Hospital every time AF happens

[Rabbitie666]

Hi can you help ? Do you always go A&E every time you get an episode of AF,My GP says I should, I've got paroxyamal AF and on asprin,Bisoprolo 5mg and Lisinopril 2.5mg thanks.

[Terjo]

Hi, I don't a go every time. Last time time the doctor told me to go to the A and E if it didn't stop in four hours but it stopped just before thank goodness . Previously I've been and it is very disturbing being out of your own home I find. My heart rate hasn't been above 200 though and I can't walk around so stay in bed. Everyone is different though and if you feel safer in hospital you should go. The awareness of how to treat AF is getting better all the time. When I first went to hospital years ago the duty doctor put me on a saline drip and that was all!

When the consultant came and saw me he told the junior doc what I had and found that he hadn't been aware of it and didn't know how to treat it. I do hope you manage ok let us know how you get on. Terjo

[jeanjeannie50]

A doc once told me to go to hospital if pulse went above 130-135. Mine can go on for days between 125-135. I usually stay home and am unable to do much. Last time it went on for 5 days and with hindsight I wished I'd taken my GP's advice and gone to A&E. I would always do what your doc advises as he knows your heart history. Jean

[Lal531]

Yes I would, the cause needs investigated / established e.g. Potassium deficiency. Its better to be safe than sorry.Its better to occupy the doctors time than the funeral directors.

[Dixiegurl in reply to Lal531]

On one occasion to ER my potassium was low and on 2 occasions the magnesium was low! How are we to know how to supplement? I wish I knew☺

[MarkS]

I had AF for 15 years and never went to A&E when I had AF. They are not specialists, if anything they are probably going to give you the wrong medicine.

Instead get an appointment to see an EP (or failing that a cardio) then follow their instructions about what to do when you have AF. I would also suggest you do not follow your GP's advice, they are generalists and from my experience (quite considerable with GPs) know very little about AF. They also tend to advise too many people to go to A&E when they should be treating them themselves. A&E is for those with acute conditions. AF is not an acute condition, it's chronic.

You need specialist advice and do you really want to spend hours queuing up in A&E?

Mark

[Hidden in reply to MarkS]

Hi Mark

It's all very well saying 'wait to see your EP or Cardio ' , -- if you can wait 3 months or so. OK if you have private insurance.What happens in the meantime if, as you suggest , GP's are not much use ?

In my considerable experience all heart conditions are given priority in A&E & they DO have access to the cardiology team.

I think you are very fortunate if you have had AF for 15 years & have never required a trip to A&E.

Sandra

[MarkS in reply to Hidden]

Hi Sandra,

The question was do you go to A&E EVERY time you have AF. I am not saying you should never go to A&E, it can be a good way to get an ECG and to bypass the system to see a cardio, who, as you agree, is the real specialist.

The key thing is to get an anti-coagulant and either a beta or calcium channel blocker if the heart rate is too high.

But to keep going to A&E once you have seen a cardio is, frankly, a waste of time and resource unless it is a real emergency (e.g. chest tightness, pain or stroke symptoms).

I had AF one day in three. I would have been in A&E every 3 days if I had followed the 4 hour rule.

Mark

[Dixiegurl in reply to MarkS]

Mark what is A&E? Is that the same as ER?

[Cyclemark in reply to Dixiegurl]

Accident & Emergency - it is the UK equivalent of ER.

[Dixiegurl in reply to Cyclemark]

I felt quite sure that it was but I couldn't decide what the A was for. Thanks

[rupert12]

I too have had a conflict with healthcare professionals about going into hospital. My medication was being changed by the A&E doctors, I came to the point that none of the medication that I was taking was being prescribed by the cardiologist. On my last admission I actually saw a cardiologist who said that all the changes in mediation at A&E is not good (7 admissions this year), he changed my medication and I have been fine since. He advised laying down when you have an attack and only go to hospital if you are feeling really ill, light headed and that you are going to pass out all the time. My experience of A&E in Canterbury have always been good, upon arriving I go straight in, no queuing and usually see a doctor straight away, although my symptoms are severe sometimes. Peoples symptoms vary greatly and I would say if you feel okay stay at home, it is more calming, but on the other hand if you feel really ill, go into hospital.

[frenchgoose]

It is hard to generalise here as each individual reacts differently when having an AF episode. If you feel faint, breathless, chest discomfort you should go.....paramedics always told me to call them if this was how I felt..and I did many times over the last years. It is just reassuring to get checked out, but boring waiting in the A&E queue.

On the other hand there are the group of AF patients who do know they are in AF or can function well when having an episode....and do not require an A&E visit.

Depends which camp you are in, and only you know that.

Thankfully an ablation three months ago have halted visits to A&E for me.....still have fingers crossed though!!!!!

Ann

[BStanding56]

I have had paroxyamal AF for 4 years, my Doctor always tells me to go to A&E whenever it goes over 4 hours, if you leave it over 24 hours they can do less for you to get you back into Sinus.I am wondering why you have AF and not on Warfarin ?, I went to a talk by a consultant about AF and he considered that Asprin was zilch in preventing strokes for people with AF. There are more knowledgeable people on here than me, but I had very symptomatic AF before I had my ablation..

