How long is too long?

I had a 'bit of a do' with the AF fairy from 1am Sunday to about 6am Monday... Longer than I've ever had it before, maximum was 12 hours, and at one point I did feel a bit poorly, sick and faint, but it passed fairly quickly (about 15 minutes and a drink of water later).

Hubby hogswangled me into a doctor's appointment today (he and the doctor conspired behind my back) although the moment the AF has gone, I feel 100%. The doctor has increased the bisoprolol dose (oh hooray) and said that in future, if the AF goes on for more than four hours I should go into hospital.

I'm sure I've heard of other people going into AF for longer than that. I mean, plenty of people live with it... Mine does get fairly fast, I seem to remember the hospital monitor when I went in that first time reading 170, but that's not the real pace, is it? I mean, the pulse when in AF is full of blips and bloops and twirly bits, it's downright impossible to tell how fast it is really...

I'd be interested in thoughts anyway. Four hours seems very short to me...

54 Replies

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  • Let's start with the 'everyone is different', warning, but if you are on an anticoagulant and not feeling poorly, there is generally no reason to go to the hospital. In 10 years of AF I only went to the hospital the first time it happened. I always converted on my own in less than 24 hours and so no reason to risk infections, increase my stress, or clog the ER when it was all under control. My EP always just suggested carrying on with my normal activity, which I did. But again....everyone is different!

  • Thanks Grandma, I've always taken the same view... I think certainly I'll leave it longer than four hours, otherwise I'd be in every time!

  • Hi, I've just had my longest afibber yet, 79 hours. I carried on doing my normal, went for a country walk yesterday, only went about 2.5 miles but was pretty tired and 'washed out' last night. It started during the night (thursday/friday) and subsided during the night (sunday/monday) but eventually 'cleared' this morning. Amazing how well I feel now. My average afibber is 30-36 hours, never been to hospital with it. GP has never advised on this! I'm on 1.25 Biso and now on Warf, waiting for an Ablation. As SMRG says we are all different. Best Wishes.

  • Thanks checkmypulse! That's really helpful. I'm glad I'm not alone :)

  • My longest was 10 days when I had pneumonia! The toughest thing was the fatigue because I don't sleep well listening to the crazy pulse in my ears.

  • Wow, ten days and pneumonia, that's awful. And I do know what you mean... It's really tough to sleep when you've got a blooming rumba going on in your ears!

  • It all depends on how it makes you feel when your AF strikes.

    I get runs of tachycardia all the time lately and it can last hours, days, weeks or months. I would only go to A+E if I felt really bad, like losing consciousness or feeling particularly worse than usual. If it goes on for days I contact my AF nurses and they will give me an appointment that week to go in for an ECG (if I haven't already had one at my GP's surgery) and a consultation. These nurses are my route to getting a cardioversion carried out. My AF usually starts with a very high rate which makes me feel ill , but then drops quite soon to around 130ish which I can just about cope with. I don't think I'd wait too long before going to hospital if my pulse stayed really high for hours and tablets hadn't helped.

    It's a good idea to dial the 111 number for advice if you are worried and not sure what to do.

    Best wishes.

    Jean

  • Thanks Jean - how do you count the rate though? Mine is such a jumble I don't know where to start...

  • This is where a specialist device such as an AliveCor comes in as it is specifically designed for measuring whilst in AF. Even if your HB is only 120 it would be virtually impossible for you to count accurately and certainly to accurately decide twice a second what was a true HB and what was a rogue signal. To get a reasonably accurate measurement you would have to count for one minute. Even if I have been sitting down for 10 minutes my HB has varied by 50% or more when considering 15 second or 30 second block so of time. I also found that a well known wrist monitor was way out (sometimes high and sometimes low) when cross checking against my AliveCor. Same goes for my finger pulseometer which measures SpO2 and HB.

    Also with the AliveCor you can print it out and then do a manual cross check and add or subtract on borderline results. I actually set the recording time on my AliveCor to be two minutes so that I get a more meaningful set of results that different readings can be better and more accurately compared.

  • Thanks Peter, I'm going to investigate the AliveCor right now...

  • I am a person who is always sceptical about gadgets and technical things and no matter what I am buying I will always do research and comparisons (my work background involved analysis and application of things even outside of my original specialist area). Also been involved with n specifications, testing, application analysis and application training.

    I certainly have been impressed with the AliveCor although I would love to get involved with them to help do some enhancements and user interactions (I have a number of ideas).

  • I'm reading that it has a case that has to be attached to the phone - mine's an old iPhone 4 so I'm not sure it will work...

  • Look on their website re compatibility. There used to be one for an iPhone 4S because I sorted for someone else about 9 months ago. The AliveCor does not actually have to be attached to the iPhone, just has to be in range. It is just for convenience that some are in cases that attach to the phone. I have an iPhone 5S and bought the AliveCor in a case for that model and keep it permanently attached.

