When to go to A and E?

I have just been diagnosed with AF and was discharged from hospital a week ago. Been given beta blockers and warfarin. I am due to have a scan this week and a 24 hour monitor next week, I thought the fibrillations had settled down but tonight I had a spell of about 2 hours of AF. I didn't know what to do. Should I go back to A and E or should I just sit it out and hope that it goes. I chose the latter and it has calmed down but I am not sure what to do if it happens again. I would love some advice from people who have had this condition for some time. Did I do the right thing or should I go to the hospital?

9 Replies

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  • Hi and welcome to the forum. Personally after diagnosis I never bothered with A and E as I already knew what was wrong and saw no point in cluttering up a department that knew less about me than I did. I believe that the general advice from some GPs is to go anyway, and some say if it lasts more than a couple of hours. From my experience they usually just monitor you and when you revert to NSR send you home. A lot of it is political I think since GPs no ,longer come out in the middle of the night like they used to when I was younger. It really is a personal choice I think and since you are in the loop and having all the right tests and are on warfarin for stroke prevention. you probably did the right thing for you. If you were still trying to get a good diagnosis I would say go every time so that they can capture it on ecg but since they already know, one has to question to what end. If being in hospital makes you feel safe then go!

    I do know what it is like and scary hardly covers it and if you have little or no support at home then another reason to go.

    At the end of the day I suppose I am saying there is no right or wrong answer. It is what you feel is right that matters and don't be fobbed off by over worked A and E staff if you need the comfort of a hospital.

    Do ask here with any worries and I'm sure somebody will have an answer.

    BobD

  • I so disagree with this advice! Both the ambulance people and the A&E doctors have told me that I should not hesitate to dial 999 if my pulse rises above 110 and stays there, or if I get any other severe or prolonged AF symptoms. The heart is under stress during AF, and it has to be brought under control. Also, in hospital you are in a 'place of safety' in case a stroke or worse happens. Earlier this year I was taken into hospital with a bout of pneumonia. The infection was quickly brought under control, but I was kept in for a further three days because I had flipped into AF and the medics were reluctant to release me until my rate and rhythm were controlled.

  • Geordielass. I think I made it clear that it was a personal choice and also that being there may help if that is what you need. I also feel strongly that A and E is used too often as a fall back situation where GPs either can't or wont treat you themselves. It is rare to find a cardiology specialist working in A and E and to be frank as I said I know far more about me than most of them. If chest pain, fainting or any other really bad symptoms were present then there is no option as I said. Regarding heart rates of 110+ I can only say that when I once rang my consultant's registrar with a pulse of 130+ he merely commented that it wouldn't kill me and try diltiazem! One of the biggest problems we face is lack of consistent treatment and responses across the UK and world in general. I sat on the committee which proposed and formulated the AF Patients Charter and that was so obvious but AFA has only been going now for about six years and whilst so much has been achieved it only goes to show us how much more needs to be done.

  • Hi BobD. It sounds like you really do know more than the medics who are dealing with you. You are so right about inconsistency. But I still say better to be safe than no longer alive! A&E is definitely full of people who should at best be treated by their GP or at worst not even be anywhere near a medical person, but as my anesthetist friend tells me, A&E staff are only too pleased to see someone who they can really help; ie an AF patient. I'm talking here of symptoms such as severe palpitations/dizziness/nausea/faintness/breathlessness/chest pain and so on, not just a fast pulse. I have never been turned away from A&E, and on only one occasion have I not been admitted for at least one or more nights on a cardiac ward, so my hospital takes AF seriously............ I look forward to the day when we get more knowledgeable and consistent health professionals.

    Stay regular! <G>

    Cathy

  • Hi Cathy, we ARE singing from the same hymn sheet! Stay well.

    Bob

  • v624jbb,

    Hi and Welcome to the forum.

    Whether or not to go to the A & E is up to you. You are on an anticoagulant so your stroke risk is managed. It really depends on how bad the attack is. I have had AF for about 13 years and only went to the hospital 3 times during very bad attacks. I knew it would stop in about 6 to 8 hours and knew I would probably be there for that long so I just waited. If you are having chest pains or feeling faint/passing out then I would go.

    You had asked before about your beta blockers. They are part of the Rate Control family. They will not stop you from having the attacks but do slow down the heart to make the attack more tolerable. The bad thing about them is that they also slow down the heart when you're not having an attack. Which could explain the fatigue and lightheadedness you wrote about. If your BP was that low (you said 80/53) I would definitely speak to your GP about it.

    Do you have an appt with a cardiologist or even better an EP? You might want to ask about Rhythm Control Meds. They try to hold the heart in rhythm which stops the attacks from happening. They are not 100% effective but do help many either stop or reduce the frequency of attacks. Most also do not slow the heart down causing the low BP.

    Please go to the main AFA site atrialfibrillation.org.uk/ and check out all of the info they have there. It is a wealth of information that will help you to understand what is happening, what to do and the treatments available for AF. They also have the info about the meds and how they affect you.

    Again Welcome to the forum and please come back and ask any questions you might have. We all have AF and understand exactly how you feel.

    Tim

  • Thank you both so much for your replies. It has put my mind at rest. I will definitely ask about rhythm control medication. Val

  • Hi

    Welcome. I was advised to go to A/E if the attack lasted longer than 2 hours. In the end I went when I was feeling so ill I couldn't cope at home, which for me was almost everytime, but as the others have said it really is up to the individual. Several times I went in and was cardioverted while I was there so it saved an extra trip.

    good luck on your journey

    Eileenp

  • Welcome to the most unique collection of hearty people on the net. I went to a&e when i was first diagnosed and then a week later when i thought i was better ..... and collapsed ! I think i would go again only if i fancied a week off work ..... ;-) seriously, if the attack is bad get down there, it will make you and your family feel better. But if you do get regular episodes, its about personal management and making sure your happy with what you are doing. If your not re - evaluate it. That may mean a few more trips until you get on a plan to deal with AF.

    Once your in the swing and get some medication that prevents attacks ( luckily for me fleicainide is my poison ) it stops the episodes and makes me live a very normal life. I also get down the gym ( get that heart pumping, you will feel better too ) go on foreign holidays and front out the fear of AF attacks. Its just my way of dealing with it.

    Its a worrying time, but a well controlled diet, exercise and family understanding will most certainly allow you to live your life to the full, no worries at all. In fact AF is a million miles from my thoughts every day, and now i have a good fitness regime, i could well say it has saved me from the reaper, because the way i was going, too many drinks, food and no exercise, i was on my way thats for sure.

    Look at the positives,they far outweigh the negatives, and tackle it head on.

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