How to check your heart rhythm by yourself
Rethink How You Check Your Heart Rhythm
Try innovative, do-it-yourself ways to monitor your heart rhythm at home to detect atrial fibrillation symptoms.
By Mary Elizabeth Dallas
Medically Reviewed by Farrokh Sohrabi, MD
If you think you might have an irregular heartbeat like atrial fibrillation, a smartphone app may be able to confirm your suspicion — but you can check your heart rhythm on your own in simple ways, too.
Sometimes the irregular heartbeat of atrial fibrillation isn't detected until the person has a life-threatening stroke or heart failure, because they notice no symptoms beforehand. In paroxysmal atrial fibrillation, symptoms come and go and may be easily overlooked.
Monitor your heart rhythm on your own through traditional or innovative new methods, and then discuss your findings with your doctor for a diagnosis. Your doctor may then order additional tests, either in the office or at home, to confirm a case of irregular heart rhythm.
Why Atrial Fibrillation Symptoms Are Tough to Detect
Normally, the heart contracts and relaxes in a steady rhythm. If you have atrial fibrillation, your heart's two upper chambers quiver or contract irregularly. As a result, blood isn't pumped properly into your heart's lower chambers.
When this happens, you may experience atrial fibrillation symptoms, including:
- Rapid and irregular heartbeat
- Fluttering or pounding in your chest
Other symptoms, such as weakness and fatigue, may be less obvious. Complicating matters, some people have no symptoms at all, says Hugh Calkins, MD, an electrophysiologist and director of the Cardiac Arrhythmia Service at Johns Hopkins Medicine in Baltimore.
"You can have atrial fibrillation all the time and be completely unaware of it," Dr. Calkins says. "For people who are completely asymptomatic, it may not be picked up until they have a stroke or heart failure."
4 Ways to Monitor Your Heart Rhythm
The method you use to monitor your own heart rhythm will depend on how often you have symptoms and how comfortable you are using medical tools or devices.
Some methods, like the classic two-finger pulse test and the stethoscope, are traditional. But today more innovative methods are available, like smartphone apps that can accurately monitor your heart rhythm no matter where you are. These may help diagnose paroxysmal atrial fibrillation even if episodes are infrequent.
1. Pulse Check
To check your pulse, place the second and third fingers of your right hand on the edge of your left wrist. Slide your fingers to the center of your wrist until you find your pulse.
While taking your pulse, it's important to remember that you're checking your heart rhythm, not your heart rate.
Rather than counting the beats, check for a steady, regular rhythm, Calkins advises. Not all people find it easy to check their pulse, Calkins cautions, perhaps because of anxiousness.
Your doctor may use a stethoscope to monitor your heart rhythm, and this is something you can also do at home, Calkins says. "Patients can buy a $20 stethoscope and listen to their heart to see if it's beating nice and regularly, or if it's jumping around," he says. But for some people, using a stethoscope may be difficult, triggering the same sort of anxiety that's associated with a pulse check.
3. Holter Monitor
If you have sporadic paroxysmal afib episodes, your healthcare provider may give you a small electrocardiogram device known as a Holter monitor to wear. It records the electrical activity of your heart for as long as you wear it, which is typically a few days. Using wireless cellular technology, the device sends the recordings to your doctor's office or a company that interprets the data.
If your afib episodes are very infrequent, you may need to use an event monitor. This device is similar to a Holter monitor, but it's only activated once an episode begins.
4. Smartphone Heart Rhythm Apps
Smartphones provide another way for people to monitor their heart rhythm. "Now there are applications you can put on a smartphone that are personal EKG monitoring systems," Calkins says. An example is the Kardia Mobile by AliveCor ($99), a tool with a smartphone app that allows you to monitor your blood pressure and heart rate, providing instant EKG analysis. Another app that enables heart rate monitoring is Cardiio (free). To measure your heart rate with Cardiio, simply place your finger over your smartphone camera flash for several seconds and wait for the results.
A study published in the journal HeartRhythm in March 2013, found that a smartphone app could accurately detect an irregular pulse in people with atrial fibrillation by analyzing signals recorded with their iPhone.
Calkins notes that heart rhythm apps could also prompt people to see their doctor. "Patients should be aware that although their heart rate varies, their heartbeat should be regular," he says.
Confirm Atrial Fibrillation With an EKG
Although you may detect an abnormal heart rhythm by checking your pulse or listening to your heart, the only way to confirm an atrial fibrillation diagnosis is to get an electrocardiogram (EKG or ECG) from your healthcare provider. This is considered the gold standard — the most reliable way to diagnose the condition and to tell what type of atrial fibrillation you have, according to Calkins.
During this test, electrodes are placed on your chest to pick up the electrical impulses that cause your heart to beat. These impulses are sent to a screen or an EKG strip. Your doctor will examine the pattern of these impulses and determine if you have an atrial fibrillation diagnosis.
In order for an EKG to pick up afib, you must be having an episode during the test. This may work well for people who've had persistent afib for many years, but if you have paroxysmal atrial fibrillation, an EKG may not detect any irregularity.
"It can be like catching a fox in the henhouse," Calkins explains. "It can also take years to go from intermittent to persistent afib."