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Tacycardia - how long before I go to A and E?

Tako2009 profile image
33 Replies

Well this is a new problem for me. I have AF and in the past year episodes have become much more frequent to the point where the ‘A’ word has been discussed and I am now on the waiting list for an ablation.

During all the years with AF I have rarely had a problem with a fast heart beat - up to now the issue has been my slow resting heart rate.

Recently in the last week though I have experienced a couple of longer runs of Tachycardia lasting several hours including all day on one occasion. This weekend- and isn’t it always the weekend when these things happen- I woke with my heart rate around 110bpm yesterday and it carried on for pretty much most of the day. I think it went back to normal-ish when I went to bed but I woke in the night with it back to 105bpm. This morning after taking an extra Bisoprolol it went back to normal briefly but is now fast again.

I should add I have no pain at all but feel absolutely exhausted- I’m not sure how serious this is and whether I should take myself to A & E today or wait to speak to Doctors or Heart nurse tomorrow.? I have no experience of tachycardia and hoped others on this forum might have experienced this issue?

Thank you for any advice xx

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Tako2009
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33 Replies
BobD profile image
BobDVolunteer

Normal heart rate is between 60 and 100 so yours is just above normal sinus rhythm and it is doubtful you would receive any treatment if you did go to A and E. Best discuss with your doctor about changes to your medication.

NB should you have any chest pain or fainting/dizzzyness then seek medical attention.

Tako2009 profile image
Tako2009 in reply toBobD

thanks Bob - as my resting hr is usually 48 it seems very high to me!! But appreciate your point - no other pain or side effects so just going to try and ride it out today. Lucky to have responsive heart rhythm nurses at Southampton so will talk to them tomorrow

BobD profile image
BobDVolunteer in reply toTako2009

With a rate of 48 I wouild be laying flat unable to function! My average rate these days is 82 and feels fine.

pottypete1 profile image
pottypete1 in reply toTako2009

I am the same as you my resting heart rate is circa 44-50 bpm. Therefore I too find 80-100 very high. I rarely had an extremely high heart rate when I was in AF. However believe me it was definitely AF and I always felt awful.

Pete

Cha275rL profile image
Cha275rL in reply toTako2009

I can relate to that. My resting heart rate is about the same as yours, and if it even goes up to 80, I feel that it’s racing. Only time I went to A&E was when it was 150, and when I got there it had slowed down. They just did an ECG and some tests and sent me home. Best to talk to your GP as Bob said.

baba profile image
baba in reply toTako2009

So you are tachycardic then.

MummaSoap profile image
MummaSoap

Hi Tako2009

As I’m not a trained medical professional, my advice would be to complete the online 111 form or call 111 and see what they recommend.

It might be nothing too concerned about but it depends how symptomatic you are with it too. I sometimes have episodes where my heart races and feels like it’s bouncing around and could burst; it brings me out in a cold sweat and this wave comes over me. On occasion I’ve actually felt like I’m battling to stay conscious and just try to focus on taking slow deep breaths in and out until it passes.

I hope that you feel better very soon 🤞🏼

Best wishes

Soap 🧼

Tako2009 profile image
Tako2009 in reply toMummaSoap

thank you - I can relate to the cold sweat but 🤞no other symptoms at the moment xx

jeanjeannie50 profile image
jeanjeannie50

Only you know exactly how you are feeling, so really only you can make the decision what to do. Like Bob I don't think it's an overly high number, but if it is making you feel ill, then that is another matter.

Out of interest what dose of Bisoprolol are you taking and what is your heart rate normally? Have you been advised to up your meds if in AF? I guess you are wary of doing that because of your normal low heart rate.

Have you tried doing deep breathing exercises, the Valsalva manoeuvre?

I'm off to do my voluntary job in an hour, so hope you can reply before then.

