When to seek medical aid

[micwal93]

Hi everyone. I'm currently in AF, hr averaging between 110-120 and it has been in AF for around 20-30 mins. How long should I wait before seeking medical aid? I've already taken a propranolol 10mg just waiting for it to kick in.

Micwal.

[Beckie1973]

From my experience if you stay sat down should start to slow down within 2-3 hrs. 

[BobD Volunteer]

Frankly I never did after initial diagnosis but the general feeling is that if your heart rate is very high. e g  over 150 for four hours or more  or if you have any chest pain then A and E is not a bad idea. Do be prepared to spend some time there as all they will  likely do is observe until you return to NSR but it may be a comfort to you.

[Finvola]

I always lay down on my right side during episodes and tried to breathe   in rhythm and concentrate on something pleasant until NSR returned - usually in about 2 hours or so.  It depends on your symptoms - pain, severe breathlessness or fainting would worry me - sometimes it can be more hassle to go to A&E than to rest quietly at home.  

Hopefully, the Propanalol will do its job soon - in the meantime, take it easy.

[micwal93 in reply to Finvola]

HR stabilised a few hours ago now, was in AF for about 30-45 mins, and hr didn't rise above 122. Might start taking the propranolol daily as I've only been taking it as a pill-in-the-pocket thus far.

[Dodie117]

I went to a&e once and that was mainly so they would put me on anticoagulant as my gp was messing about. Otherwise sat it out at home and usually lasted 5 or 6 hours.  Had an ablation and nothing for more than two years.

[dmac4646]

are you on blood thinners of any kind , the propananol should slow the rate after a while but if this is a regular thing you should see if blood thinners are indicated.

[micwal93 in reply to dmac4646]

Blood thinners not needed because I'm young and have no stroke risk, I rarely have attacks.

[Hidden]

Mine's fast, and it lasted 22 hours once. My GP said afterwards that I would have been justified in going to A&E but I have to admit I hate the idea of hanging around there... Place is full of sick people

[dave1950]

 My GP said I should make an appointment with him if it lasted more than 3 days. Mine always lasts about 36 hours and goes back to normal, but is more irregular than ultra fast. We all seem to be different so it is difficult to say really. The advice on here is useful but often as varied as the medical profession!

[checkmypulse]

I went to A&E once, on the first re occurrence of AF 3 weeks after ablation with HR of 160 which had been going for 30 hours or so. It was much more aggressive than before the procedure so was scary. They did just monitor me for about 10 hours, gave me 1.25 Biso and kept me overnight to see EP next day.  They did say I should have come in sooner. Only had to wait 10 minutes in waiting area, seemed to jump the queue.

[RichMert]

Slightly controversial but, I would say that it depends what your long term aim is. If you are looking to get an ablation then, from experience they seem to take the number of A&E visits into account. That said, I would say that the Ambulance or Paramedic should make that call and I would not have just turned up at A&E without the AF episode. ditto 'checkmypulse', I ended up with a 175 visit after the first ablation resulting in a 'redo'.

[absolutepatsy in reply to RichMert]

I'm with you on that one, I was told by Paramedic to call the Ambulance as each A&E visit is then recorded and you see the Cardiologist sooner. If you are not being seen each time then how will the Cardiologist or EP know what treatment / follow up you need. 

[RichMert in reply to absolutepatsy]

My eventual EP told me to document every episode. In truth, you do not seem to progress towards any form of diagnosis or game plan until you see the EP. The Ambulance service will tell you to always call them if in doubt as they are able to get you an ECG at the earliest opportunity whereas your GP surgery may result in a long wait (pointless if you suffer from PAF). Please do not get me wrong, I would not call an Ambulance unless I was really concerned. I have been criticised on each occasion for leaving it too long so, I have learnt my lesson. It took 3 years to diagnose my PAF and when my EP finally got an ECG trace he was annoyed that it had taken so long to diagnose.

[Hidden]

I just had this dituation yesterday,my first afib was 4 mo ago. Yesterday morning my heart decided to throw a fit for 10 hours. I called my doc after an hour and he had me take an additional sotalol, said to go to ER if I had chest pain or short of breath. My heart rate stayed around 120-130, then 10 hours later it suddenly went back to normal   Today all is well.  I think what you do depends on your doc and who is paying for the medical care to be honest. 

[Musetta]

Hi micwal,

I was diagnosed in 2012 - in casualty I was put on a trolley immediately, ECG done and

cannula inserted for blood tests and drugs. transferred to a bed, hooked up to a machine interviewed and then the hours of waiting began. Finally discharged when back in NSR ( normal sinus rhythm) given a letter for doctor/cardiologist.

Cardiologist suggested to go back to casualty when ever my pulse rate was irregular (150-200 bpm) and the episode lasted for more than 1-2 hours or if I was feeling breathless or had chest pain. Fortunate my AF episodes have not reared it's ugly head and previous episodes have been managed at home and have reverted to NSR spontaneously.

I hope this helps you,

All the best,

Musetta

 

[Hidden]

Initially I was told by the arrhythmia nurses that I should go to A&E after 2 hours of AF.  Later on I was advised 4 hours.  Do not leave it over 48 hours as they are limited to what they can do, i.e. they can't do a cardioversion after 48 hours have passed.

I always felt a bit embarrassed going to A&E with it....feeling that there were people in there worse off than me...but each time I went it was a left turn into the major part of A&E. Mostly was just monitored with shots of flecainide until NSR.  Had cardioversion once and a near cardioversion once (went through with AF, but as soon as the anaesthetic bottle was snapped, suddenly went into NSR).  The highest my pulse rate went to was 140.

I went to A&E 7 or 8 times and I'm convinced that this prompted earlier action to resolve the problem.....I guess it's very expensive a visit to the emergency dept.