Heart Stuff Update

[For The Popcorn]

I posted about my atrial fibrillation in a recent post about EKGs. Let me share some of my story and tell you about a nifty little device that could save your life.

Let's start with the device. For around a hundred bucks, you can buy Kardia 6L EKG recorder that's about the size of a credit card folded in half. In less than a minute, you can have a high quality "1 lead" EKG by holding each end with your fingers or a "6 lead" EKG by holding the ends with your fingers and touching the back to your left leg. This is a device recognized by cardiologists and personally used by many. Send them a pdf of the result and they believe what the data shows.

It was discovered I had arterial fibulation (afib) back in June. Afib is caused by overactive areas in the atria that send out erroneous pulses rapidly, which makes the heart beat rapidly and irregularly. The result is that the ventricle can't pump blood efficiently, and any bit of activity leaves you breathless and out of energy. But this isn't likely to kill you. The big hazard is that all this improper motion in the atria can result in blood clots, which then break away and can cause a stroke or other blockages.

Afib can be corrected by cardioversion – a shock to the heart with a defibrillator or chemically. For people who haven't been in afib long, this may be a one&done procedure. I had a cardioversion. I was in rhythm for about 4 days before I slipped back into afib.

I had another cardioversion after taking a drug that helps you stay in rhythm (and has serious side effects if taken very long). This one lasted about 5 or 6 days.

I had another cardioversion. This time, the doctor shocked me 5 times, and I didn't covert back to rhythm. A different doctor, different equipment, different day, heart was being stubborn, who knows.

Last Saturday, I woke up and I was in rhythm. Spontaneous reversion.

One way to treat afib is by cardiac ablation – catheters are inserted and threaded into your heart to map out the overactive areas and then use RF energy (or freezing) to isolate the overactive areas by creating scar tissue and isolating them electrically from the rest of the heart. This had been the treatment plan for me all along, but it took some time to rule out other problems and get the procedure scheduled.

Wednesday morning I had a pre-procedure CT scan. Wednesday morning, I woke up out of rhythm again! And an hour later, I was back in rhythm! The body plays cruel tricks, and as far as I know, Saturday and this time are the only times it's happened.

I had my ablation Thursday (yesterday as I write this). I don't know if "piece of cake" and "easy as pie" translate to the Queen's English, but you should get the idea. It was about a three-and-a-half hour procedure, under general anesthesia. Three catheters were inserted into veins in my groin and snaked to my heart, where the mapping and ablation were done.

After the procedure was finished, I had to be flat on my back for 4+ hours to allow the veins to seal. I had some oozing, so even longer flat on my back. Because my procedure started late in the afternoon, I had to stay in the hospital overnight. I slept flat on my back until 1:30 am (an hour longer than I needed to) when my back said "enough!" Between preparation, the procedure and waiting on the veins, I had been flat on back for 12 hours. This was the most painful part of the procedure!

Today, I have no pain (well, other than the usual ), I'm in rhythm and I feel great. It does take time for the scars to form, so there's a change I'll slip out of rhythm and need another cardioversion, but I'm optimistic.

This is a Kardia plot showing afib. Note the irregular spacing. Some beats close together, sometimes looking like a beat was skipped.

This plot is the neatest plot Kardia provides. It's the spacing between heart beats. It makes irregular beats simple to see...and boy did I have them!

These are the measurements taken today.

 

[rjenkinsgb]

For info, the latest (at least) Apple watches include an ECG (EKG) facility - the sensor is in the watch crown - as well as the optical pulse and blood oxygen sensors.

There are options you can enable to give alerts for afib, as well unduly high or unduly low heart rate etc.
Also fall detection.

ps. The dust at the top is inside the cheap clip-on screen protector. It's not visible except in the photo and I've taken the screen protector off and polished everything, with no effect.

 

[For The Popcorn]

The problem I have with the Apple Watch is that it's a closed system. I use an Android phone, and the watch won't interface to Android.

The cost of a Kardia is about a quarter the cost of the Apple watch and also can do a 6 lead EKG which in some cases provides vital information to a cardiologist.

At any rate, if you have an Apple watch, check your EKG once in a while. An occasional arrhythmia can happen for various reasons, but if it happens regularly, best check with your doctor. Catching something early may prevent more serious problems from developing.