Jean

Tako2009 profile image
Tako2009 in reply tojeanjeannie50

normal resting hr 48 - 50bpm. Because usually my hr goes down worryingly lower at times Bisoprolol dose currently is 1.25mg. I have upped dose to 2.5 and then 3.75 over the last couple of days but that’s not working! No pain or other symptoms so will probably phone heart nurses tomorrow morning- 🤞it isn’t getting worse at the moment xx

jeanjeannie50 profile image
jeanjeannie50 in reply toTako2009

Yes, a good idea to call your heart nurses tomorrow morning. So the reason you can't take a large dose of Bisoprolol is your heart could quickly return to your normal rate or even below! Is it the beta blockers that take your heart rate down to 48-50 or is that your rate without any medication? It's a tricky situation and I'm sorry there's not much that can be said to help

Let us know how you get on please.

Jean

pottypete1 profile image
pottypete1

Towards the end of the many years I suffered AF I went into Tachycardia with a rate never below 130bpm. If I did anything physical it rose to at least 160bpm.

My EP was made aware and after an :Adenosine Challenge" decided I should have another ablation. My EP said that I should not stay in Tachycardia for too long. I had to wait 3 months for the ablation but the result has been that now 6 years later I am, so far, free of AF and Tachycardia.

I am telling you this because as Bob says 110bpm is not a good reason the attend A&E.

I would contact your EP's secretary or the Arrhythmia Nurse department tomorrow if the symptoms prevail. It is unlikely to result in any instant treatment but as you are on the list for an ablation it might just push you up the list a little.

My EP said that Tachycardia is easier to deal with by ablation than AF but all the same I went down to the Cath. Lab. at about 08:30 in the morning and surfaced again around 17:30. The longest procedure I ever had.

Of course if you get chest pain or feel faint or dizzy seek medical advice by calling 111.

Hope you feel better soon.

Pete

Tako2009 profile image
Tako2009 in reply topottypete1

thank you for your reply - gives me hope ❤️

MyHF profile image
MyHF

I was in af in October last year but also have had other heart diagnoses since. Ignore what bobD said!! If your resting heart rate is over 100(especially while you sleep) then you need to seek medical advice. The term tachycardia is a resting heart rate over 100bpm which you have. It maybe as simple as an extra prescription for rate control but you need to ask for medical advice. I have a friend who has been in AF for almost 2 years. He has been lost in the queue but he is seen as low risk as his resting heart rate is between 60-80bpm. I jumped in front of him and got immediate medical help as I was in tachycardia. My conditions are under control for now thanks to wonderful medication but the last thing my cardiologist said to me was don’t leave it so long that you can’t walk the length of yourself next time. So to me that advice should apply to everyone, you said you have no pain or symptoms, let’s get help before you do!

Karendeena profile image
Karendeena in reply toMyHF

I have to disagree here, my EP who is a Professor and pioneered robotic ablation would advise me otherwise. I was told irrespective of the actual heart rate (and of course I am medicated) that I just need to sit it out UNLESS I feel particularly unwell, breathless, pains in my chest or faint. I usually revert after 30 hours although it slows in the final 24 hours. I was also told that it takes a long time to do any lasting damage to the heart Having said that I have been advised for an ablation and I am currently on the waiting list.

I do wonder why consultants give different advice though.

kocoach profile image
kocoach in reply toMyHF

I've had afib and tachycardia for 32 years now and every time I go to the ER with rates of 170-200BPM what I have been told over the years is to just ride it out which I try and do. Sometimes I panic when it's 200 or over and when I go to ER all they do is monitor me and when it slows down send me home. Fear and anxiety plays a HUGE part in those of us with afib and it makes us think and do some crazy things. Over the years I've learned to just deal with it.

MyHF profile image
MyHF

I would just like to say my point again in a less provocative way. “Hardly tachycardia” is not something a cardiologist would ever say! Tachycardia is something that a cardiologist would be concerned about even if it’s 101bpm. At the very least you should call 111. Good luck!

kocoach profile image
kocoach in reply toMyHF

So we should tell trained Drs. and EPs. we're not going to listen to them, that we know better then they?

