Editor’s note: Ethan Weiss, a cardiologist at UCSF, reflects on a recent patient who may well be a forerunner of many more patients in the near future.
I saw a man in his early 40’s. He’s super healthy. He had a Ziopatch as part of a general medical workup (not really important why). He was having some mild palpitations that were not terribly symptomatic.
The Zio showed a few symptomatic extra systoles and a few runs of what the computer called “supraventricular tachycardia”.
The cardiologist over-reading the study said: “Agree except at least 2 of the runs of SVT were actually atrial fib”
Here’s an example:
The patient saw a cardiologist at another hospital who thought it was AF and prescribed aspirin. The patient got another opinion at another hospital and the doctor there said it was not AF. The patient came to me for a 3rd opinion.
I think we are going to be seeing a lot of this. (The Apple Watch and devices like the AliveCor KardiaBand will add to the volume.)
Frankly I’m not sure what it is. It’s probably not AF, but I’m also not sure it matters.
The scientist in me wonders if this is what early lone AF might look like. The doctor in me feels like we have done this patient a disservice. The economist in me wants to cry.
—by Ethan Weiss