 

[Nigel Goodwin]

There are plenty of other cheap watches that will measure your heart rate, and warn you of afib - or an app on your phone will measure heart rate, simply by shining the 'flash' LED through your finger and reading the variations caused by your heart beat using it's camera.

Personally I have a 'chest strap' monitor (as used in the gym), and when I go walking this connects (via Ant+) to my Garmin Walking GPS - and creates a nice graph of altitude against heart rate. You can also get them as Bluetooth, or both - but at the time i got mine it was Ant+ only - a few phones will accept Ant+ (neither of mine will), but pretty well any will accept Bluetooth.

The Kardia device is pretty cool though

 

[rjenkinsgb]

The problem I have with the Apple Watch is that it's a closed system. I use an Android phone, and the watch won't interface to Android.

The cost of a Kardia is about a quarter the cost of the Apple watch and also can do a 6 lead EKG which in some cases provides vital information to a cardiologist.

Absolutely, but I suspect there are quite a few people who already own them just don't realise all the capabilities included.

The Apple ones have only just barely got to the point, at 7th version, that I consider one more capable than the Pebble smartwatches I've used since they first came out on Kickstarter, ten years ago.
(And they still can't compete on battery life - barely two days for the Apple 7 vs ten days for the last Pebble).

At least they now have an always on screen, that the Pebble ones have always had!

 

[Tony Stewart]

I like the Kardia and bought one for $59 cdn TY
I wonder what PI% means in digit oximeters 10% down to 2% pulse interval deviation Averaged of 4, or ?
this is dynamic so what is the threshold for A-fib? > 25% ?

I had no wrist pulse with a bypass to elbow 3yrs ago but surgically unavoidable neuropathy now yet full strength.

p.s. My Kardia arrived quickly but it failed to start, connect to two different devices, battery was OK. so it is now back to sender with their prepaid courier label. (27-Nov)

 

[For The Popcorn]

Looks like PI is the perfusion index, which seems to be kind of a "signal stength" meter. If the pulse ox is poorly positioned or blood flow is restricted because of cold hands, the number drops. I don't think it's got any diagnostic function.

It's a few days after my procedure and I'm pleased to report that I'm feeling great, more energetic, pain-free and in rhythm. Pretty amazing technology.

 

[Nigel Goodwin]

Looks like PI is the perfusion index, which seems to be kind of a "signal stength" meter. If the pulse ox is poorly positioned or blood flow is restricted because of cold hands, the number drops. I don't think it's got any diagnostic function.

It's a few days after my procedure and I'm pleased to report that I'm feeling great, more energetic, pain-free and in rhythm. Pretty amazing technology.

Congratulations, are you considering going to cardiac exercise classes?, I presume you have support groups over there?. I've just got back from my Monday session.

 

[For The Popcorn]

Yep, I've been doing rehab (exercising) twice a week. This week I'm taking it easy until my followup appointment, then back to work.

 

[Nigel Goodwin]

Yep, I've been doing rehab (exercising) twice a week. This week I'm taking it easy until my followup appointment, then back to work.

I do circuit training twice a week with my heart support group, and do a little dumbbell work at home every day - during 3 weeks in ICU I lost all my muscle mass, and could barely lift a cup of coffee when I came out. While muscle is easy to lose as you get old, it's not so easy to restore - however, a year or so on I'm now up to 2x8kg bicep curls. When the weather is nice I walk as well, getting up top about 5 miles now.

If you can continue going to rehab, I would recommend it - we have a good few members who have been going to the group 20+ years, which is an encouraging length of time after a heart attack or other cardiac problems.

 

[Tony Stewart]

Had an oops 3 weeks ago brushing my finger tip to the bone on a rip circ. saw trimming a hedge top.
That did a nice job cutting thru all the veins and nerves. Dr. was hopeful it will reconnect. Styptic and a tourniquet were essential since the blood thinner pill would prevent clotting. I drove 1hr myself to emerg. to a more distant hospital to reduce the 4hr typical wait to 1hr. to get stitches.

 

[For The Popcorn]

Yikes. Hope it heals well!

An update on my progress – it's been almost 3 weeks since my ablation. I'm staying in rhythm and feeling more energetic. It can take a month or more before the ablation is fully effective, but it's a success so far.

