
Heading to a cardiologist - omnibrain
https://www.reddit.com/r/AppleWatch/comments/a40qm5/heading_to_a_cardiologist/
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empath75
I’ve got the Kardia and had the opposite experience. I was having heart
palpitations and was convinced I was dying even though every time I went to
the cardiologist they said it was just premature contractions and nothing to
worry about.

Since it was intermittent, I was convinced they just weren’t capturing the
afib while it was happening. The doctor recommended I get the kardia.

After a few weeks of compulsively checking the kardia every time I had a
palpitations it kept saying over and over again ‘normal’. I even captured a
few that had visible skipped beats and sent them in to their technicians and
they said ‘pvcs’, the same thing the cardiologist told me.

After a month or so, I finally convinced myself I wasn’t dying and the pvcs
slowed down to the point where I barely noticed them.

Turns out that anxiety about heart palpitations _causes heart palpitations_
which is sort of fucked if you think about it.

I basically quit caffeine, started exercising more and now I just get pvcs for
a few minutes every few weeks or so instead of for hours every few days.

So yeah, if you have any anxiety about heart stuff at all, I recommend getting
the new watch.

~~~
BenjiWiebe
I've had PVC's too. Getting enough sleep is what takes care of mine. When I
get overtired they start to come back.

~~~
rootusrootus
That's happened to me, too. Worst episode I ever had was in India earlier this
year, while dealing with jet lag and a significant case of gastrointestinal
poisoning, my PVCs stepped up to once every two-three beats. For a short time,
they spiraled into some form of SVT (not formally diagnosed as this was before
I started carrying an EKG on me) that resulted in visible chest movement (as
in you could stand in front of me and watch my chest shaking) and a 240 bpm
reading on my Apple Watch. Good times. Between being absolutely run-over-by-
train tired and having (likely) electrolyte imbalances due to the impossibly
large amount of liquid going in one end and out the other, my heart was not at
all pleased.

Now that I'm back on my routine schedule, I find that everything is mostly
okay if I get a full night's sleep and take my meds. Even with the meds,
though, if I get woken up by the kids or something and get a half-night of
sleep, the PVCs ramp up quite a bit. As does the temptation to find some
caffeine, which would be completely counterproductive.

Sorry for the wall of text.

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happybuy
Apple as the world's leading health tech company is currently underrated and
not widely thought about.

Despite a confused and unfocused introduction, the genesis of the Apple Watch
came about when Steve Jobs was ill and had to experience the issues with the
healthcare system first hand. It's been documented that the watch project came
about as a result of this experience and the true goal for it is to contribute
significantly to improvements across health and the broader healthcare system.

The biggest issue with introducing a new wearable product is having users
happily wear it. In recent times, only Apple has been successful in doing so.
This shouldn't be dismissed as it will give them a market advantage for
decades to come.

~~~
curt15
Meanwhile, the Android OEMs that tried to get in front of the Apple Watch by
rushing their own products to market seem forever condemned to third-class
marketshare. What happened?

~~~
happybuy
Apple managed to get people happy to wear a computer on their body for most of
their waking hours. Even 10 years ago such a thing would have been considered
far fetched.

They called this computer a watch so that people had a shortcut to think about
its utility and placement on the body.

They then introduced it as a high-end fashion item (e.g. in gold) to ensure
that style makers can't dismiss it as simply a geek low end piece of
technology. It didn't need to continue to be a high end item but by
introducing it as this, it managed to allay any potential initial low end
connotations.

They managed to make it a high-end fashion item by hiring some of the most
experienced people in luxury goods. People such as the former CEO of Burberry,
the former CEO of Yves Saint Laurent and world class designers such as Marc
Newson.

What did Android OEMs do? They slapped some technology together, grabbing an
OS from Google and a processor from Qualcomm. Lately they've tried partnering.
None of it will work and they should just give-up trying to compete with such
a multi-faceted approach that Apple is taking with wearables.