Clareowenpearcy profile image
Clareowenpearcy in reply toMyHF

sorry disagree! No other symptoms ride it out.

mjames1 profile image
mjames1

One person's tachycardia can be another person's normal :) So in your case, with such a low resting pulse, 110 is definitely high.

That said, while in general a HR of 110 alone doesn't necessitate a trip to the A&E, if accompanied by symptoms such as chest pain, dizziness, shortness of breath, weakness/numbness in the limbs -- then the A&E is where you want to go. Or, if you just feel very unwell and unsafe, again go to the A&E, for at least peace of mind.

Moving forward, if you don't have one already, a home ekg device like Kardia or Apple Watch can be helpful to document what exactly is going on during these episodes, as arrhythmia's come in so many different flavors. This could be very helpful for your doctors to implement or modify an existing treatment plan. Hope this passes and you feel better. Let us know how things turn out.

Jim

WildIris profile image
WildIris

For me a heart rate of just 10bpm-20bpm more than normal means afib. So you may have some other arrhythmia or something going on with your heart or body, depending on how you feel otherwise, maybe you should find out. (my afib isn't very symptomatic-just light-headed, tired)

waveylines profile image
waveylines

For your norm this IS a big change.. More tricky as you are swinging from your norm of 48 to episodes of over a hundred at rest. Any big changes like this you need to report to your cardiologists secretary and ask for contact.. They may decide on a 24/48 tracker.... I suffer with tachycardia all the time... and it's not pleasent, very tiring. My tachycardia was managed in the end by rate control meds, beta blockers did not work for me but calcium channel blocker helps. It's still high on meds - in the 90s - but better than 130s but no where near my norm of 70s.

Barb1 profile image
Barb1

I was in permanent tachycardia ( 110-140) for over a year and when my 5th ablation failed to get me into SR, that's when I had the Pace and Ablate.

JeanetteH profile image
JeanetteH in reply toBarb1

Im considering pace and ablate after a 3rd failed ablation.Do you still feel the AF and how did it affect you?

Barb1 profile image
Barb1 in reply toJeanetteH

I don't feel the AF now although I still get breathless. The anaesthetist described my AF as permanently running a Marathon even when I was asleep. Spot on, I thought.

BrotherThomas profile image
BrotherThomas

I was told by a cardiologist to go to a&e if my heart rate went above 100 and stayed there for more than 20 minutes. As always, there's lots of conflicting advice from the medics so go to a&e if you want to, at the very least you may get reassurance that everything is fine.

bassets profile image
bassets

Whatever you decide to do let us know how you are going on please. Best wishes.

Ppiman profile image
Ppiman

I used to get quite frequent mild tachycardia much in the range you are experiencing, with occasional AF. These days I seem to get less of that but more frequent AF. The symptoms are similar and, again, much as you feel but I also often got a kind of chest aching that was under the left rib and spread into my back. These days, a daily tablet of bisoprolol (1.25mg) seems to be keeping things on a more even keel at the cost of bradycardia, however.

Do you have a home ECG device to find out whether the tachycardia is being caused by AF? Much of the time, mine wasn't. The most comprehensive home device is currently the Wellue AI but even their inexpensive hand-held AI model gives quite a decent analysis without any monthly fee.

Steve

Karendeena profile image
Karendeena

Hi there, I always get tachycardia with my episodes and they go on for 30 hours plus. I don't go to A & E unless I feel breathless or have chest pain (so far so good this hasn't occurred as yet).

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Sounds like you need tests. A Cardiac Specialist go private if necessary.

Bisoprolol only brought down my Heart Rate to 156 Day when tested physically by private H/S he said I was 120 plus at rest.

I needed ccb Diltiazem to bring down H/Rate and 180mg too much. We settled on 120mg AM and 2.5mg Bisoprolol at PM. Night rate is lways 47 average.