[giddytd1]

I had to go to A+E a couple of weeks ago as I had two attacks of AF within a couple of hours. I felt a bit guilty when I was there because my heart rate appeared to have settled . Maybe it was the reassurance knowing that I had done the right thing. I spoke to my GP about it and she said that I should always go to A+E if in AF.

[Terjo]

How very varied each persons experiences are. I don't take warfarin as five years ago I had a massive bleed into the lining of my liver and it was touch and go. I've havent taken warfarin since then until i had to take it for six weeks before I had a cardioversion after being in permanent AF for a year , the EP that I saw suggested this before an ablation . He put me on Flecanide too. I've had about three outbreaks in the last year and now I'm off bisoperol the sky hasn't fallen and I'm enjoying myself and able to do so much more. Hope you all find a way through the maze.

The more we can communicate the more doctors will treat us as individuals.

[cbsrbpm]

I usually go to A & E if it lasts more than 4 hours, there are times when it has stopped as I was booking myself in but they still keep me in and check me out, they are very good. I too take Aspirin and now realise after joining this forum that it is quite useless for AF. I am still very nrevous to start the Warfarin, although my consultants over the years have all wanted to prescribe it, as I am extremely accident prone and bruise for no reason at all. I feel as if I am caught between the Devil and the deep blue sea. I have no qualms about going to A & E if it doesn't convert in a few hours.

Best wishes

Brenda

[ferric24 in reply to cbsrbpm]

Hi Brenda, I have been on warfarin for 4 years, and this is checked and maintained by my local practice every month. Its effects are measured and the dose adjusted to keep within set limits. I do bruise a bit more easily, but you do not bleed too much if cut. It is a minor inconvenience but much better than the elevated stroke risk without effective medication.

Regards

Ken

[cbsrbpm in reply to ferric24]

Thanks Ken, I need everyone to keep telling me, I'm such a coward!

[Offcut]

I do not always know I am in AF. I had a heart attack (while Driving) because I was hitting 178 BPM with a missed flow so much I lost O2 to my heart. When I was in hospital I peaked at 218 BPM. it was only at that point I knew something was wrong( besides the feeling of a cricket ball going though my chest). I have long spells of 126/150 BPM and have never been to A & E for AF. I have had junior doctors at my GP Practice as if I want to go. I am on warfarin and have been since 1992

[Mamamarilyn]

Thanks to everyone for their replies.....I was about to ask exactly the same question. I would also like to hear from anyone who's on Dabigatran as opposed to Warfarin.......it seems so much more hassle-free! I was diagnosed with PAF 3 weeks ago and am waiting for an OP echo and a meeting with the anti- coagulant team.

[skary]

So difficult to give just one answer as we all are unique... I live 30 miles from nearest hospital which makes things a bit awkward . I'm in and out of sinus often so unless I felt really bad would stay put . But as others on here have said everyone's different so do whatever makes you feel safer..... and if that means going to A&E...then go & don't feel guilty ....that's what hospitals are for.

I'm on Rivaroxaban instead of Warfarin and so far so good. I was on Warfarin but it caused a major flare up of IBS...so now we will see how it goes.

Nikki

[TheStand]

Rabbitie,

What skary and other have said is true. It is a very individual choice. If you are feeling faint or having chest pains I would say to definitely go. All the other symptoms are experienced differently by everyone. If the attack has lasted an extended period then they can give you a drug to help bring you out of the attack. Also you have to consider whether you are protected from stroke (the primary concern from AF). If you are on an anticoagulant then you can feel a little better about waiting it out. If I was only taking aspirin or nothing at all for the stroke risk I would probably go.

Only you know how you feel. Just listen to your body.

Tim

[beano2013]

when I had AF I went into hospital on numerous occasions when pulse around 200 plus. I had a good G.P:. and we discussed an ablation which was performed June 2011. This has made a significant difference and, to date, no recurrence of AF although I understand it can return. I looked at alternative to warfarin, but cautious of new drugs on offer. I, therefore chose to buy my own INR monitor and this has been a great success. No more waiting to have my INR read. If I am concerned it could have changed due to antibiotics, foods etc., all I have to do is check reading and adjust accordingly. I can contact clinic anytime if I am concerned otherwise I phone in every 6 months. So all in all I am delighted and, if suitable for you, I would opt for an ablation procedure and would chose warfarin as opposed to asprin, which as has already been stated if now considered ineffective in preventing a stroke. Best wishes Beano jones 1

[beano2013]

If there is anyone in the Staffordshire, England area who would wish to discuss AF or wish to set up a support group I would be happy to hear from you. Beano Jones 1

[Bunny92]

I have been to A&E 3 times in the past year, and the last time, the consultant told me not to bother with A&E, but to go to my GP instead. I went to talk to my GP and took the letter that the hospital had given me, and he went balistic! He said I should go to A&E anytime I felt that I couldn't cope, i.e. if I wasn't getting enough oxygen, or felt I might pass out. They could give me oxygen, whereas my GP (or our local cottage hospital) couldn't do that. He said the consultant was being awkward because of politics. So, im stuck in the middle not knowing where I stand. I posted on here, and was told its always best to go to A&E and im inclined to agree with that comment.

[Geordielass]

Yes, absolutely. Take the doctor's advice!