Thanks for all the links! I'll study up. Now I'm excited about getting my monitor.

Oh, I feel every PVC and PAC. I hate them. They feel like my heart is hiccuping. Today, I was getting them every fourth beat or so. They drive me crazy. I've been getting them since high school.

I believe that a diagnosis of presence/absence of Afib from presence/absence of well defined P waves cannot be made using a 1-lead device like a OMRON HCG-801 or a ZIO-PATCH. A full ECG is needed, and is assumed by articles that associate Afib with absence of a P wave.
See http://dc.ee.ubm-us.com/i/42250/47 that states "the Zio Patch .. uses only a single lead ..as a result is capable only of retrieving the heartbeat's R-wave and not the its P- or T-waves, which provide additional information"
See http://askville.amazon.com/Portable-Handheld-HCG-801-Monitor-Omron/AnswerViewer.do?requestId=25930039 that states about the Omron: " Impossible to get any useful information on P-R, QRS, or other intervals. P waves almost invisible"
My ECG strips obtained from the OMRON and a ZIO-PATCH do not show a well defined P wave, although I am in NSR as confirmed by the cardiologist ECG that shows not only a regular rhythm but also a clear P wave.
But both the Omron (30 secs measurement) and the Zio patch (14 days measurement) can reliably detect the presence/absence of Afib by recording over time the regularity of the heart beat R-wave. If you are in Afib, then the intervals between heart beats are continuously changing. If you are in NSR, then the intervals are roughly constant. If you have PAC's or PVC's, then the intervals are roughly constant, with an occasional obvious irregularity. For instance an strip with a PAC shows a sequence of regular intervals, with the exception of a short interval followed by a long interval. Also both the Omron and the Zio patch strips show a quite different wave irregularity for a PAC or a PVC, so that you can reliably tell them apart.

Ecofr. Unless you have an Omron, you can't make any statements about the device. That website you cited includes people's opinions about the device...some great, some not so great. The fact of the matter is afib is so easy to detect you don't need a complicated device. It clearly shows afib when a person has afib. It tells you it is an irregular rhythm also. When my wife uses it there is a classic nsr pattern and normal heart rhythm message. It works fine to tell if you arein afib or not. Seeing is believing. The rest is conjecture. Petey

Hi ecofr,

My experience with the Omron is different than yours and one of the reviewers. I usually have no problem seeing the presence or absence of a p wave. I often bring my Omron when seeing my ep or cardiologist and use it at the same time they are doing a 12 lead ecg and found the results the same.

Some research that the Omron supports detection of afib and other arrhytmias can be found at:
http://www.omronmedical.com.au/uploads/110/21/HCG-801-Z_paper_by_Scherr_D_et_al.pdf
http://www.medscape.com/viewarticle/803626
http://www.omronmedical.com.au/index.pl/case_studies


opsyn

Petey, I have a Omron and I use it frequently. I have also compared my Omron traces with my Zio Patch traces and their interpretations by the Zio Patch experts.

Opsyn, thanks for the interesting articles.

After reading them I stand partially corrected. My understanding is now that some Omron NSR traces present a clear P wave, while others don't.
The first article states "P waves were discernible in at least 50% of the tracing in 95% of all leadless (Omron) recordings and 88% of all event monitor recordings" that were judged to be in NSR.
The second article does not mention P waves. The third article shows case studies. To me P waves were discernible in some but not all the NSR traces.

In any case I believe that the Omron is always a good device to detect Afib by showing consistent rhythm irregularities, vs showing a consistently regular rhythm (NSR), or a regular rhythm with occasional irregularities (NSR with PACs, PVCs and others).

Petey, I don't think it is easy to tell apart occasional Afib vs NSR with PAC's, PVCs without a device like the Omron.

Of course if your Afib is always associated with a truly unusually high heart rate (true for most patients) then you don't need a Omron ecg, A watch will do.

I plan to continue to use the Omron, and check it against a Zio Patch run every 6 months.

I would be very interested in this smart phone app.

Carol, my PVC's and PAC's feel just like sanibel said. Feels like your heart quits beating for a short time, then it beats quickly too many times and then it pauses and repeats. For me it lasts a couple beats or so.

ecofr:

Tell us more about your zio patch (how much it costs, if it is prescription only, is it used only after an ablation, how the results are interpreted, if you can see the tracings too).

As you know, the irregularly irregular heart beat (ventricular) is the other big indicator of afib (besides absence of the P Wave). If you have that irregular heart beat and the P wave is absent, there isn't much chance of not having afib.

My doctor likes the OMRON. I also have the below ECG that was half the price and has 3 leads:

http://www.ebay.com/itm/Portable-Handheld-home-ECG-EKG-Heart-Monitor-MD100B-/270504286158?pt=LH_DefaultDomain_0&hash=item3efb4fd7ce

I didn't buy it on ebay. I bought it direct. I found it harder to use and no difference in tracings. You can set it for longer runs.

I guess you have to decide why you want a portable ECG. I wanted to see if I could get myself out of afib by exercising. For someone who has few episodes and are symptomatic, the machines could give you reinforcement that you can ID afib... and detect silent afb.

On the subject of PVCs and PACs again. For those of you newbies, they are regularly irregular (they have a pattern, like every other beat, 2 at a time, or 1 spaced out much longer). That irregularly irregular pattern (heart rate would look something like this with each beat: 80, 95 90, 117, 90, 110, 82, 60, 77, 130, 62,etc) is the thing that will distinguish afib from other rhythm disturbances, whether you understand the P wave thing or not. Again, for the newbies, the P wave is the atrial beat in a normal heart rhythm (NSR). QRS is the ventricular rate (where your heart rate is measured... your pulse) and the T wave (repolarization or recovery wave, from the ventricles). If you are in afib, your atrium shake instead of beating (hence the squiggly line) which in turn affects the ventricular regularity (since the atrium is supposed to "kick" the ventricles. That is a simplification, but you get the idea.

petey

Petey,
My insurance (Medicare + Blue Cross supplemental) covered the cost of the Zio Patch run. I believe a 14 day run costs around $600 if you buy it directly. A doctor has to prescribe it. You can use it before or after an ablation to know about any arrhythmias you had over a 14 days period.
The results are interpreted by specialists in the Zio Patch company, your doctor receives a printed report with a one page summary of findings, and seven 2-day sub-reports detailing abnormalities such as # of PACs, SVT runs, etc. ECG traces of the most relevant abnormalities are included. My worse abnormality was a few seconds SVT run. You can get a copy of the report from your doctor.

It's easy to install, you can take showers, after 14 days you mail it in a prepaid little package.
I use a finger pulse oxymeter, the Omron ecg, and a zio-patch run every 6 months to detect post ablation symptomless afib. I am not on thinners.

My Omron and Zio Patch traces are quite similar, the P wave is clear in some but not all of the RR intervals, the rhythm is regular with occasional PACs and very rare PVCs.