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mhb
I don't understand something from the the reddit thread. He said his heart
rate was finally down from 120-140. If that's your non-exertion heart rate,
isn't that a pretty good sign that you should see a doctor? Apart from any
more sophisticated diagnosis?

~~~
JshWright
Yeah, if your heart is beating that fast, you should go see a doctor... If a
fast heart rate is accompanied by other symptoms (feeling light-headed, short
of breath, etc), call an ambulance.

~~~
edentel
I’ve had a handful of those episodes over the summer but only after heavy
exertion. Running stairs for 4 hours at an indoor water park, TKD sparring,
and once or twice after very stressful events. I wrote it all off to a
stressful year with unique occurrences. That morning I just happened to be
paying attention and the Watch was the final straw that made it click.

~~~
peatmoss
Pardon for asking, but if you’re doing TKD sparring, my hunch is that you’re
otherwise pretty fit? I do a lot of aikido as my primary source of cardio
exercise, and my resting heart (Apple Watch 3, now thinking about the 4) is
quite low (low/mid 50s). I have no idea what my heartrate is when I’m at peak
exertion, because I can’t practically wear the watch on the mat, but I suspect
it’s probably up pretty high.

So, if I understand things correctly, your doctor would otherwise probably
look at you and be like, “nah, don’t need to worry about this guy’s heart.” Is
that fair to say?

~~~
mikestew
_So, if I understand things correctly, your doctor would otherwise probably
look at you and be like, “nah, don’t need to worry about this guy’s heart.” Is
that fair to say?_

Not OP, and I’m sure as hell not a cardiologist, but I would have fit that
description. Wolfes-Parkinson, and would only rarely raise its head under
narrow circumstances involving exertion. If you looked at my heart (which they
did) and it didn’t repro the problem, you’d never know the difference. Former
Cat 1 bike racer, and pretty damned good distance runner, I was for sure fit.
But you can’t outrun genetics.

HR of 145bpm an hour after exercise told me, “something ain’t right”,
abalation fixed it. I’m not diagnosing, and odds are darned good that OP
doesn’t have _my_ problem, but if it were me I’d pay a visit to doctor. Being
fit doesn’t exclude one from heart problems. Wolfes-Parkinson killed a college
ball player many years ago, and I personally witnessed a 35 year old Cat2 bike
racer drop dead mid-race from what I suspect was Wolfes-Parkinson or a similar
heart-related anomaly (again, IANACardiologist).

And as a side note, I wish the Apple Watch were around fifteen years ago. In
an attempt to get a repro, I wore this inconvenient contraption for a few
weeks (no repro). I know it’s only single lead, but at least I would have had
_something_ to record data when the problem repro’ed. And were the watch to
have picked up something, I would have gone to the doctor a lot sooner because
at least I had _a_ tool that’s probably better than Dr. Google. As it was, “I
should make a doctor appointment. Meh, probably nothing.” Men...amirite?

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graupel
Anyone know - can I stop in an Apple Store and try this on a demo watch which
is out for display, or do you have to be logged-in to iCloud and paired to a
phone for it to work?

~~~
alienreborn
Don't know about demo at Apple Store but setup of ECG required Health app on
my iPhone. So if you already have an iPhone, you can just 'buy' the watch, use
it for couple of weeks and return it if it doesn't interest you using Apple 14
day return policy.

------
captainperl
The reddit post was interesting but not helpful (actionable) for other
patients.

In the USA, if you experience the symptoms of a heart attack, you just take a
taxi to the emergency ward, walk up to the receptionist and say, "I think I'm
having a heart attack."

You will get priority over everybody else, minimal forms, and you don't need
insurance to get initial treatment.

If you can think of other reasons for the symptoms, like you went to the gym
for the first time the day before and have chest muscle soreness, then you can
just sit in the lobby while you sort things out. (Walking up a flight of
stairs at the hospital is a good DIY stress test. Some on-call doctors
actually ask what entrance you arrived at, and if there's a ramp, they know
you're prolly ok if you walked in.)

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lordnacho
I went on a weird diet of pure fat once and my wife could feel my heart was
skipping a beat.

Went to a cardiologist and he told me to stop, though he said it might be a
virus. I wore a machine for a day and it was showing loads of missed beats.

No symptoms since.

Worth doing if you ever suspect anything with your heart.

