AF episode - when to go to emergency room and when to sit it out at home?

They never seem overly concerned Michele..I bet if it was them they would or one of their family members it's really frustrating when you go to the doctor for this wicked AF and they don't seem concerned at all so you don't know when to go the hospital when not to go to the hospital one doctor in the ER told me well you can wait it out for 24 hours my cardiologist told me to get right to the hospital so who do you believe they need to come together.this is scary enough not to know what to do thank you for letting me vent I hope you find the right answers that you're seeking this is the right side to be on as everyone has the same problem when we all can use good information have a blessed day🙏

I have had episodes last 13 days and not gone to hospital. The last time I had a long episode I was admitted and was able to be cardioverted with meds. My doc says unless I am in pain or pass out, stay home, call office if it goes for days...but wait it out. So far that is ok with me, while we try different meds. I relax, deep breathe and hydrate. On Tikosyn now and episodes are shorter.   I don’t hear any consistent answer about when to go to ER.

You  should go to doctor or er. The longer you are in it the more damage it can do to your heart. First time  I went was not the first time in had had it but it was the longest up to that point. Spent many hours a the hospital and it finally just stopped. About 4 mths later back again this time it took Meds in IV to stop  it.  I month or so later back again. There all night and this time  it wouldn’t stop not even for the Meds. They put me to sleep and shocked my heart that worked. Now I take two Meds to help. Haven’t had it but a fluttering here or the until tonight. Hit about 8:23pm and now st 10:25 till going on. Took my pill and that keeps it from go back up to 161 or more but it is yoyoing between 50 points but at least not sooo high.  You need to be on blood thinner at least so you want get a blood clot and stroke out. 

You stop don’t want it going on long. The long the  episode the more damage it can do to your heart. 

Yes thankyou Laura it's now over was in af for 29 hrs this time it's not nice very scary especially when you get chest pains are breathless the most awful part for me though is the pounding I can feel in my chest and i can actually feel the irregular rapid bearing of my heart etc but hey I'm through it and i take rivorabaxan for thinking my blood been on it over 2 year now no probs and version for the 1st which I personally don't think they make the slightest difference in bringing my ad rate down back to the cardio in March .I'm 48 and have suffered with ad for over 2 years and at diagnosis suffered a Tia other than that I'm fine

Sorry meant verapmil for the a fib ...predictive text other mistakes in there I apologise

Glad your ok now Michelle 😄 I'm a similar age to you and diagnosed AF 2.5 years ago. Although I had had palpitations all the time for many many years before which doctors didn't seem to bother about , like you I don't like the pounding feeling I discribe it to my friends as my heart doing sumersolts and handstands 😳

I hope you don't get another episode for some time

Thank you sharing your experience Phil and for explaining what happens to the heart during episodes

I am also on diltiziem and warfarin and also flecinide

Would rather not be on any medication but hey ho there's worse things people have to live with

Wishing you all the best 😌

Hello Phil - I have just been following this discussion regarding AFib and when to sit it out and when to go to the hospital.   I do hope that you are still an active member of this site as I see this discussion originally took place a year ago.

it's 6am and I havn't slept all night - I was diagnosed with AF July last year (2017) after being rushed into hospital with a racing heart and palpitations. I am on a Beta Blocker and Blood thinner as well as medication for High Blood pressure.  Since my diagnosis I have had an Echo cardiogram and todl there was no further action required, to continue with the medication prescribed, and to attend blood tests twice yearly.   I havn't seen a consultant since the morning I left hospital last July, but I have made several trips to my GP with complaints of severe tiredness and  lethargy - but on all occasions they really havn't seemed  that bothered and I have left the surgery feeling more confused and upset than when I went in.

I have been really upset of late because I am gaining so much weight - primariiy due to lack of exercise and comfort eating - I have Tinnitus, I hear my own pulse continuously, so when i attempted to exercise or go for a good walk in the past as soon as my heart rate started to rise I went into a blind panic and dashed for home - I havn't left the house except to go to my GP's since Christmas - I am terrified of initiating an Afib attack.   I feel totally lost and scared to bits most of the time If I'm honest.   Back to tonight, I've had a rough few weeks panicking over my weight and the consequences of it in relation to my Afib - I contacted the British Heart Association and asked about information on losing weight which will stay off and they have given me a wonderful plan to follow which has lifted my spirits somewhat.  I weighed myself in today after 2 weeks on the plan to find I have lost 5lbs which I am very happy with, but I realise to make it more effective I must exercise, so this afternoon I took myself for a walk along the Promenade at a fairly brisk pace - I was soon out of breath and headed for home after 20 minutes, but once rested I felt really quite elated with both the walk and the weight loss - I had a nice healthy but satisfying dinner, and then decided to treat myself to a soak in the bath.  Sitting on the sofa later feeling relaxed and happy with my progress, watched a film and did my nails.  I went to bed about 1 am and read for a while not feeling ready for sleep when my heart started to do the rumba - not beating fast, I checked it at 59 bpm ( since starting my meds last July my heart runs at between 45 and 60 , which my GP doesn't feel bothered about). but jumping around spasmodically and then going back to normal for 10 or 15 mins and then jumping around again - this is still going on only the time between each attack is getting longer.  

