Apple Watch re: SVT, mainly PSVT, of the AVNRT variety

Posted by opiestrer @opiestrer, Apr 6 9:47am

I am a 76 year old male.

I've had PSVT for 30 years. (Rapid heart rate over 140 bpm for minutes or hours.)

Every cardiologist I have seen says, "benign.... "
and further, " we can prescribe medication or surgical ablation to 95% control it if you can't control it yourself."

For many years I just endured the SVT high bpm until I learned the valsalva maneuver.

As an engineer who loves research, I have kept good records for all those years. My SVT occurred once a month or so for many years but has recently changed to once or twice a day in 2024.

I wear a Polar H9 chest strap plus a Garmin Vivosmart 4 almost all the time, even sleeping. My app software is "Heart Graph" app by Smoky Cat Software, (Android and Apple, no subscription needed and no ads, this app is the best and I tried about 30 others..) plus Garmin Connect app, plus Apple Health app. I was once prescribed the medical DME "holter" device to wear for a 7 day period last year.

I share my amateur graphs with my doctors and would be happy to share them here if allowed. The typical SVT graph would show a normal 72 bpm base rate, then a skyrocket shoot up to 140 bpm or higher, then I perform my vagus nerve valsalva maneuver and the result is a trigger of a very rapid decline back down to 72 bpm or so. The graph clearly shows a maximum of usually 2 minutes at the max rate, so my valsalva maneuver works well.

In my early years, before learning about the vagus nerve, I would log up to two hours at the high rate.

Thank you dear reader, for I am finally getting to my question.

It is my non-expert opinion that each person only gets so many millions of heart beats. So, if I can stop my SVT quickly, I win. But, last night my uncomfortable Polar H9 chest strap dislodged and I lost monitoring and I missed a 45 minute SVT episode at 1230am. I never awoke. Normally the linked alarm on my smart phone would have wakened me immediately. This morning my Garmin app showed me when the SVT occurred while sleeping. ( I use the H9 with the Smoky Cat app to wake me.)

Finally, my question:
I want to know if anyone has a Series 9 Apple Watch with blood oxygen monitor feature to record their SVT and how well it works for you? I think that device will allow me to get rid of the chest strap and also be more accurate.

Plus, I will try to get my Medicare Advantage health insurance pay for it as a DME, durable medical device.

So, two questions:

1. Apple Series 9 watch for SVT monitor?
2. Insurance covered Apple watch as DME?

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

lb80 | @lb80 | Apr 7 2:02pm

opiestrer (@opiestrer) Sorry, I don't have the Apple watch you mentioned. But
I'm desperate to know ... what is the "vagus nerve valsalva maneuver" that you use that has been so successful for you? I'm sure other readers would like to know as well. I have tachycardia and some AFIB, but the vagus nerve valsalva maneuvers I tried never worked for me. Thanks in advance.

opiestrer | @opiestrer | Apr 7 3:32pm

lb80,

You can web search it, but here is my explanation.
At the gym or during the day, I can feel the SVT occurring. At night, however I have an alarm on my smart watch to wake me when it’s above 100 beats per minute. The symptoms are lightheadedness and a slight throbbing in my heart, and I put my finger on my neck and I noticed my racing. Also, when I hold my finger tips together, they are both moving against each other. They’re not steady. I put my feet on the ground while sitting, bend over and press everything I can against my heart muscle. This is exactly what’s occurring. I am putting "meat" against my actual heart because the heart muscle is in the chest cavity and just like when someone does CPR and presses on your chest to compress the heart to save your life. The the same thing when you compress your chest. You squeeze all your upper body muscles and you pretend you’re doing a big bowel movement, you hold your breath and try to push air out but you don't let it out. You push push push in as hard as you can until you almost blackout and that stops my rapid heart rate within 10 or 15 seconds.
The electro-physics principle that is happening in my SVT case is that just like a party balloon that you rub on dry hair and then a stick to the ceiling, my heart muscle has different nodes that are putting out heartbeat signals instead of that single one node that is supposed to do it. So when my heart is touched by tissues in my chest, it is just like putting a wet blanket or a wet rag or wet towel on that party balloon and all the static electricity disappears. The same thing is happening to my heart and the other sources of heart beats go away and the only one source that left is my 60 or 70 bpm correct node.
I am totally unaware of any condition, other than my supra ventricular tachycardia that I have. PVCs and other maladies may have occurred because of some other heart abnormal feature that cannot be quieted by the vagus nerve maneuver.

I provide another picture from 12/22/2022 that occurred at my gym. I did not have my heart strap on at the time so the graph shows that it took me a minute or so to put the strap on then I waited a minute just so I could have something on the graph to show my doctor and then I did the vagus nerve maneuver and dropped it immediately.

opiestrer | @opiestrer | Apr 7 5:04pm

Wait a minute. I’m sure a moderator reads these topics from time to time and I just recalled that you have or might have afib. Nothing in the valsalva maneuver or the vagus nerve procedure that I described will help with a bad heart valve or a bad main heart signal. My amateur explanation was to show that all it does is prevent the extra beats from those extra nodes from occurring. So I think it’s only valid for supraventricular tachycardia.

PSVT

Paroxysmal (occasional)

Supra (on the outside)

Ventricular (the chamber)

Tachycardia (abnormal heart rate over 100 bpm)

opiestrer | @opiestrer | Apr 21 10:19am

Little neg news and big positive news.

The negative is my health insurance company just laughed at me about them paying for an Apple Watch. I predict Apple will be listed as a medical device in 5 years.

My big news is that I went ahead and bought an Apple iWatch Series 9, 45mm, with blood oxygen feature*.

It monitors my heart rate incredibly well. I am very satisfied.

Here are two pictures. Note that the graphs provided in Apple's Health App are too small to evaluate. So, I use the Smoky Cat Heart Rate app to display my overnight heart rate. This app is free without ads. A small one time fee for alarms...

No SVT episodes caught yet but I will post graph pic when it does happen.

I also post my Apple Heart App sleep graph that is made each night by Apple.

So, my two original questions are answered.

* Apple can no longer provide blood oxygen feature because of a lawsuit. But there is still plenty of old Series 9 iWatch inventory out there. Look for the words, "blood oxygen" and model #! ending in LL/A. The newer model without blood oxygen ends in LW/A.

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