I've been in fast AF for about 6 hours, taken my beta blocker and flecainide but it's not done much. My heart rate was around 160 and has dropped to about 100 but keeps going back up. Not sure if to ride it out or go to A&E? I don't feel too bad, how long do people wait before going in?
A&E?: I've been in fast AF for about... - Atrial Fibrillati...
A&E?
Written by
SteveA
To view profiles and participate in discussions please or .
Read more about...
41 Replies
•
I have had fast A.F. for a long time. Thankfully now mostly controlled by medication. I have never been into A and E. As I just about coped and felt it would be a wasted journey if all thhey did was monitor me. I felt I would be going in for nothing. However, now I wish I hadnt been so stoic. When my husband had fast A.F. recently my G.P. daughter in law made him go in to A and E. Even though his pulse was back to normal by the time he got there, they said he must always go in if it had lasted more than a few hours and must never feel a nuisance. He now has an appointment to see an E.P. which it took me years and years to get and in the end I went privately. He is , as yet not anticoagulated so I suppose that may account for their concern but then, nor was I. X
If you are on your own or if you need it recorded then yes. I seem to recall you are already under an EP? Also consider that you will probably get more attention early evening than later on when the pubs head towards closing. Also if any chest or head pains straight away. Otherwise it's up to you!!!!
No I'm not on my own, and yes I'm under a EP booked for my ablation this Wednesday. This is now the longest AF episode I've had and its doesn't seem to be showing any signs of stopping, I've taken 100mg of Flecainde this morning as my pip but I'm not sure if I should take more. I guess if I went in they could do an ecg and advise me.
It's a nuisance when this all happens at the weekend when you can't get hold of EP. My gut feeling is to get an ECG since ablation is only 4 days away since ECG may give additional information. They can also do blood tests. I am guessing that your EP is in a different hospital to your local A&E? If your EP's hospital has an A&E I would go there by car (as in most cases ambulance will only take you to the nearest) because the EP's A&E will be able to access your records and it is also possible that they can contact him for direction if he is on call or even contact another EP there. That way you will get a more informed decision. Worth a try.
It's stopped! I think I've found the secret cure, put your coat on and eat a chocolate brownie 👍
I've got a track of it on my alivecor, I will have a chat with him when I go in on Wednesday for my ablation. So happy I don't have to sit in the a&e waiting room for hours! I'm going to have a cup of tea and another brownie, rock and roll sat night!
in reply to PeterWh
PeterWh, You must be very fortunate to have such good access to a EP? Unless it is a dire emergency, getting a appointment to see an EP usually takes weeks or months? As for your records... they will be on computer and can be accessed by any hospital (with your permission). There are many hospitals that stow all paper medical records in a different place to the hospital.... have to request them and await delivery? Patients can sign up to have their records available in an emergency (by computer) ...... You will be asked if it is OK for them to access these..... You can of course refuse this? Certainly worth considering if you have health problems?
PeterWh in reply to
Wreck
There are many people on here who have stated in posts that they can email their EP or their secretary and get a response. You can always write to them. With my EP / hospital they prefer electronic because it can go straight into their computer system.
As for accessing patient records unfortunately in the vast majority of cases there is NO cross access to medical records even though individual ones are electronic. Cross access is a MYTH (though some things are getting better). The project to do that was abandoned about 8 or 9 years ago by Gordon Brown.
In SOME areas GPs can access SOME of the medical records generated by the hospitals and in other areas they can not. Sometimes if a CCG has more than one hospital the electronic records can not be accessed by the different hospitals!!! Some hospitals that have gone over to electronic records still only have partial records done electronically because of the preferences of consultants. So in one department / sub-department only enters things electronically there and then and in the same department another consultant and his staff record everything on paper and then some details may be entered on the system at some time on some future date. As for historical records that is very much hit and miss.
My GP practice in particular and the local CCG have been keen promotion of electronic records and access. We have been able to order prescriptions electronically for circa 5 or 6 years. For at least 2 years I order prescriptions on-line, they are electronically approved by the surgery then electronically transmitted to the pharmacy who dispense and then deliver the medicines. Usually if I order on one working day they are here the next working day. However on more than one occasion it is the same day. On one occasion I ordered at 7.30am and it was delivered at 11:00am the same morning!!
My recent records are currently across my GP, across four (4) CCGs and two (2) other hospitals. However I keep my own paper file (and do store some electronically). I am no way unique.
I request (and get) copies of all correspondence, ECGs, blood tests, etc. On two occasions I have received a letter / report that the GP hasn't and on one occasion they received one that I didn't. Where I am the CCG runs the anticoagulation service and the INR blood tests are automatically sent to the patient each time in the post.
in reply to PeterWh
PeterWh, Thanks for your very informative reply. I live in an area with similar set up as yourself- where electronic storage and access is very good. I too, also receive my paperwork of all events, especially patient discharge notes, and A and E treatments. You certainly are fortunate to have better access to your EP.... Postcode lottery?
