AF or ectopics?

[Sambaqui]

I was diagnosed with PAF in January during a visit to A & E after passing out briefly. Until recently (and now recovered from the shock and initially prescribed medication) I have been largely unaware of symptoms but sometimes I notice a rapid light drumming in my chest for short periods – up to 30 seconds – and usually early in the morning on waking up. If sufficiently awake I finger-check my pulse and it seems to be in sinus. My question is: can there be AF when the pulse is in sinus or does this drumming indicate ectopics, which a recent seven-day ecg shows to be quite frequent, though there was no incidence of AF.

[BobD Volunteer]

It is pretty well impossible to say without an ECG but generally speaking if your pulse is regular then it is not AF. Gaps in your pulse indicate ectopics. Sounds to me like brief runs of tachyacardia (fast heart rate) which are quite common and apparently quickly self righting in your case.

The problem with us is that we all get far too sensitive to what our hearts are doing and notice things others are unaware of. Try not to get too stressed about them

[Sambaqui in reply to BobD]

Thanks, Bob, for your helpful words. I guess the over-sensitivity comes with the condition - and also a real curiosity about all these different rhythmic possibilities that our hearts are capable of. It would be great to learn more about the various ecg patterns and their medical implications (without the necessity of training as a cardiologist!).

[BobD Volunteer in reply to Sambaqui]

Sometimes too much knowledge can be as bad as too little. Few doctors who are not specialists can really read and understand ECG traces. I read a lecture some years ago where a room full of doctors were given a series of traces and something like 70% either missed something important or got the wrong result. According to a software guru I know it is important to know the gender of the person tested as that can have an affect on the results due to amplitude differences. After fifteen years I understand about three rhythms but would not stake my life on that. lol

[Sambaqui in reply to BobD]

Three rhythms are three more than I understand - and it doesn't seem likely I'll be able to find an evening class on the subject. If doctors have problems, I am wondering about the accuracy of the interpretations offered by a Kardia.

[BobD Volunteer in reply to Sambaqui]

A lot come back unclassified I understand. One big problem with Kardia is interference. One needs to moisten fingers and be very steady or all sorts of funny lines appear . I can only get about five or six groups mid trace which are clean usually but it must be six months since I did a trace I guess.

[DK81 in reply to BobD]

In order to decide whether to take anticoagulant medication we need to know how the heart is performing. This is essential information, but is difficult, if not impossible, to obtain. There must be a scale ranging from NSR at one end to AFib where blood clotting is moderately likely to occur at some stage. Many people will experience something in between, maybe a mixture over time of NSR, ectopic beats and AFib. The balance of these, including the duration of each phase, is one parameter of the phenomenon. I cannot see the point of analysing everything if the information referred to above is not available.

[Sambaqui in reply to DK81]

I guess what sets us on the inquiring path is the idea (fantasy?) that we might be able to get some idea of the balance and therefore be better able to make choices in treatment.

I wonder is there such a thing as a 365 day ecg?

[Sambaqui]

Thanks for all your responses to my question(s), Bob. They are much appreciated.