What should I do during AF attack ?how should I manage it, did anyone notice that major changes of INR test result mayvcoz AF attack ?

[Maitha]

Should I go every time to ER ? Or what else

[Beancounter Volunteer]

Hi Maitha

I don't suffer from paroxysmal AF but permament, so difficult for me to give you a direct response, but from what others have written here, the answer seem to be that it depends on you.

Many here will cope with an attack at home, perhaps finding a place to try and wait it out or relax, but if the attack gets more serious, then they will seek help at ER of similar. I regret that some emergency rooms are not always very helpful, some just saying call your doctor, so this is something that you are going to have work through yourself, and I would suggest talking to your doctor about it, you might both agree that say a pulse of over 200 for more than x hours needs ER attention, but less than that you should try and cope at home. It's difficult I know, and perhaps others with more direct experience could comment for you.

Re major changes in INR, no I am not aware of anyone who reports these as a trigger, and it's kinda hard to see why they would be. Major changes usually only occur during the initial period on warfarin when you are trying to settle the INR, and that usually settles down after a few months at worst, and has no real effect on the electrical pulses in the heart, which is after all where AF has it's challenges.

Hope this helps, but also hope someone with direct experience will comment for you

Rgds

Ian

[Bagrat]

I have ended up in A&E all three times I have had an episode. Obviously the first time, paramedics said it was AF and would probably settle before I got to hospital but it didn't, lasted from 1 am till I was cardioverted the next day at 3.30pm. Second time was the same went in at midnight ish and converted to normal rhythm at 11am after an armful of drugs in A&E but classed as spontaneous conversion. Third time had flu so felt awful and decided chest felt tight so husband drove me 10pm. Another armful of different drugs. Converted 2.30am. Discussed plan with consultant if/when it happens again and asked why classed as spontaneous conversion back to normal . He said if I feel ok stay home and try and sleep as all drugs given in A&E are to maintain normal rhythm not get it back (maybe someone should tell them that??) If I have any chest pain to go in just in case. otherwise stay home till morning, perhaps stay nothing by mouth in case I need admitting for cardioversion.

I really think it depends what sort of person you are and how accommodating your emergency room. Our out of hours doc was no help last time so rather than ring for an emergency ambulance I rang Coronary Care Unit. They say always come if you are concerned. GP says wait thirty minutes

so I guess you do whatever feels right for you.

Oh and GP also said try swallowing a small piece of ice and pinch your nose and try to blow. can't say I fancy either!!

I do ramble, so keep calm and carry on I guess.

Wendy B

[Maitha]

Thank you both for your helpful advices

Maitha