any medical advice please? Feel really fobbed off

[Almosteaster]

Hey

does anyone know anything about the reliability of Apple Watch ECGs?

basically I’ve had several episodes of what I believe could be vtach however I understand artefacts etc can make the results unreliable. I’ve already had a 48hr heart tape which was clear as I didn’t have any episodes in this time, however the episodes can come on randomly and I’ve tried to capture it on my Apple Watch ecg.

im already under cardiology for a completely separate unrelated issue and I’ve mentioned it already but to be honest I’ve not had the best experience with my care there and I’ve had so many experiences of being fobbed off by them. I showed them my ECGs and they just said it’s useless because of artifacts. Basically I’m just not sure what to do!

im obviously concerned in case it is vtach but i dont know how to get it diagnosed or at least checked. I’m happy to go privately but just wondered, are the Apple Watch ecgs just completely useless and no point even looking at them?

i’ll attach some of them below

thanks xx

So the first 2 were when I was getting symptoms and the last one is just a normal one for me when I’m not having any symptoms/issues etc

It's a skilled job reading an ecg, not for the lay person.

You cannot diagnose anything from an Apple Watch. You might consider getting yourself a KardiaMobile device, which records a basic tracing of ECG from your finger tips. You could use it when you get symptoms. A health care professional could take a look at that.

Please don't say that you have been fobbed off. You have been investigated with a 48 hour tape. If it didn't show anything, what else can the doctor say other than it didn't show anything?

I was investigated with the tape because of my other heart issue (which was initially fobbed off as a mental health issue until I was correctly diagnosed and treated with an operation) and I felt fobbed off because when I mentioned it the doctor barely even looked and said it’ll just be artifact! Honestly I’ve felt fobbed off every step of the way so it’s hard to fully trust them, hence why I was considering going private

I've had a GP and a cardiologist say that the ecg on an Apple Watch is fairly reliable, and a result I've received a diagnosis partly because of the ECG I sent them

That’s really interesting thanks👍🏼 seems to be people have mixed opinions on their usefulness x

Hmm … whilst you cannot 100 percent diagnose an arrhythmia on an Apple Watch I wouldn’t ignore that! (GP here)
What are the symptoms?
How long do symptoms last?
I wouldn’t get myself to a doctor pretty promptly with that trace.

Usually sweats, palpitations and a sick feeling. It usually gets better within 2-15 minutes but feels absolutely rotten during that time

found another similar tracing from recently, I’ll attach it below

To be fair I came fully prepared to witness some health anxiety - but if I or a loved one had those traces, correlating with symptoms (it would be interesting to know what these are and how long the episodes last) then I would be extremely concerned and seeking further follow up. The 48 hour tape is worthless if you had no episodes during it.

Specialists in clinic are short of time and focusing on the issue you are there to see them about, which can sometimes cause them to be dismissive of new unrelated issues. Silly as it sounds when you are already under a cardiologist, I would advise you go back to your GP.

Full disclaimer not a cardiologist.

To be honest whilst I could absolutely be wrong, I would be very suspicious you are having episodes of VT. This history in combination with the apple watch tracing is extremely concerning. Next time this happens call an ambulance. In the meantime see your GP urgently.

My mum had a heart issue never captured on the tape etc as it sporadic. She captured it on Apple Watch and was diagnosed thereafter.

Given the symptoms I wouldn’t ignore be extremely concerned.
Agree, see GP urgently and go ED when symptomatic.
Best wishes.

I think the problem is that by the time I get on a monitor etc it’s over, and without them confirming it on their tests they can’t do anything about it I guess

ahh so annoying, as soon as I have another episode I’ll head over asap to try and get them to capture it!

does anyone know if a tape or ambulatory monitor like a holter would be enough for a diagnosis? Willing to pay privately for a longer one/repeat to try and capture it on that but just not sure there’s a point if it can only be diagnosed on a 12 lead ecg

I think the symptoms combined with the trace from the Apple watch is alarming, and truthfully (whilst not a cardiologist), I don't think the response you've had from the cardiologist is adequate given the level of risk. There is more than can be done to investigate - a 7 day tape for example. It's important to see a GP asap to get a new referral and also to discuss anything else that may be relevant eg any medications you are taking.

