to the findings of a wearable, TBH..
Cardicor /kardicor is a device that records an actual tracing, but is user triggered..
To say 50% of people with PAF DON’T know they have it is likely an understatement, so triggering would be a challenge.
7 day recordings do exist,,might be of use..
DrP
There's even the Zio patch that can be worn for 14 days. I had one of those. (Wasn't on the NHS though.) It seemed to produce good (in my case reassuring) data.
Another option for continuous ECG is this. https://uk.fourthfrontier.com/products/frontier-x
I've got one after a brush with arrythmia a couple of years ago. Very good for continuous tracing, it's basically a holter monitor (but with fewer leads) gives excellent traces and my cardiologist has been happy to look at the traces for signs of AF.
It's way better than the kardia I had for a bit.