  • I have one working with my 4s and it doesn't need to be attached to yr phone. It's fine just to be near as the phone detects the gizmo. The most recent version is compatible with most phones and iPads, but the website gives a full list.

  • Thank you both - I will have a look at the website :)

  • I ordered one earlier today.

  • Mine is a 4s, the blurb says it will work with a 4 and 4s

  • How do you set the time limit to two minutes on an Aliver cor please. Sann

  • - Open the App as usual.

    - Select ... option on top right (to the right of word Insights).

    - Select Settings

    - At top under recording options is Duration - select this

    Then press the 2 minutes option and the tick moves to that line

    - Then press back option twice and you are at the ... menu screen.

    Hope that it works OK on yours (mine is an iPhone).

  • Thanks a lot for that Peter, I've done it for 2 mins now. I too have an I phone , that's got one thing sorted out I now have to sort getting it printed out as I want to keep a record of them for when I next visit Gp thanks once again, be well. Sann

  • IF USING iPHONE

    - Go to the JOURNAL screen.

    - Select the reading that you want to print and touch to open it.

    - The actual recording I'll open to allow you to scroll through it (if you want - do standard swiping of screen).

    - Select SHARE icon on top right.

    - An options menu pops up and you can select print or email or PDF. If you select email it creates a PDF and then you can print from that email.

    IF USING COMPUTER

    - Not done it for a bit and my PC is not working so can't test it!!!

    - Log into eu.alivecor.com

    - Steps similar to above

    - You can save each PDF as you go along.

    - You can print PDF from directory that you have saved them in.

  • Hi there Peter, sorry to bother you again but can you send me the details again of how to set the alivecor to different times for taking. I meant to write it down but I forgot, thanks Sann

  • No problems - it is 4 posts above on this page.

  • I have a good BP machine which will 'sometimes' record what's happening correctly, trouble is what's happening in my arm is not always what my heart is doing. Paramedics were amazed by this when they were last called out to me (they were all quite young), but in hospital consultants knew it happened. I also have a stethescope and have found this really helpful.

  • That's really interesting, I can see how that could be because I can't work out from my finger on my pulse what is a beat and what isn't. Do I count those really weak rumbles? I think a stethescope is a great idea, I may just invest in one, thanks...

  • Hi, would you believe I had a paramedic (in her 40's who said she had not heard of PAF

  • How strange! I wonder if she became a paramedic late in life.

  • Or early in life say 20 to 25 years ago!!!

  • That's incredible, you wouldn't believe it was possible, would you?

  • When I was in AF it was recorded at ~145 bpm an hour after it began. I'm sure it was higher at the start though, when it was visibly bouncing in my chest. I definitely couldn't have stayed at home in that state.

    I say follow your gp's 4 hour advice and err on the side of caution.

    Pat

  • Thanks Pat... I will try to be sensible :)

  • My GP said EP on side of caution and told me off once for not going to A&E when BP dropped. Best to be in a place where things can be done quickly.

  • True, Peter. But I'm often on my own with a blind, diabetic dog so I have to choose my crises wisely...

  • Oh bless you both (wish I lived near to help you out in emergencies!!!)

  • Aww thank you - sending hugs! The people here are the best :)

  • Aww it must be awful for you living alone I don't think I could cope, lots of love and the people are the best on here I agree with you.Sann x

  • There's a difference between having AF and having Fast AF. If it's not affecting your ventricular rate then there's probably not much harm in leaving it if you feel OK, but if you're tachycardic I don't think that's doing you much good in the long run.

    I get Fast AF, so I don't like leaving it too long in case I overrun the 48 hour limit for a DCCV.

  • Mine is fast AF too ectopic... I guess maybe I will have to revise my 'do nothing' strategy, but it's tough. Disruptive. Blooming AF...

  • Firstly, I have recently bought an AliveCor and am pretty certain that you do NOT have to attach it to any device in order for it to work. Free standing works just fine.

    I now need to say that my condition seems so minor in comparison to many who post on here that I sometimes wonder if I even have AF or if I have even have any advise to offer......however, I am going to add my small contribution.

    When in NSR my resting heart rate is around 50bpm. When in AF my resting HR is something in the 100bpm area and so twice my "normal" HR. When in AF I feel slightly odd, I can feel my heart arythmia. Being a man I obviously have no idea what it is like to be affected by the hormonal imbalance that a woman's period produces but I have suggested to my wife that I feel that my AF does something similar.

    Apart from feeling "slightly odd", and I am feeling this as I type, I don't really have a serious problem with my AF. To put this into context, if your non AF resting HR is 70 then 120 is OK.

    For me 100bpm over a 24 or so hour period would be of little concern. Stay loose, don't stress....the most important point that I can offer is.....DON'T STRESS!!

  • Ha, yes, I'm going to write 'don't panic!' in large, friendly letters all over the house I think! I'm pretty sure that when I felt worst, it was largely due to panicking a bit.

    I am also beginning to think that I'm going to have to get myself an AliveCor so that I have a proper idea of what my heart rate goes up to - I find it impossible to count the squiggles.