 

[Nigel Goodwin]

Had an oops 3 weeks ago brushing my finger tip to the bone on a rip circ. saw trimming a hedge top.
That did a nice job cutting thru all the veins and nerves. Dr. was hopeful it will reconnect. Styptic and a tourniquet were essential since the blood thinner pill would prevent clotting. I drove 1hr myself to emerg. to a more distant hospital to reduce the 4hr typical wait to 1hr. to get stitches.

A number of years ago I removed the finger tips from three fingers of my right hand (I missed the thumb and little finger) with an electric plane - so no stitches, nothing to stitch

At A&E they said I'd "only removed the pulp", as it hadn't quite gone down to the bone - you could see bone, but it hadn't been damaged.

All they did was apply cream and bandages, and I went to the doctors, or back to the hospital, every few days to have it examined and redressed.

Every time they removed the bandages there was no improvement, just leaking nasty coloured 'stuff' At no time was I offered any suggestion as to what the outcome might be - it would have been nice to have been told that they grow back

Then one day, at the hospital, they took the bandages off and the finger ends had scabbed over (think small gross golf balls on the ends of each finger) - and they left them un-bandaged. This was a nightmare driving back to work, as while they were very sensitive before, they were EXTREMELY sensitive like that. So on my way back to work, I called at a Pharmacy, and bought surgical tape etc. to wrap them up.

One thing they did say at the hospital was that I wouldn't get full feeling back in the fingers, which was correct, but it's certainly far better than I imagined - particularly when I didn't even know they would grow back.

So you're quite likely to see some loss of sensation, but it may be less than you imagine, the ends of my fingers were completely gone, yet they grew back and work quite well.

Good luck.

 

[Tony Stewart]

Before when I lived in Winterpeg, my fingers had good circulation and heat in -30'C Feb. Now the fingertip turned like bleached-white even with mitts on after 15 min at 0'C. So heat capacity = 10% , feeling 0% and full finger swollen 33% to improve flow. So it returned to pink.

I read there are 5 million meters of vascular pathways.

It's a miracle how the body repairs some parts.

 

[Nigel Goodwin]

Before when I lived in Winterpeg, my fingers had good circulation and heat in -30'C Feb. Now the fingertip turned like bleached-white even with mitts on after 15 min at 0'C. So heat capacity = 10% , feeling 0% and full finger swollen 33% to improve flow. So it returned to pink.

I read there are 5 million meters of vascular pathways.

It's a miracle how the body repairs some parts.

Yes, and when you have regular visits to the 'hand clinic' at the hospital, you're absolutely amazed how many of the population are walking about with missing digits. Looking round the waiting room, it was full of digit-less people

While I was waiting there one day, an elderly man and women walked in, and he was sent straight through as an emergency - and his wife sat down next to me (busy waiting room, not many seats). So we were talking, and she explained her husband had caught his fingers in a hedge trimmer

She said their next door neighbour was a GP, so he bandaged the hand, and sent him to A&E (who sent him through to the hand clinic) - apparently the fingers hadn't been 'removed', just badly damaged.

Anyway, we were talking, and I noticed she had a couple of fingers missing from her hand - so I commented on it - to be told it was "from horse riding". I didn't get any more information, and ever since that day I've not been able to find anyone (and I've asked in horse riding circles) who can suggest what she meant?.

I thought does a horse perhaps bite your fingers off?, do you fall off and your fingers get caught in the reins, and rips them off? - no one has any idea?.

 

[For The Popcorn]

I had a physic teacher in high school who had no ring finger on his left hand. It wasn't amputated, there was no space for it. The cause is not for the squeamish, so please don't continue if this applies to you.

Spoiler

Many years before, he had jumped off the roof of a camper, and caught his wedding ring on a roof rack. The entire finger, tendons, etc. were literally ripped from his arm.

 

[rjenkinsgb]

Tony Iommi (of Black Sabbath) lost two fingertips as a teenager, in an industrial accident - and he is still one of the worlds top guitarists!

 

[Nigel Goodwin]

Tony Iommi (of Black Sabbath) lost two fingertips as a teenager, in an industrial accident - and he is still one of the worlds top guitarists!

I know, pretty amazing isn't he - it's suggested that it's the reason for the invention of heavy metal, because of his unusual playing technique.

I like the way his dummy finger tips in the picture have the suggestion of nails on them