High Heart Rate

Hi 

I'm nearly three years in with my Medtronic Dual Lead Pacemaker - August 2017 for total heart block which lasted 20 seconds in the middle of one night whilst I was asleep and only picked up because I had been feeling faint at times and had a Reveal Device implanted a year before with nothing startling until this! 
 

I wear an Apple Watch which I know some cardiologists say are not reliable for recording ECGs or heart rate reliably. I've been having palpitations ongoing but noticed two days ago when I looked at stats on my watch after getting up out of bed my HR was around 55 (normal for me I'm set at 60) but steadily climbed higher and higher  for an hour when I was really only eating breakfast doing nothing strenuous at all. 
 

Between 8.27 and 9.28 am my heart rate varied between 86 and 141 bpm really high for me with me being fairly sedentary during that hour I'm just wondering whether I need to report to my cardiologist and have a pacemaker check or maybe don't take what the Apple Watch says as gospel?  Any advice please? 
 

 

 


5 Comments

High heart rate

by Gemita - 2020-06-30 13:10:51

Hello Foxy49,

I would speak to your doctors if you feel your heart is running away at times just to be safe.  Any heart rate over 100 bpm would be regarded as “tachycardia” and will need to be assessed by your medical team.

Regarding Apple Watch and other personal monitors, firstly I would get used to checking your pulse manually (I check mine at the neck) to see if you can feel a regular or an irregular heart beat.  Then try to get used to feel whether the beat is slow, normal or fast.  You will soon get to feel what is normal for you.  At the same time, you can still use your home monitoring devices to help confirm what you may be feeling.  The home monitors may not always be able to accurately assess speed or rhythm during an arrhythmia, particularly if it is irregular like Atrial Fibrillation, but it will still give us an indication whether we are running slow, fast, regular or irregular or anything off the scale might result in an error message (my blood pressure monitor does this without fail) but it has been confirmed by my doctors to be very accurate in all other respects.

However, my symptoms alone are usually enough for me to know what is going on in my heart.   When I have tachycardia I may experience breathlessness and chest pain at rest or on exertion,  when I have bradycardia (yes even with my pacemaker!), I may experience weakness and dizziness.  I hate irregular rhythms most like Atrial Fibrillation when I feel very unsteady.  Fast atrial arrhythmias like Flutter, Tachycardia, providing I do not exert myself, I can tolerate better.

I too have had long term monitoring (Reveal Linq) and this has taught me so much about my rhythm disturbances and I can usually tell what rhythm I am in and the speed of my heart rate just by "how it feels".  If your heart rate is confirmed going up to 141 bpm, I would consider this to be abnormally high and you should speak to your doctors.  But I would go on how “I feel” too rather than on the numbers alone shown on your Apple Watch.  Your doctors will not only want to know your “numbers” but they will most importantly want to know what your symptoms are at the time.  Keep a diary of date, time you feel your heart symptoms and what you were doing at the time, so that your doctors may confirm with any pacemaker downloads any concerning events you have had like sudden surges in heart rate, changes in heart rhythm.

It could be that you have started getting a fast heart rhythm and your doctors should be made aware of this.  Please don’t suffer in silence.

 

 

Tachycardia

by AgentX86 - 2020-06-30 14:56:31

Watches aren't great for tracking heart rate but the Apple watch does get good reviews for its EKG function. Understand that it's only a single lead EKG and will miss things. It will only diagnose AFib/possible AFib/normal but if you can read EKGs there is a lot of information.

It should be pretty easy to check for tachycardia though. Just count heart beats over 30 seconds and multiply by two. If it's greater than 100, report it to your doctors. You can back it up with an EKG from your watch. Your doctor should use that as evidence.

If it were me...

by CyborgMike - 2020-06-30 21:36:50

A few things about the watch...  On the newer Apple Watches there are four ways of getting your HR that will vary considerably in accuracy. 1) passive monitoring - the watch wakes up about every five minutes checks your HR and records it. Over time these readings get combined and averaged, so if you look back at your history you will see a general trend. This "mode" is informative, but not that reliable, since sampling is so infrequent. 2) Manual check - you can open the HR app on the watch and have it manually check your pulse. I always suggest taking your pulse manually a number of times to make sure the watch is accurate with your arm/wrist. This mode should be very accurate if you have a normal pulse and the watch works well with your wrist (snug, good circulation, etc). 3) In workout mode - when you tell the watch you are working out (like a walk or run) it samples and logs at a much higher rate, so you will get a much more accurate trend. 4) ECG - in ECG mode, assuming you have a good contact on your finger to the crown, the ECG is very accurate at both rate, but also wave form. In almost all cases (except ECG) the watch will lose the HR or report too high if there is any type of arythmia (eg. Afib).

So... if it were me and I was feeling well, I would be suspicious, but I wouldn't call my doc or worry about it. I'd see if it continued to show up and/or I might tell my watch that I was going for a walk (workout mode) before getting out of bed and then stop the walk 30 min later to see a higher resolution trend of the data. 

In general, the rule of thumb is if you are feeling fine you shouldn't worry too much about it. Your body is the better indicator.

Apple Watch

by twodrifters - 2020-07-04 00:58:06

Just yesterday my Apple Watch notified me of a high heart rate (109) but I could tell I was in atrial bigeminy (every other beat is premature).  I have the Kardia app which does a one lead EKG, so I double checked the irregular rhythm.  I also manually checked my HR at my wrist.  It was 76.  

I have suspected inaccurate HR numbers as per the Apple Watch when I have an irregular rhythm, and it does seem to be the case at times.

I'm disappointed to see that you have to deal with bradycardia even with a pacemaker.  I don't know if that's common or not, since I am a newcomer here and just learning in preparation for getting a pacemaker in a few weeks.  I hope you are able to ascertain what is going on and get good input when you see your dr.

High Heart Rate

by Foxy49 - 2020-07-04 03:25:32

Thanks very much for all your helpful comments. I contacted my Cardiologist with a screenshot of my heart rate figures from my watch for the hour I was between 130 to141 bpm rate

i am having a 72 hour monitor fitted on Monday. I will report back in due course. 

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