The skeptical cardiologist has been evaluating the AliveCor mobile ECG device for use with a smartphone to detect atrial fibrillation. In my initial post on this I found it to be accurate in identifying atrial fibrillation in my patients.
I’ve been using it in my office fairly regularly and encouraging my patients with intermittent AF to acquire the device and use it to monitor their heart rhythm.
When they make recordings they can be uploaded to me via internet for my review.
The other day I was examining a patient who I was seeing for syncope (passing out) and I noticed when listening to his heart that his pulse was very irregular.
I pulled out my iPhone with AliveCor stuck on the case and made the recording you see below. 
Although the AliveCor app diagnosed it as “possible AF” it is very clearly normal sinus rhythm with frequent premature ventricular contractions (PVC), a totally different (and more benign) rhythm.
I’ll continue on with this evaluation and I’ll be particularly interested in how AliveCor performs in other patients with PVCs which are a common cause of palpitations in the general population.
If AliveCor cannot differentiate AF from PVCS it may lead a lot of users to become unduly concerned about their heart rhythm.
palpitatingly yours
-ACP
Navigating Treatment Options For Atrial Fibrillation 
do statin drugs have cardiotoxic properties that make heart muscles weaker weaker and damage nerves which in turn will aggravate hardining of the arteries? ken s
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In a word. No.
Although that misinformation is propagated on the web, especially by sites peddling CoQ10.
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Sir,
Is the rhythm “very clearly normal sinus rhythm with frequent PVCs”? I see no definite P waves. The basic rhythm is regular. Could this be
Atrial fibrillation with heart block and multifocal PVCs, possibly a manifestation of Digitalis toxicity?
I would appreciate your comments as a learning experience.
Thank you
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To me the rhythm is very clearly sinus rhythm. I’ve enlarged a section of the rhythm strip and put arrows on it pointing at what I consider regular, consistent morphology, consistent distance from QRS deflections that are the p waves. I’ve put that image on my cardiac testing page-here.
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Hi Dr. P.
Thanks for these blog posts. I was wondering what a PVC would look line on the AliveCor, and this helps answer that question.
I have been using the AliveCor Kardia to keep track of some rare but very annoying premature beats that I have been having. I am seeing a cardiologist, and I wore an event monitor for a month. However, the event monitor didn’t pick anything up. Admittedly, that month I didn’t have many events, but I was surprised they didn’t see *any*.
Well, with the AliveCor I have been able to capture a few of these events, which feel like a spring going off in my chest. They don’t look like PVCs. I will of course also be sharing this with my cardiologist, but I thought it would good to share here.
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Looking at your tracing, I see 3 PVCs.
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Hi Dr. I have the alivecore as well and it’s come back a couple of times possible afib which makes me a nervous wreck. I send it in only to find out I have pacs with a very fast rate. I’m 35 no heart issues besides anxiety. I think this device might be making me worse because I check it constantly. I only have it because I woke up one night at 3am with like skipped beats then heart went racing lasted about 15 min and just stopped went back into normal rhythm. So no one knows what it was anyway should I continue to monitor?
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There are definitely times when AliveCor misinterprets an irregular tachycardia as afib when it is clearly not.
It might be better for you not to utilize it if is creating more stress in your life and has misdiagnosed your tracings multiple times.
If you want to send me a tracing I can see if the AliveCor interpretation is correct
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Sure how do I send it?
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You should be able to send it to the email DRP@theskepticalcardiologist.com.
Using Kardia/Alivecor there should be a symbol for a letter/email which you touch with the relevant EKG open. This should activate an email and then you enter in the above email address.
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Tried to send says invalid email I have to alive core tracings to send that both say possible afib….
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I send an email to your personal email.
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I am pretty much in the same boat as Barbara. I am 29 and have no heart issues and have had 2 echocardiograms both came back normal. I have anxiety about what I think are occasional PVCs/PACs which I have felt for around 9 years but I have never been able to record one. I have worn 24hr and 30day monitors which showed no PVCs or PACs. I saw this device and hoped it might ease my anxiety if I could record and confirm one. Instead it did quite the opposite I got two readings of “possible afib” the other day. I sent them to AliveCor but they came back “Regular Rhythm, Undetermined Origin”. If you are not too busy would you mind looking at my Kardia EKG Strips if I sent them to you. I sent a message to the cardiologist I have seen in the past but she has not gotten back to me.
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Hi John!!! I finally caught mine I have paf afib or lone afib. I was on a beta blocker for a month and did slow my heart rate down but it caused me more skipped beats well at least the toprol xl I had a slight attack for two min I stoppedctuat and took the tartrate one instead it’s been ok. I have noticed an hour or two before my next dose I get the skipped beats again so I recently just stop that last night to see and so far not getting any skipped beats also I tried to tell my doctor when I was on the Toprol XL if after two with Wheaties of taking it was I supposed to have really high heart rate I didn’t think beta blockers do then he said no it’s fine it’s just anxiety again the same thing he told me when I had this epic a fib episode while ago I was just turns ou or two before my next dose I get the skipped beats again so I recently just stop that last night to see and so far not getting any skipped beats also I tried to tell my doctor when I was on the Toprol XL after two or three days of taking it was I supposed to have really high heart rate and a lot of skipped beats. I didn’t think beta blockers do then he said no it’s fine it’s just anxiety again the same thing he told me when I had this epic a fib episode awhile ago I of course I understand he’s a doctor but I know my own body and I knew something wasn’t right and I soon as I switch to the other one it was fine the only thing I get is an hour to before a bunch of PVCs and then I take it they’re gone but now I have not taken it for almost 24 hours now and I have no issues just my fast heart rate returned. It’s not that fast like 8095 compared to it being 60 to 65 during the day from the beta blocker.
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