Do I stay or do I go to A&E - I don't want to have to go through the ambulance to A&E and 5 hours in resus to be sent home again - feeling like a time waster/  

Taking on board what you have said I am inclined to sit it out - your post on here told me more about my own condition than anyone else has done, and reading your words hs helped me to get through the night so Thank You.

Regards, and a very big Hug,

Barbara.

Hi Barbra,

Yep, I’m still here. I’m very pleased that you found my comments helpful. Sometimes it seems to me that I’m talking to myself for my own benefit, which may be true to some extent, since my situation does not seem to be the same as most other folk. I suppose the thing to bear in mind is that, 1. we’re all different and 2. we only hear from a tiny proportion of people on a forum like this so it is by no means representative.

It sounds to me like you are coping with your AF much better than you give yourself credit for. You’re taking your medication, continuing to learn about AF and the way it affects you, doing sensible things like being conscious of your weight and exercising and not overreacting if you become aware of your AF.

Of course one needs to be cautious; if you start to feel pain in the chest and arms or jaw, like everyone, even those without AF, I would start to think about going to A&E. I would say that if you are having a bout of AF and start to feel very anxious or uncomfortable then it’s time to seek some medical advice. If your heart just won’t settle down, after a “suitable period”, I would seek medical advice. As to what a suitable period is, well, that’s something only you can gauge. For me .... well, I haven't had to deal with a situation where I felt I needed to go to A&E because of the AF .... I think if my heartrate went up to 200 bpm and showed no signs of coming down after say 4 hours or my heart was palpitating continuously for that period or if I felt giddy all the time then I'd go see the doc.

I have heard it said, and don’t quote me because I’m not sure where I heard this, that AF per se will not kill you. It will however make you more prone to blood clots and thus attendant issues like stroke. Hence the anti-clotting drugs that you are taking -note these are anti-clotting agents and I believe they don’t actually make your blood thinner, they just cause the blood to take longer to clot, at least my medication does. If I was going to be concerned about anything, and this may be just me being paranoid, it would be that you only have your blood checked twice yearly. I am on Warfarin because I have a prosthetic heart valve fitted which means that I need to check my INR every 6 weeks or so maybe more frequently if I don’t follow a bland diet – and I don’t because, hey, life’s for living! However you may be on different anti-clotting drugs to me so I can’t comment on that, just question it.

The other thing I would do is to research the drugs your are taking. You may well find that a side effect is tiredness and/or lethargy.

For me I just muddle on. Like you I can hear my heartbeat quite clearly, especially in bed at night. This may seem irrelevant but bear with me. Some long time ago I was diagnosed with a heart murmur and told that one day I would need to have a prosthetic heart valve fitted. This was a surprise to me as I had no symptoms that I was aware of. Obviously I was somewhat concerned and became very aware of my heartbeat; listening to it, checking it persistently. One time I was doing some gardening, raking the soil I seem to recall, and I checked my heartbeat and it had risen from my resting heart rate of 65-70 to 124’ish. This alarmed me and I became very concerned, anxious and depressed. What I learned eventually of course is that one’s heartrate is supposed to increase if one undertakes some exercise.

At the moment I am looking into purchasing a Kardia Mobile which allows you to monitor your ECG and tell you if you are in AF plus a number of other details about palpitations. You can even send the results either to yourself so that you can take it with you when you visit your doctor next or send it directly to a consultant. This device is reviewed on the NHS website so it’s worth considering. However I probably won’t buy one for a number of reasons. In your case it depends how you deal with these situations. I need to know as much as possible about the topic. On the other hand if all this scares you then learning more about what your heart is doing may make you more concerned than ever and that would be counterproductive.

Well Barbra I hope the above helps. I think you are doing well, keep it up.

Nil illegitimi carborundum, don’t let this noisome condition bully you!

Regards,

Phil.