  • You can use the AliveCor if you just hold it in close proximity to the microphone input on any compatible smart device.

  • I managed to download the app to the phone and it seems okay, so fingers crossed!

  • The app doesn't work without the device.

  • Yes, I just wanted to check that it would download and work in theory :)

    Always trying to plan ahead lol.

  • Whilst I agree that if you can stay at home you are going to be more comfortable and less risk of infection, if you feel unwell with AF the advice I received has always been to go to hospital if AF persists for more than 24 hours.

    I also think that if your AF is progressing it may be time to seek an appointment with an EP for a review, there is an excellent one at the RD&E. I don't think that it is the length of time in an AF episode per se which is significant but the change in pattern for you.

    The symptoms of feeling faint and feeling sick are good indicators that something is going on which is putting your body under stress - I always felt dreadful with fast AF and my BP plummeted leaving me incapacitated if the episode was more than a few hours.

    Good to hear from you as I was wondering how you are as I have missed your posts but sorry you had this experience.

    Best wishes CD

  • I haven't been posting because I hadn't had an episode since March, so I had nothing to post about, which is good I think... But it came back with a vengeance this time. I do answer posts when I think I have something to say and I do want to keep in touch :)

    The doctor was musing that perhaps it was time for me to see the cardio again and I will press that if the AF keeps breaking through. It wasn't a nice experience at all, being in AF for that long, and on reflection perhaps 24 hours is more than enough, Sunday dinner or not!

  • Not sure about the hospital visit, that's got to be your call. I'd have to be bad to go to A&E. I've seen my HR go up to 170/180 on their monitor and I felt OK, don't believe it was that high actually, as I know what it's like up there from cycling before I had AF and I'd be glowing red. But if your AF is changing, then I'd go see your cardio/EP, see if some change in treatment might help, new drug/whatever.

    Good luck with it anyhow Liz :-) .

    Koll

    Re the AliveCor, just hold it near the device, dampen your fingers, and hold it steady, hands on table etc.

  • Thanks Koll, yes I know what you mean - I hate the thought of trailing in to A&E. I will probably try to settle on a happy medium. I would certainly like to see the cardio guy again, not sure if there are any EPs out here in the sticks.

    Thank you very much - and for the instructions on using the AliveCor :)

    Lis

  • Your experience with increasing episodes sounds familiar. Mine went from two or three "blips" a day to 15 or 20 seconds, then one day with a 45 minute run that sent me to the InstaCare (mini emergency for minor issues without an appointment), then hours at a time, and finally full time, never stopped. I found out from a neighbor (not my GP) about the rhythm specialists in our area and tried one cardioversion along with metropolol then flecainide, all to no avail. By then, I had gone several months with this thing...all without blood thinner, I might add...before a wonderfully successful ablation a year ago September. My point being, you can live with it, especially if you are on some sort of anticoagulant, but why? Get on the list for an ablation, because it's almost certain to get worse, and depending on how debilitating yours is, will be a life changer. I've known people in full time afib who can't even feel it, those of us who feel it and are tired but functioning, and others, like my brother, who get faint and dangerously low blood pressure. I've traded in all the half measures and medications for the ablation, and so very glad I did! Best wishes with whatever works for you!

  • Thanks very much tech2learn, and certainly if the increased bisoprolol doesn't get it under complete control I shall be back asking the doctor for a referral to the cardiologist, with a view to asking for an ablation.

    I don't like the escalation at all, particularly as the doctor's obviously concerned about how long it went on for. I was tired all day, mostly okay, but had a funny few minutes I don't particularly want to have again. I'm so glad that the ablation worked so well for you and thank you so much for the best wishes.

  • If my pulse is very fast (which has been 3 times) over 180 I go, was just monitored and went back to normal on its own after 20 mins of getting there!! Was told by cardio registra to go if lasted more than half hour (but think meant if tachicardic) which thankfully although attacks getting more frequentin last month, they not that fast just bouncing about for couple of hours, hope this helps

  • Thanks Lingooz, yes it does help - I think I'm going to have to get an AliveCor so I get a proper idea of the speed my heart is going at, which will give me a much better idea of what I should or don't need to be doing... Sometimes I think half of the rubbish blips and bloops need to be ignored, but an 'expert' opinion would really help!

  • I have pacemaker fitted and last reading said I was in af for 19 hours and I was unaware however I had a run of 30 mins when called ambulance as I felt so unwell and bp was also really high paramedics did ecg and took me to a and e My advice is if you feel ill with it go to a n e or call paramedics as only an ecg can give true picture of what's going on and even if you have alivecor how will you interpret readings ? if I am just aware of palpitations I try to cool. Myself with cold compress and deep breathe and I have found I can revert to nsr but I felt really unwell with it I would go to hospital

  • Thanks grandad, that makes a lot of sense... I've decided that if I feel unwell again I'll stop playing the heroine and take myself in, even if that means missing Sunday dinner (sigh)

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