~~~
TuringNYC
>> diet of pure fat

Why? Was this in attempt to get to ketosis?

~~~
lordnacho
Some local gym I signed up to said it would work. Felt awful.

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kingofpandora
I've had afib and it's not as scary as "heart problem" and "cardiologist"
makes it sound like. Where I live at least, you don't even go to a
cardiologist but an electrophysiologist and if you get the operation, it's a
same-day in and out or maybe one night procedure with 85% success rate.

~~~
stared
> get the operation, it's a same-day

Could you expand on that? Radio-frequency ablation is not something that is
done the same day.

~~~
DanBC
King of pandora is saying that the operation can be done as a day surgery
under a local, and the patient can go home the same day.

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leowoo91
Good to see they got FDA approval for ECG. Anyway, I wish they could measure
glucose levels without going under skin which is still far from happening.

~~~
bmogen
Isn't that the roadmap for Verily(Google)'s opthmalogy line? Contact lenses
with blood glucose sensing?

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sunstone
I clued into my afib when I tried to take my heart rate in the usual way by
counting pulses but the pulses were too irregular to count consistently.

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dzek69
> pressure still elevated around 125/80 Elevated? 120/80 is perfect. 135/x
> seems only a bit worrying for everyone around me. I recently had around
> 150/x for whole week.

I know something is going on, keeping on doing the checks, but saying 125/80
is elevated sounds so silly to me. I've never seen such nice pressure on
myself.

~~~
c0nducktr
120/80 is now considered per-hypertension.

~~~
Guereric
Source? I have never seen 120/80 mmHg, which is vastly considered normal for
those without CV disease, labelled as pre-hypertension.

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the_arun
Does AppleWatch measure the ECG on the wrist or the crown? Cause it asks me to
hold Crown while collecting ECG data.

~~~
Despegar
There's two features: the irregular heart rhythm notification (available on
Series 1 and later) which uses the heart rate sensor and is passively
monitoring you, and the ECG app (only available on Series 4) which is an
actual ECG (lead 1).

>If the PPG-based arrhythmia detection is enabled, each tachogram is
classified using a proprietary algorithm to determine if an irregular rhythm
may be present. An irregular tachogram initiates a cascade of more frequent
tachogram collection (as frequently as possible, subject to a minimum spacing
of 15 minutes) and analysis. Tachograms are collected and analyzed only if the
user remains still enough to obtain a reading; because of this, the algorithm
is not always monitoring the user, but rather is doing so opportunistically
when adequate signal is available for collection/analysis. If five out of six
sequential tachograms (including the initial one) are classified as irregular
within a 48-hour period, the user is notified of the potential arrhythmia. In
addition to the notification, the user can access more information related to
these irregular tachograms within the Health app (Figure 1). If two tachograms
are classified as not irregular before the threshold is reached, the cycle is
reset and tachogram collection returns to the baseline rate (every two hours).

Apple published a white paper and a mini site for medical professionals about
it [1][2].

[1]
[https://www.apple.com/healthcare/site/docs/Apple_Watch_Arrhy...](https://www.apple.com/healthcare/site/docs/Apple_Watch_Arrhythmia_Detection.pdf)

[2] [https://www.apple.com/healthcare/apple-
watch/](https://www.apple.com/healthcare/apple-watch/)

~~~
JshWright
To clarify a bit, the first (passive) feature only uses data from the wrist.
The ECG app requires both the wrist and the crown.

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doctorpangloss
I agree, men should go to the doctor more often. It would improve their life
spans.

~~~
tptacek
Isn't one of the early conclusions of the "evidence based medicine" movement
that this is _not_ in fact true?

~~~
jen729w
At age ~35 I had a pretty comprehensive medical checkup as part of my
Australian permanent residency application.

I asked the doctor if I should be getting checked like this regularly.

“Do you feel okay?”, he asked. I said yep. “Then no”, he said.

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agumonkey
Well done Apple, well done