You should have ECG, 24-hr monitoring and ECHO.

Having an ablation without proper monitoring is dangerous. My ECHO show an enlarged chamber so no ablations. Never had a cardioversion or put on fecc... a rhythmn med.

Some have Diltiazem Calcium Channel Blocker in the pocket.

Sweating excessively. fatigue especially on exertion and on first med Metoprolol pauses at night.

Has your thyroid been checked?

Like most of us you need to find someone who is interested in your AF.

Even the DHB public left me.

Bisoprolol BB mainly checked my BP levels not H/Rate.

Diltiazem mainly checked H/Rate level.

I experimented and I cant do without either separatedly.

Take care, be patient and get a specialist. Drs dont change drugs and only raise the dosage. My private H/Sp introduced me to CCB and within 2 hours H/R dropped to 51 on 180mg. Now o 120mg which suits me.

Controlled

123/69. 62-69 H/R Day. 47 Night.

cheers JOY. 74. (NZ)

Never called A&E except for the stroe in 2019. And after a fall Aug 2021.

bgzcle profile image
bgzcle

Tako, I understand you completely. I had no symptoms I could feel, but my EKG's and wearing a HOLTER monitor indicated I had both intermittently a racing and low beating heart rates sometimes reaching 180bpm and going as low as 30 bpm. My only active and noticeable symptom was I always felt fatigue, worn out. Many times I could sit and fall asleep for short naps. My cardiologist recommended I have a pacemaker for the low beats and continue an increased dose of Metoprolol and then follow my pacemaker monitor for 3 months. This corrected my low beats to a consistently normal beat, however I did not have an ablation and was always resistant to having one for nearly 5 years, as it turns out that was probably a mistake, had I done that I may have corrected my Tachycardia, prior to now having having "Brackytacky" . After my pacemaker was installed and a 90 day monitor, I still had several instances of 140 - 185 high bpm. I was told I needed and AV Ablation, disconnecting my top chamber from communicating with my bottom chamber, reducing the risks of heart failure. So, I had this procedure and for me the result has been amazing, but I expect even more as the reset my consistent heartbeat rates from 80 downward to 70 which will be in two weeks and then to 60 bpm some 90 days later which should be my final setting. The only downside if their is one to AV Ablation and a pacemaker, it is irreversible as it has been coined .. "the choice of last resort" No turning back. I have now put my life in the hands of a pacemaker. However, the odds of pacemaker failure are less then 2%, but, I believe my risk of heart failure without AV Ablation is significantly higher. You may want to consider having the A word. Good lock!

NoeB76 profile image
NoeB76

Hiya. I'm 75 and was on propranalol and then bisoprolol, as I was told I had 'panic attacks' - for over 4 years. It was only by calling 999 when I was having 'an episode' when the Paramedics did an ECG at home, that AF was identified. I was taken to A&E and put on Flecanide. Was told propranolol would help 'palpitations', which was why the meds weren't making any difference. I'm not convinced Flecanide solves the problem, but although having frequent episodes, they are not as 'severe' as they were 8 months ago. I would go and discuss your problems with your nurse/GP or whoever you see normally. Hope this helps. Good Luck.

2learn profile image
2learn

Hi, I had tachycardia started in Jan 22, my pulse was much higher towards 200. In Dec 21 I'd had heart surgery and pacemaker inserted, I think tachy was my bonus. Anyway it used to give me 3 or 4 episodes a day where I thought I would faint, be sick and lose control of my bowels all at same time. Fortunately head between knees usually controlled it and bisoprolol. However, it meant I couldn't drive and too nervous to go out much, didn't want something drastic happening away from home. All my heart surgery etc was private and so GP not involved or A&E and choice was cardioversion or ablation to try to fix it. Wanted it done quickly as it was ruining my life and had a private ablation in March 22. So far that has worked. Good luck with whatever you do

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