When to call the doc

Hi my first post here. I'm looking for some advice on when to to see the doctor.

I was diagnosed with Afib in Oct 2014 after a year of feeling tired. Had a cardio version 2 months ago which lasted for 2 weeks . The last three days I've been in and out of Afib almost hourly. I've had enough of spending 8 hours in A&E on previous occasions, and then when the Afib subsides told to go home almost as if I'm wastting their time and then the Afib starts up aging the next day. There seems to be very little guidance or advice given of how seriously to take an attack and when to give in and go to a&e.

Any advice?

25 Replies

  • Hi,

    I was advised to go to A and E if I had a prolonged episode and became breathless and feeling as though I was going to faint or any sort of chest pain..

    I agree that Hospital A and E depts. all treat us differently but you know your body and if it goes on too long get yourself checked out that's what they are there for.You will more than likely get used to this over the coming months and will be wise as to when to seek help.

    Good luck


  • Hiya. Wendicarro is right. And if you go to a & e often enuff they will admit you eventually.

    What you really need is to see a cardiologist, and then an electrophysiologist who specialises in heart rhythm problems. See your GP about a referral. asap.


  • Yes I agree with PIP PIP

  • Ask your GP for a referral to a Electrophysiologist for a consultation and tests. You need to get a full diagnosis from a specialist so you can get a proper treatment plan. With a good diagnosis and treatment plan your need to go to A&E should be minimised. At the moment it sounds as though you are swimming around with not much support.

    There are a list of EP's on the AFA website shown by region have a look.

    Good luck.

  • Sorry to hear you, like the rest of us, get struck down, geoffn.

    I'd say go to A & E only if something seems very wrong or if you feel very worried. I find a portable ECG gadget, like Alivecor, very reassuring and helpful. It will give you an idea of a) what silly things your heart is up to and b) the approximate number of beats per minute. You can repeat the ECG and see if it is improving or getting worse. I invariably find it is the former. You can then show the details to a doctor.

    As the others say, you need to get to know your AF and to have a means of dealing with it. We all have slightly different versions of it and there are many ways forward, such as a pill in the pocket to halt the attack, daily medication to keep the heart ticking over properly or intervention called an ablation by an Electrophysiologist to correct areas in the heart that cause the AF.

    Have you had a 24 hour/ 48 hour or 7 day monitor and an echocardiogram?

  • I have an Alivecor unit it is very useful. I have had a 24 and 48 hour monitor and a electrocardiogram. From that I know i have a slightly leaky valve but the cardiologist did not seem concerned . I do have an appointment for an ablation but that’s in the end of September!

    It's more the lack of advice than anything else and 2 weeks good then wham heart thudding and sweating. When I was put on Warferin nobody said " Oh By the way you will have bruises everywhere from the slightest knock and red marks from even the slightest graze." I’ve since been reading every thing on the web about it. but its the day to day living with it that’s scary finding out about.

  • It gets better and easier to live with as time goes by and you gain experience. I've had such conflicting advice - one doctor said to go to A & E after half and hour of AF. I'd asked for advice after I'd got by quite well with a 16 hour bout that righted itself suddenly. I was 200 miles from home, with a string of appointments and train journeys and had just carried on.

    It's worth remembering that AF isn't a very fatal sort of affliction.

  • I suspect that you must either have a very high INR (When was it last checked?) or just be one of those people who bruise easily. I have been on Warfarin for ten years and seldom have a problem. When I work it is with machinery and metal tools building engines for old race cars and apart from an occasional leak if I gash myself I never have a problem . My wife who is not on Warfarin bruises if I glare at her or she walks within two feet of a solid object. I do gardening and cut trees up for our log burner with a chain saw too but I'm not allowed near it if there is nobody else at home. LOL

    Regarding going to A and E I found it largely a waste of everybody's time once you have a diagnosis and treatment plan as they seldom do much other than observe BUT if you have any chest pain or feel dizzy or faint then you must get medical advice. AF won't kill you but I know it feels like it sometimes and a comforting word helps at that time. A and E seldom has the time for that. Does your EP not have an Arrhythmia Nurse Consultant/Specialist who you can call for re- assurance? Many do and they are a great resource.


  • INR is good checked last week. When I showed bruising and marks to the Inr nurse she said they were normal. But I could have been told when I started taking warfrin and it would have saved me a fair bit of stress.

    Good news I've just got a email from my doctor saying I can drive again!

  • OK about driving. Unless you were incapacitated by your AF there was no reason for you not to drive and since March this year no reason to advise DVLA either.


  • Bob can you give any references re DVLA requirements .I've looked on the DVLA site and it still says you have to report it.

  • Only if you are incapacitated. You used to have to report whatever but that changed in March this year. Prior to that one had to complete form H1

  • Form H1 completed and sent off weeks ago after consultant told me to contact the eglantine. After 3 weeks and no response I called the dvla . They said they take 8 weeks to respond. I said that according to their documentation I should only be off driving for 4 weeks. They said they take 8 weeks to respond After repeatedly asking they grudgingly admitted that as I still had a license if my doctor said I was fit to drive I could legally drive. Interestingly when I called my car insurance company they were not interested in taking any details.

  • my sister has been diagnosed with af did not want warferin is on new drug rivaroxaban which you may want to look into.