Hello.  I am new to this site so not sure if I’ll get picked up. It would be great to have an afib support group.  But Barbara first I hope your feeling better. Afib is terrible. It makes us think the worst possible thing.  But from what I understand as long as your on a beta blocker, a blood thinner to protect clots, and another possible anti arythmic drug called flecicide spelled wrong ur safe. U could get the bouts of irregular heart rate still.  If u get more then often afib attacks then we should all consider ablation surgery.  I’ve had echo cardio gram and it shows no heart diesease.  I also suffer from acute panic disorder.  So when I begin to fib my anxiety goes bananas. Which only exasperated the afib and more the high pulse.  In the Er I’ll be in a panic and once I calm down I’ll convert usually after 10-20 hours and then my pulse goes down when I’m calm which they assume is stress.  So to answer ur question I would always just consult with your cardiologist after each one.  If you are having a lot and on meds it may mean u need an ablation but u will be ok.  Millions of people have this. It’s just sucky and uncomfortable. I had an attack last night my third in 5 weeks.  Looks like I’ll need ablation. Plus the new meds make me short of breath all the time. Does anyone else feel that way ? 

Hello Brian,

I am feeling better now about the afib - I do get palpitations still, usually at night - but nothing that has made me too anxious.

I am still without any anxiety medication - which is a nightmare when it is bad, and I worry that my anxiety attack will bring on an afib episode - it's a vicious circle I'm afraid, as I am sure you are aware.

After getting nowhere with my GP on either the constant tiredness/weakness and the lack of any support for my anxiety I decided to change my GP practice in the hope of finding support elsewhere.

My new GP read through my notes on screen and ordered a full range of blood tests, and yet another ECG ( which really only tells what is happening at that moment. and not at night or the early hours when my heart is doing the Rumba) and also a referral to the Heart Clinic and a Cardiologist - FINALLY - Plus the request for 24 hr heart monitoring, to see what is going on.

I had an Echo, which was completely clear., shortly after my visit to A&E after my first ( and only) attack.

What I want to know is Am I suffering with afib -  do I have an underlying heart problem or is it my old arch enemy GAD ( Generalised Anxiety Disorder ) which I was diagnosed with 7 years ago, and for which I am supposed to take regular medication ( Citalopram ).

For 3 months prior to my afib attack, which took my heart rate up to 196 before it was controlled, I had been cutting down on my  Anxiety meds - I had been feeling absolutely fine, no Anxiety or panic attacks - no knotted stomach, waves of intense fear/panic no feelings of impending gloom, absolutely nothing, and took it upon myself to wean myself off the citalopram  ( I only took 20mg a day anyway ) as I thought I didn't need it anymore.  Over that  period I had been going through some pretty emotional stuff - my only Son left home and moved quite a way away with his job, I was so lonely without him, cried a lot in private, stopped going out, and started to notice my GAD symptoms returning.   So is that what caused my afib attack - I need answers, and hopefully I will get them with this referral.  If it turns out that I still need to take my blood thinner and Beta Blocker then so be it but can you please prescribe me some anti anxiety meds please Mr Consultant because I can't take Citalopram with the Blood thinner as they clash, and the GP's won't prescribe for me as they don't know what to give me - and I am really suffering here believe me.

The tiredness and weakness has improved a great deal since I stopped taking my Beta blocker in the morning and turned it to an evening dose instead - but I do suffer with breathlessness - as do many who take the blood thinner/Beta blocker combination.

I am so sorry Brian for rambling on, but a situation is always understood better if you know the basic background I find.   I hope you are keeping well, and the breatlhessness isn't bothering you too much

Babs x

 

HI Barbara.  Afib is so tricky and a real pain in the butt.  First it can come on at any time regardless of what ever your doing.  First as long as you are on a blood thinner like eliquis which prevents clots that is key.  I would recommend being on a beta blocker as a well.  Yes you feel tired but it does get better.  My afib was coming almost weekly and was frightening.   They put me on a med called fluecenine.  It’s an artyrhmia med. and though I still get s flutter it helps.  If it continues I’ll get an ablation but there is nothing to worry about just stay on blood thinners and if your pulse ever gets over 140 see the doc or go to ER.  As for anxiety meds I highly recommend it if your afib is directly connected.  Mine is. They put me on clonozepam.  I don’t like how tired it makes me. But omg the panic obsessing rapid heart rate etc has stopped.  I feel like I’m functioning except for being tried.  So get involved with yoga meditation and some low dose anxiety meds and don’t let the fibs rule your life. 

Hello just like to say I can relate to you on so many levels. I have suffered  with GAD most of my adult life and 2 years ago was diagnosed  with afib which was a huge shock. Last year my son  decided  to move to another country  something  I'm still  trying to come to terms with. Kind regards April