Smart watch to monitor heart

There is no reasonable 'benefit' to being in permanent AF....or knowing that you are in that cardiac state. There would be a great benefit from being free of the dysrhythmia, though. Your heart remodels itself over time and this can lead to other problems when you spend a long time in AF.

What I mean is, if you really ARE in permanent AF, and must live like that because no specialist deems your heart fixable for some reason, then knowing what your rate is might be the best you can hope for with a wearable device, not that you ARE fibrillating. I say this because the health field doesn't advise leaving heart rates above 100 at rest. Rates much above 100 signify pathology that could lead to heart failure....I mean real 'failure' due to exhaustion.

So, to your second question above, yes, someone who is new to AF should be aware of changes in either frequency of runs of the arrhythmia, their duration, or heart rate when they go into ANY dysrhythmia. The reason is that the heart will change, or remodel, itself to adapt to the different conditions. This could mean enlargement of the atrium, mitral valve prolapse, ventricular enlargement, and drastic changes in the ejection fraction as a result. Someone wearing a device that might alert them will help them to realize that things are beginning to slide downhill, maybe at a faster rate than hoped, and that they need to get in line for an intervention.

I have been told by my cardiologist that because quality of life is good, intervention represents more risk than reward over living with afib. Confused.

I was also told that there is no proven longevity benefit to ablation although I meet the criteria for procedure.

When I began to research about AF, I read that the thinking in the medical field was that rate control and rhythm control was thought to have offered good results. Few patients returned, so they thought they had the answers. Then, somebody thought to do a follow-up using records and tombstone records...literally, cross-referencing between obituaries and those whose records were public insofar as their health was concerned. The result was that, their apparently infrequent return visits to their GPs notwithstanding, most patients diagnosed with AF 30 years ago and sent away with drugs were not doing well after all. They were dead.

Ablations are relatively new compared to, say therapies for diabetes, or bypass surgery. It's still a young procedure. In time, I am quite certain that the data will show a marked longevity difference, even if only five or six years. Who would pass those years up? Who would pass up a single year if it were symptom-free (assuming longevity was moot?) For some of us, living with AF makes us feel lousy, or extremely uneasy and anxious. If a day were lost to a catheter ablation, and you could be guaranteed of no AF for a whole 365 days when your burden would otherwise be something like 5-10%, I think many of us would want it.

The other thing is that, while a successful ablation (one full year free of AF) might help one to live longer, it's other co-component is its improvement in quality of life. As with so much of modern medicine, it is to treat symptoms since some symptoms rob us of the desire to continue living.

Lastly, I was always worried about the problem of remodeling, mitral valve prolapse, enlargement of the left atrium, and general heart failure, all possible and decidedly probably according to all the recent literature if one spends a great deal of time, or permanently, in AF. A successful ablation will stop that process. I don't see how it could help but to increase longevity.

kfox21: '...I have been told by my cardiologist that because quality of life is good, intervention represents more risk than reward over living with afib. Confused.;

Not knowing everything that was said, by you or by him/her, I can understand your confusion. In fact, I'm wondering about how secure this advisor is about his/her ability to help you ....at all. My EP claimed a success rate of 75% for a first ablation, and that he was running around 80% success for a follow-up ablation. When you find one with that level of skill, experience, and confidence, you should expect similar results for yourself.

There is risk in a colonoscopy. There's a surprisingly high risk of myocarditis from a dental prophylaxis. We have those every few months to a few years, depending on the patient. If things go well and you only have to have a first ablation, that could be it for many years, perhaps for as long as you live. The risk of complications from the best EPs runs about 1%. Taking the reciprocal of that low risk, would you buy a lottery ticket if you hade 99% chance of winning? I would. In fact, I'd take the 1% risk of a complication from an AF just to be able to sleep better, not have to pace while my wife and I are watching TV...or supposed to be. Not have to make plans to go to the ER when I don't self-revert inside of six hours, wondering if this is the time when no cardioversion or pill will work, and I'll have to endure being in permanent AF until an EP can perform an ablationb...in four months.

Perhaps the person you saw is being frank and feels that the risk he/she is likely to impose on you is probably not worth it and you should do the best you can for now. I don't know if you and that person agreed on a definition of 'quality of life' since that tends to be subjective....but...

At some point, you may come to understand that, as the literature says widely, AF is a progressive disorder. It will get worse in time. You'll have to determine for yourself when you can't abide the sensations and the unease you feel. Hopefully, you'll have rapid access to a good EP who can help you when that time comes. Just don't allow yourself to be in AF for long periods, and never for more than 24 hours with a rate above 100. You really want to avoid some of the problems that develop over time with a heart that spends a lot of time in AF.

Apple watches are limited esp. on for those with higher heart rates in Afib. From the Apple site
https://support.apple.com/en-us/120278
A heart rate under 50 BPM or over 120 BPM in ECG version 1 affects the ECG app’s ability to check for AFib. In ECG version 2, a heart rate under 50 BPM or over 150 BPM can affect the ECG app's ability to check for AFib.
Also note In ECG version 1, your heart rate is between 100 and 120 BPM and you are not in AFib.
That is not a good monitor if it says you are not in Afib between 100-120.

Below is an excellent article that most of us can understand. It may need to be read more than once. Note this article was published in 2013. That is 11 years ago and we have seen a lot of progress in mapping techniques and surgical techniques that have improved long term ablation outcomes. FYI ablations have been around for 40 years. Meanwhile I go in Sept 25 for my 2nd ablation. My first one was April 2019. During the last 10 months I started to have increasing activity of Afib events occurring about every 4 weeks on average. I have no trigger and an excellent diet. The good news is I have self converted on all these events with all of them lasting between 8-36 hours which is not bad. My HR has stayed in the 70s~80s during all those events. My normal resting HR is about 48- 50. Also my BP remains normal during all these events. And my yearly ECHOs have shown stability in heart function. It remains within normal range and a 55% ejection fraction ratio. The simple Kardia device has proven very helpful because I can catch the event in real time and send it on to my doc as a pdf. In fact he decided based on the Kardia that I would be a good candidate for a 2nd ablation at age 76,
Meanwhile by 80 year old brother continues to control his Afib with medicine after ignoring his Afib years ago when he had multiple pulmonary embolisms that usually kill someone.
"The Progressive Nature of Atrial Fibrillation:A Rationale for Early Restoration and Maintenance of Sinus Rhythm"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153232/