afib and sleep apnea

[poppypete]

Jim...

re: "My suggestion is to start with either a Kardia Mobile or Kardia Band and 
(1) learn to identify what type of afib you have, assuming you are in aib and do not have another type of irregular heart beat. Once you get this basic understanding you should be able to extrapolate what is going on in the water,  but in any event 
(2) you will know what is going on out of the water, which I assume is most of your life  "

I took this advice finally, and have now a Kardia Mobile.

The attached reading, from this morning after arising from an excellent night of rest, suggests to me this particular one minute is without afib (only during that minute, I now understand), as it differs from what was showing up yesterday afternoon (which I won't at this time attach, as personal details are included).

Am I reading with correct understanding???

Cheers...poppypete 

[jmjm28]

PoppyPete, I only see one two-page, 60 second ecg on the attachment from Friday July 27th at 5:08am. Note that on the top it says "Possible Atrial Fibrillation". Because of this you cannot assume that you are not in afib.

I am not a doctor so won't try to interpret the ecg, however this means that you could very possibly be in afib. To find out, you will either want to bring or email the ecg to your
doctor (preferably an electrophisiologist as opposed to a GP or cardiologist) or if available in your part of the world, use Kardia's analysis service where you pay a
fee for a board certified cardiologist to review the ecg. I am assuming you are in Australia or thereabouts or your time stamp is wrong. Here, on the East Coast of the U.S.
it's still July 26th.

For future reference, when you are not in afib, the ecg will say "Normal" with usually a green background.


Jim

[Jimsp1]

After a combination of using CPAP(AHI now <1) and a few ablations (PVI's) my occasional Afib events appear to be gone. To confirm this so I could stop using Eliquis my physician installed a implantable loop recorder(Reveal LINQ) which has a 3 year battery life. This nifty little device has build in algorithms to detect Afib and other arrhythmias. There is also a small and hand held device you can use to mark when you think an event has occurred (or perhaps after you've been swimming) Each night a monitor setting next to my APAP reads data from the recorder and the transmits the data to a collection center. Periodically they will sent a report to my physician. After 8 months with no Afib events my physician OKed discontinuing the Eliquis. I'm still continuing the monitoring in case the Afib reappears.


I also have the a Kardia mobile which was very helpful as my Afib events were periodic and I was able to record one of them to share with my physician.

[poppypete]

Jim...

re: "For future reference, when you are not in afib, the ecg will say "Normal" with usually a green background."

Thanks for all that info, and your points are well noted. I'm still looking into them.

I did a 'guest' reading on my partner, and so I now have seen/compared what a 'normal' egg reading looks like, and is recorded showing 'normal', so yes, I was a bit premature in my excitement!!!

I also noted that her heart rate range during the 30sec recording, was only + or - 3bpm, whereas mine is of the order of + or - 30-40bpm...which suggests I have tachycardia???

I'll get in touch with my cardiologist in the first instance, and clear up this up...and let him know I now have a Kadia Mobile.

Appreciate your comments, as always...poppypete 

[jmjm28]

Hi PP,

By definition Tachycardia would be over 100 bpm and you were at 79. What meds are you taking? I wouldn't be surprised if you are on rate control meds because afib often presents with a very high heart rate but not always.

When you say your partner's HR varied by only plus or minus 3bpm are you talking about what you observed during the ecg or something else? It's not unusual with afib to have variance in HR because afib is an irregular beat and often the actual HR is not what is shown on a HR monitor but can be computed from the ecg itself if you are knowledgeable.

Glad you figured it out and contacted your cardiologist. Did you email him the ecg and did he confirm you were in afib? In any event, now you will have a much better idea what kind of rhythm you are having and can track better the effect of different interventions such as CPAP or I believe an upcoming ablation? Just to throw out an idea, are you overweight at all? Some studies suggest that if someone overweight loses 10% of their body weight they have a significantly better chance of staying out of afib. On a personal note, I had 15 episodees of afib and SVT last month and none this month. The difference was I lost 15 pounds and started the FODMAP diet. I can't for sure say this was cause and effect but I'm hopeful.

Jim

[poppypete]

Hi PP,

By definition Tachycardia would be over 100 bpm and you were at 79. What meds are you taking? I wouldn't be surprised if you are on rate control meds because afib often presents with a very high heart rate but not always.

(Sotalol 80mg half morning/half at night; Marevan/Warfarin 4mg in lead up to cardioversion on 4 Sept; Telemisartan HCTZ 40/12.5=Micardis Plus one daily)

When you say your partner's HR varied by only plus or minus 3bpm are you talking about what you observed during the ecg Yes or something else? It's not unusual with afib to have variance in HR because afib is an irregular beat and often the actual HR is not what is shown on a HR monitor but can be computed from the ecg itself if you are knowledgeable.

