Accurate heart rate monitoring post pacer

I am post Medtronic DC pacer 6/30/20 for trifasiclular block. I am generally doing better but wondering if anyone is having trouble with heart rate monitors. When working out on Zwift my HR (via Bluetooth)increases fairly appropriately but at one point starts decreasing despite continued heavy exertion falling back. to the 70's. On the other hand my Apple Watch records a high rate at the same time. Any explanations?


confusing the monitors

by Tracey_E - 2020-10-02 16:25:11

It's pretty common for monitors not to be accurate for us. When in doubt, count manually or use an oximeter or blood pressure monitor, but even those can be fooled. They may miss paced beats, there may be small beats between the strong beats that are missed, it may pick up the pacing as a beat as well as the real beats, the pacer itself can interfere. Don't trust any of them, just use it as a guideline. If you feel bad, stop and count manually. 

My apple watch is the most accurate I've found, it uses the blood under the skin on the wrist where it sits. However, I have occasional dips that we picked up on my recent stress test that I've never noticed on the watch. Big dips, like dropping from 160 to 110 then going back to 160. Any time I've used the thing on my phone where you put your finger, it says my rate is over 200. Last time I tried a garmin with a chest strap,it read 0. The monitors built into elliptical machines that pick up your rate from the handles are all over the place, up then down then up. Some people get accurate readings without issue.

+1 for the Apple Watch

by CyborgMike - 2020-10-03 02:05:37

All consumer HR monitors are subject to inaccuracy due to poor connection (skin conductivity), poor placement, over simplified software, etc. Most do not deal with "noise" well, in the form of abnormal beats, arythmia, junctional rythms, afib, etc. Different monitors will work better or worse for different people.

For me, I've found my Apple Watch to be invaluable.  98% of the time it gives me good readings during workouts, resting, and it keeps good logs all day long. That said, ocassionally weird stuff happens -- like it can't lock on my HR during a walk or run. Most of the time it is benign, but sometimes my heart is in an irregular rhythm. If I look down and see it isn't capturing the HR or the number looks odd or I suspect an issue then I pause and switch to an ECG read for 30 seconds. The ECG is incredibly accurate and gives a high resolution visual view of my heart beat. It is also 10X better at giving an accurate HR count than the standard "back of wrist read".  For me it is the gold standard.  I might go months without using the ECG but it is nice to know it is there when I need it.


Smart watches and HR

by bill328 - 2020-10-03 13:29:54

On my last visit to my EP I ask him about my smartwatch indicating a low HR, below the threshold of my PM. I take Losartan and diltiazem for high BP. The first thing he did was to take me off diltiazem for a 2 weeks monitor, diltiazem slows the heart. Secondly, he said that if you have normal HR smartwatches work pretty good, but if you have PVC's the smartwatch tends to count the PVC event as one beat. Knowing this I now use my smartwatch and a general indicator of my HR. Since stopping the diltiazem my HR has stayed well above the trip point for my PM, which is 50. Also, my BP has stayed in the 130-140/70-80 range.

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