VT, which is the risk I am concerned about, affects every single lead on the ECG in a rather obvious and characteristic way. So you do not need a 12 lead ECG to diagnose it. It will be apparent on a holster monitor, or indeed an Apple watch... Of course you should also have a 12 lead ECG. It gets a bit complicated but you could for example have a bundle branch block in which case a different type of arrhythmia can masquerade as VT. Also sometimes telltale clues to an underlying arrhythmogenic disorder are present on 12 lead ECG.

This looks similar to mine and they diagnosed SVT. Like PP said because it was so sporadic it was missed on the holter necklace, ECGs and echo scan, but diagnosed because of symptom description and my Apple Watch data

Another voice saying get a Kardia (Amazon). They are used by cardiologists to track sporadic events in their patients and can identify atrial fibrillation in the moment. All other rhythms they tell you are normal, or unusual and then you can download a pdf of the tracing to email to a doctor. In the US they have an option to send the pdf to one of their cardiologists for a small fee for it to be read within the hour. Its really a very reliable medical device

Oh I’ll definitely look into getting a Kardia device, are they taken more seriously than Apple Watch ECGs?

Not a cardiologist but I am a doctor. At least one of those traces looks like VT. I’d be getting seen urgently and you could request a reveal device-implantable under the skin, stays in for 2 years and you can assess arrhythmias with it after they’ve happened and send straight to cardiologists.
I have also seen someone come in due to their Apple Watch “heart rate” show 200 but it was his tremor though.

When I was having heartbeat irregularities my surgery loaned me a Kardia device, might that be an option rather than buying your own? I had it for a couple of weeks and whenever I had an incident I would put my fingers on the pads and it would record a trace.

I felt so incredibly odd and unwell, and sometimes fainted while it was happening, so I felt validated when I managed to record them, as ECGs in the surgery had also shown nothing. Because of the abnormalities, I was then referred to cardio and given a holter monitor for a week. This showed bradycardia/trigeminy and wasn't serious (both completely disappeared when I went on HRT) but I was grateful to be taken seriously. It's pretty disconcerting when your heartbeat starts going nuts and you have no idea why. Yours sounds potentially much more serious so I hope you get it sorted asap.

I had some cardiac issues a few years ago, my Apple Watch was pretty accurate in comparison with the proper medical equipment. I had a long conversation with the paramedic about it in the ambulance and he confirmed it was accurate.
It's obviously not 100% but is a good indicator (in my opinion.)

Not a doctor. Just an anxious person.

If my Apple Watch ECGs looked like that I would go to A&E. Have you turned on the atrial fibrillation history? That will at least capture more data, including when you're asleep.

I have a history of PVCs, which I am repeatedly told are not something to worry about. When I feel I am having them and I do an ECG on my watch they show up. I wouldn't have been confident about that before I downloaded an app called ECG+ which gives more insight that the regular Apple app.

As I say, I'm not a doctor! But your ECG looks pretty similar to this one, which the X user (who IS) a cardiologist diagnoses immediately as VT.

Please be as pushy as you need to be.

x.com/toaster_pastry/status/1736211064067670328?s=46

Alongside everything above, if you feel you're being fobbed off, them contact PALS ...

I had an issue once with a consultant being dismissive. I was offered a different consultant really quickly.

Ah thanks so much everyone for the help and advice. Going to see about going privately and getting a kardia device in the meantime. Xx

My Kardia was suggested by my cardiologist and my Dad’s GP monitors him with the pdfs from his Kardia.

They are approved by NICE for detecting atrial fibrillation and have a CE mark as a medical grade ECG detecting cardiac arrhythmia.

Oh wow that’s brilliant to know thanks! I’ve ordered one from Amazon, really hopeful it helps!👍🏼👍🏼