Another Round of Heart Monitoring

About this time last year I was four months removed from my ablation and was one month past my 3-month blanking period. My father had died a few weeks prior and I was having rampant and annoying PVCs and PACs. Dr. Natale’s office sent me a heart rate monitor just to be sure it wasn’t afib rearing its ugly head again (which I knew wasn’t the case) and also to be sure it was just benign PVCs and PACs. It turned out to be exactly that – benign PVCs and PACs.

Well here I am a year later and I’m having periodic bouts of PVCs and PACs again. I’ve been having them on an off since this time last year. I go from having days where I have nothing but solid NSR to days where my PVCs and PACs are so bad I feel like I’m in afib! Fortunately, things have settled down in the past few weeks so I’ve had more solid NSR days than bad PVC/PAC days.

Three weeks ago the PVCs and PACs were so bad that I broke down and called Dr. Natale’s office for help. They recommended we do another round of heart monitoring just to be sure everything is o.k. I was relieved that a heart monitor was going to be sent but wouldn’t you know it, the next day my PVCs and PACs stopped. Simply making that phone call and knowing that a heart monitor was on the way was enough placebo effect to calm my heart.

I was tempted to call and cancel the heart monitor but I figured with my luck I’d do that and as soon as I got off the phone to cancel, my PVCs and PACs would kick in big time so I abandoned that thought.

The Heart Monitor Arrives

This time around the heart monitor I was given is much different than the one I had last year. Instead of the typical 3-lead monitor where you have a bunch of wires and a smart phone-size monitor that you put in your pocket, this year’s monitor is just a small device with 2 leads. It literally hangs from the 2 leads. You don’t put it in your pocket. This year’s monitor is from a company called CardioKey.

This is what the monitor looked like on me last year:

Click on the images for bigger images.

This is what the monitor looks like this year:

I like this device much better than last year but it has one design flaw. While the device is really light it just hangs there by the two wires so as you move around you feel this thing bouncing around behind your shirt. Sleeping with it is a pain in the butt too because you can feel it “tugging” on the wires as it hangs there. This was an easy fix. I tape it down with medical tape like this:

Now I don’t even know it’s there. I exercise with it and go about all my daily activities like normal. At night I also wear a tight-fitting muscle t-shirt which helps to keep it even more secure against my body as I’m moving around in my sleep.

14 Days of Heart Monitoring

I officially started the monitoring at 11 a.m. on Tuesday, July 12th. This is only a 14-day monitoring period so I’ll officially be done at 11 a.m. on Tuesday, July 26th. At that time I’ll send the monitor back and we’ll see what they tell me. I’m sure like last year they’ll tell me it’s benign PVCs and PACs. At least I’m hoping that’s what they tell me. As always, I will keep you posted!

The Placebo Effect

During this round of heart monitoring, a few things have come to mind that I want to share. The first thought that came to mind was the placebo effect and the amazing power of the mind. As I mentioned, literally the day after I talked to my doctor and was told a heart monitor would be sent to me, my PVCs and PACs disappeared. In the past few weeks I have only had a few days where they were “bad.” And even when they were bad they weren’t nearly as severe as they were prior to ordering the monitor.

I don’t know if you’re keeping track of the timeline here but I keep referencing the past “few weeks.” The monitor arrived about three weeks ago but because my heart has been so calm and “normal,” I was reluctant to use it. I can’t tell you how many times I was tempted to return it.

I have pretty good health insurance but it’s a high deductible plan that resets every year. Our policy just reset in the spring so every healthcare expense right now is out-of-pocket. Last year my 14-day monitor cost over $1,000! I’m sure it will be the same this year. I didn’t want to needlessly incur a $1,000 expense if my heart was nothing but NSR so the monitor sat on my desk for a couple weeks.

I finally broke down and decided to use it but in this first week I have only had one or two episodes where I felt any PVCs and PACs. And both times they were only “bad” for a few hours. What I mean by bad is that I could feel them constantly. They weren’t debilitating. They were just annoying.

Getting back to the placebo effect, the mere presence of having this heart monitor has helped calm things down. It will be interesting to see what happens once the monitoring period is over and I return the monitor. If the PVCs and PACs come roaring back then I’ll know my issue is more of a mental issue than a physical issue. If that ends up being the case, knowing that alone will help me address these PVCs and PACs as I can work on different ways to channel my thoughts.

The Technological Advancements in Heart Monitoring

The other thought that came to mind is I’m amazed at the advancements that have been made with these heart monitors. I remember when I had my first heart monitor back in 2006, shortly after my first official atrial fibrillation episode. It was a bulky, heavy device and I had to call the monitoring company every night from a land line to transmit the day’s results. You couldn’t use your cell phone. It was a pain to wear and a pain to have to call every night to send in the results.

Today these devices are so small that you don’t even know you’re wearing them. And the results are either automatically sent wirelessly or they are stored on the device directly for the entire monitoring period. That’s how the Cardiokey monitor I’m using now works. Once I return it they’ll be able to plug it into a computer and download the results as it’s just a fancy USB device.

While I’m impressed and happy how things have progressed over the years, I believe more can (and should) be done. They have heart monitors now that are so small and light that you stick them on your chest like a patch. Here is the ZIO XT Patch as an example:

Why can’t a device like this be the standard? Why do hospitals and doctors even bother with the “old technology” where you have any wires? The device I have now is great but there are still two annoying wires to deal with and is a “clunky” device compared to a patch device. Why can’t every patient that needs periodic monitoring have a patch device? I suppose it all comes down to money and expense. Regardless, I look forward to the day when all heart monitoring devices are simple patches or some other wearable device.

But the even bigger issue is why do I need to go to my doctor to have my own heart monitored? This one baffles me. I can already take EKG readings on my own with my AliveCor monitor. Why can’t someone invent a device that allows for continuous, around-the-clock monitoring for use at home? AliveCor is the closest thing we have right now but it’s a far cry from what would be ideal.

Or why can’t the companies that already have continuous, around-the-clock monitoring – like the ZIO XT patch – offer their devices directly to the public? Monitoring your heart is no different than monitoring your blood pressure. I shouldn’t need a “prescription” from a doctor to have one of these fancy heart monitoring devices sent to me. I should be able to go directly to these companies and order one myself just like I can to monitor my blood pressure.

I’m not asking, nor am I expecting, these companies to analyze the results or be responsible for them. I only need them to provide the device and the results. I can then interpret the results myself, do nothing with them, or have my doctor look at them. Again, it’s no different than getting the results from a blood pressure device. I can look at them and say, “Gee, this is bad. I better have a doctor take a look at this,” or, “Gee, looks like things are o.k. I’m good to go for now.”

This would be far more convenient for the patient and would be far cheaper too. I’ll probably end up paying well over $1,000 for 14 days of monitoring – only to be told everything is fine. That’s ridiculous! It shouldn’t cost more than $250 (give or take), to order a device directly from a company and have my heart monitored for a couple weeks. And I should be able to do this anytime I want. It’s my heart. It’s my health. I should be able to have direct access to basic heart monitoring and it shouldn’t cost me an arm and a leg either! The doctor only needs to be involved if I need him/her to interpret the results and provide recommendations.

I’m confident this will be a reality in my lifetime. I just hope it’s sooner than later. Another benefit of having direct, affordable access to continuous heart monitoring is that it might help calm the hearts of patients from the placebo affect alone and would give many patients peace of mind whenever they needed it!

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