  • I agree with all the previous comments. In my case, after helpful advice from this forum, I went to see the EP privately for consultation and within a year I had a pacemaker fitted and an AV Node ablation and have now got some quality back in my life. It is sad that we AF sufferers have to fight to get the treatment we need.

    Best of luck, tell your GP you want to see an EP asap, I paid £175 for my consultation and worth every penny as I had been ten years fobbed off with nothing to worry about, here is some aspirin!

    Take care and hope you get help soon.


  • Thanks for the prompt replys

    I have been referred to a the cardiology department and had a cardioversion but started afibing after two weeks after two weeks. Twice afib has stopped in the ambulance and once when I was in the resuscitation unit in A&E while being prepared to be cardioverted. I was admitted to the Cardio care unit for two days with Afib .The nurse came over to tell me the team was on its way up to the ward to do a cardioversion when she looked at my monitor she saw that I had reverted to normal rhythm . i was on my way home in an half hour.

    It's the shall I shan't I wittering that is causing as much stress as the Afib. You can't tell if its going to last 5 min or 5 days. I do have an AliveCor unit which is marvellous . No am I aren’t I. sorry about the rant.


  • Do get the phone number of your cardio care unit. Mine have always been helpful when I have rung and then if they send you to A & E, you can ward off any suggestion that you'd have been OK at home. Yes, an Alivecor (I have an Omron) is a great asset.

  • That's a good idea .I did not know you could call them . I thought the only access was Doctors appointment ,111 or A&E . i'll look the number up now.

  • Good advice from Rellim. My AF nurses are there at the end of the phone whenever I need them.


  • Called local cardio care unit. ward clerk who took my details she spoke to a nurse . The ward clerk came back to me and the advise was "Contact your GP"

  • Perhaps you don't have AF specialist nurses at your hospital then. That's a shame. Mind you thinking about it your GP some times has to refer you to them first, unless you go in via A+E and then they should pop and introduce themselves.

    It's all bit of a minefield isn't it!


  • It's a lottery. 10 years ago when I lived somewhere else, I had bad aFib. I went to A&E. They took me straight to the front of the queue, broken legs, everything else pushed to one side. I was on an ECG and seeing a doctor within about a minute. Then straight up to the coronary ward for 8 days being monitored 24/7 and tried on different drugs till they found the one that worked on me. Then I went home feeling totally normal.

    10 years later I live somewhere else. I get bad arrhythmia, just as bad as 10 years ago. I go to A&E locally, and to be honest I may as well have stayed at home. Complete waste of time. Now I don't bother going although to be honest I haven't had a reason to go recently as the drugs are working well I'm glad to say.

    Not much help except I think you've just got to make your own mind up and take advice from an expert (EP etc). But if really in doubt, I'd go because the most that can happen is you waste some time.


  • I know exactly how you feel I was diagnosed over 2 years ago and like you spent hours sometimes days in hospital with no treatment or worse still pumped with drugs I knew nothing about. I soon learned how to control the symptoms with bisoprolol but I am very sensitive to it and can only take low dose. I have been rushed to i c u from doctors giving me the wrong meds and not listening to me.

    But the last time I ignored the AF the day after it settled I had a Heart Attack !!! And was told I should have gone to hospital when AF started.

    Trouble is I am between 2 hospitals so I get differing advice.

    The reason I had a Heart Attack was because they had taken me off the Warfarin so the AF caused a clot. Our lives in their hands !!!

  • That's interesting how I did not know do you control your symptoms with bisoprolol? How do you varie your daily dose and what sensitivitys are there

  • I was given very precise information of when I needed to go immediately to hospital as follows:-

    If I had pain

    If in AF for more than 24 hours continuously

    If my HR exceeded 200

    If my BP dropped below 90/60 (well that was normal for me so I amended that to 70/40). For some it would be an increase in BP, which might be more worrying.

    If I felt particularly unwell and was cold and clammy

    Syncope (fainting)

    I had an unusual experience of being perfectly normal whilst laying prone but immediately going into very fast AF if so much as lifted my head, lay flat I was normal. After 48 hours of AF with HR 120-185 my husband insisted on calling an ambulance and I was taken to A&E where I was the subject of much interest. For about 7 hours whilst I waited for a bed on acute cardiac I was visited frequently by lots of different doctors who keep asking me to sit up, when I did my blood pressure dropped quickly until I fainted and my AF kicked in big time and when I lay down again, reverted almost normal, although still in AF and BP stayed low. The consistent response was 'wow, never seen that before'. After 2 days in cardiac care with alarms going off every few minutes and in and out of AF I reverted into NSR and had absolutely no treatment and I was discharged.

    I think the point is when anything unusual happens it is probably better to be monitored as just occasionally things can go wrong and if it does it will happen quickly so hospital is the best place.

    Alternatively if you can monitor your status at home with Alivecor and are relatively ok with riding out an episode and are being treated by an EP (not a cardiologist) and are relatively ok, I personally think it a waste of time being in A&E as all they will normally do is monitor you. If that gives you reassurance, then do it, if you are more comfortable at home, stay at home. I really don't think there is a definitive unless your doctor says otherwise.

    After ablation 15 months ago no more AF, thankfully, and my BP is a very constant 106/65, the highest it has ever been in my life and I feel SO much better.

    See an EP asap. Best wishes.

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