Glad you figured it out and contacted your cardiologist. Did you email him the ecg and did he confirm you were in afib? I am yet to be back in touch with him In any event, now you will have a much better idea what kind of rhythm you are having and can track better the effect of different interventions such as CPAP or I believe an upcoming ablation? Cardioversion 4 Sept 
Just to throw out an idea, are you overweight at all? Yes 
Some studies suggest that if someone overweight loses 10% of their body weight they have a significantly better chance of staying out of afib. On a personal note, I had 15 episodees of afib and SVT last month and none this month. The difference was I lost 15 pounds and started the FODMAP diet. I can't for sure say this was cause and effect but I'm hopeful.
Definitely worth my trying to lose some weight, and see if that helps me too.

Jim

Thanks Jim...poppypete ('PP') 

[jmjm28]

PP,

Your efforts on sleep apnea here show you are motivated to modify your lifestyle both in regards to afib and I assume your general overall health. However, if you are
medically obese (Defined as BMI over 30 or 30 pounds overweight) then losing weight can significantly improve your chances of staying out of afib, potentially more than any a CPAP machine or even a medical approach. But according to the studies, the major benefits begin when you lose 10% of your body weight which takes a real commitment as well as a plan that you should run by your doctor to make sure you lose that weight in a safe fashion. Not only will it increase your chances of licking your afib but losing this amount of weight may potentially significantly reduce your sleep apneas even without a machine. Combining your weight loss with an appropriate exercise program should give you even further benefits. Not as studied, but beneficial to some of us with afib, including myself, is the FODMAP diet developed by Monash University in your country, Australia.

"....After an average of four years, 45 percent of patients who lost 10 percent or more of their body weight and 22 percent of patients who lost 3 to 9 percent of their weight achieved freedom from atrial fibrillation symptoms without the use of any atrial fibrillation surgery or medication. Only 13 percent of patients who lost less than 3 percent of their body weight were free of symptoms without these treatments. Even with the use of surgery or medication, those who lost more weight were substantially more likely to achieve freedom from atrial fibrillation symptoms....

https://news.heart.org/losing-weight-sub...rillation/

Jim

[poppypete]

I posted this (below) on my other thread about software...

• ...without eliciting any response:
  

"12-03-2018, 09:34 AM 
RE: ChoiceMMed oximeter MD300W314
Last Thursday afternoon, 29th November, I was finally cardioverted...successful on the first attempt and discharged in rhythm/sinus.

I took a Kadia reading over 1 minute next morning, with Finding by AliveCor: Unclassified...and my pulse rate was 51bpm.

My AHI result for the hours I was using my ASV reflected as usual...<1, however it was not my best night as I awoke over 4 sessions of brief periods...this being somewhat unusual for me (of the last 4 months).

For Friday, Saturday and most of Sunday I was pleased with my low heart rate (monitored periodically with a heart band monitor and a Suunto watch), and a finger SpO2 reader when not wearing the heart monitor band....and my sleep apnea results.

On Sunday night I attended a neighbourhood Xmas drinks 'do', and had over 4 hours, 5 Hahn Lite stubbies while wearing the monitor...my first alcoholic drink since the previous Tuesday.

Alas, I noted a change to the 'below 90' readings, to rise to 'above 100' and up to 135 on walking home.

Now one neighbour is a retired doctor, and on showing him the Kadia graph result of the previous Friday morning, suggested the absence of 'a P wave' might indicate that I was still in Afib...and this was confirmed with my GP yesterday morning.

I will be seeing again my cardiologist on his return from holidays on 17th December, and meanwhile will continue on beta blocker and blood thinner tablets as previously prescribed until then, but what I would like to present to both him and the sleep physician I'll see after that consult, is the SleepyHead data and the SpO2 data on the one graph.

Previous posts have explained both my own Windows MediView download of SpO2 being read separately to the SleepyHead data, but has the latest work resolved past issues, and, if I purchase something from Supplier #19 now, will I be able to achieve my objective now...to see the SpO2 data within the SleepyHead graphs???

Thanks...poppypete."

Now I have had my cardiologist visit, with the outcome that I will not be attempting cardioversion again...seeking to control the Afib with medication from here on.

This is due to my age (74), and the fact that the cardioversion 'correction' only held for such a short period of time.

My beta blocker dose has now been doubled...to 80mg Sotalol morning and night.

I'm off Warfarin now, reverting to Eliquis dose of 5mg twice a day.

My ASV machine's sleep assistance (with collar) is giving me excellent results (last night 7hr 30min, uninterrupted by only 4 hypopnea...no apnea)...but I would dearly like to be able to read my SpO2 and heart rate within the SleepyHead charts.

What I need now is to get an SpO2 reader to replace my current one, which doesn't do that...

• ...so can anyone offer advice on this please?
  

Cheers...poppypete. 

[Sleeprider]

Many members seem to successfully use Sleepyhead with CMS oximeters to show data side by side. I don't use this equipment so am not much help. The ASV presents an interesting use of the data because in addition to events, you can see where the machine is increasing pressure support and working harder to prevent apnea, hypopnea and periodic breathing. Glad to hear the ASV is still working out for you. Happy and healthy new year.

[jaswilliams]

Get a contec CMS 50F will do a reasonable job. But instructions are very poor also you will have more success if you install the software in a custom location on your pc otherwise you have to jump through a few hoops to import the spo2 files into sleepyhead. It’s not 100% but usable for occasional use.