PeterWh in reply to
I suspect partially a postcode lottery; partly a particular hospital lottery and partially a consultant or doctor lottery.
As to the intricacies of records.
My GP is in one CCG area.
In the same CCG I am under 3 different specialisms at one hospital and audiology at another hospital and went to A&E at a 3rd hospital in the CCG. The A&E hospital were able to see my audiology records but not the others!!! GP can see some of the info but by no means all.
Last year I was taken to the A&E that is closest to my home and they can't see any of my other electronic records nor can the GP see theirs.
The hospital that I am under two heart specialists is in another CCG and again they can't see any of my electronic records at any of the other hospitals / GP nor can either of them see the heart hospital records.
I wonder how much it would cost/save if everyone sang from the same hymn sheet i.e. one electronic system used by all Health Authorities. The time saving of sharing data would be immense and also cut admin time and frustration. However would everyone read it that needed to, if everyone knew it was there for someone to read.
Sorry I will stop dreaming and get back to the real world.
Hi Steve,
My cardio advised me to go A&E if pulse rate remains at 150bpm and irregular for over an hour. An A&E visit at least gives you you peace of mind - an AF episode can be a bewildering experience.
Cheers, Musetta
SteveA, If you have no other heart problems, then anything over 150bpm should be checked out. I would advise that you call an ambulance -as they will soon make a informed decision..... and you will not have to sit in an A and E waiting room. The Paramedic (or Technician) should always be the first line of inquiry. Do not delay if there is chest discomfort. If everything looks favourable you will be given the choice of declining a hospital visit. Ring 111 for all enquiries and reassurance.... they will soon despatch an ambulance if needed.
SteveA in reply to
I actually called 111 just before I had made the decision to go to check I was doing the right thing, they went through a scripted checklist and the advice was given as the end to go to a&e within the hour. I put my coat on to leave and it's stopped just as quick as it started!
Ruthelaine in reply to
111 sent an ambulance and said it was the quickest way of getting an ECG done. I then lay in a corridor in A and E for an hour with the paramedics until a monitor cubicle was available in majors!
Steve
Glad it's stopped. It is scary the first time you go to 150 plus. A&E
will probably, as you and others surmise, will just monitor and perhaps
try a beta blocker or another dose of whatever you are taking. Perhaps a
waste of time but much more reassuring being in a place of safety than
at home feeling vulnerable. My GP sent me when he couldn't read my pulse,
it was too high (he said). I had been 160 for 3 days on and off. The hospital
said I shouldn't have waited so long. Others on here have felt the hospital
considered it a waste of their resources! So is there a definite answer?
The next bout of AF at 150ish isn't normally so scary. Let your EP know Monday.
Good luck for the procedure.
in reply to checkmypulse
Checkmypulse , I think you have missed the point of going to hospital A and E? A pulse of over 150bpm needs medical intervention to lower pulse rate. Yes they do monitor the patient .... to get an accurate picture of what is happening and use drug regimes to lessen the rate. When they are happy that the heart rate and (or) rhythm is back to an acceptable level -then the patient is discharged to home (or other). This is certainly not a waste of time or resources. It is far better to request an ambulance than go to A and E. You really do need evidence of the event ...and have no way of knowing how long the event will continue? Could be minutes, hours or days? Leaving the heart at a racing pace is not a good idea. Consider what is good for the heart and good for you- If in doubt-call them out!
SteveA in reply to
The first time I went in with an afib episode my heart rate was up at about 190 and they focused on getting the rate down first. I was also given flec by IV and kept in to monitor how I reacted
PeterWh in reply to
The other thing that I was told by my GP is that if things start to get worse (especially if quite rapidly) you are in the right place for things to done quickly.
Thanks 
Steve not sure if you've had your pre assessement for your ablation yet? I have cryo ablation booked for Tuesday and had pre assessment on Friday. Because I was in AFib at pre assessment I had to have a TOE Scan to check the heart for blood clots (even though I am on anti coagulants). I'd let them know you've had this episode in case they need to do the scan before hand so to not have any problems on Wednesday. Good luck Wednesday, hopefully we will both be out the other side of AFib this time next week.
PS: I rode out a 31hr AFib session this weekend at home too, it's exhausting, my EP told me unless I had chest pain or felt very unwell I was OK to stay at home in AFib. I can't do the pill in pocket anymore which is a pain. But was so relieved when mine finally converted to NSR yesterday. (My average rate was 140bpm, fluctuates between 80-160bpm usually). I use my Alivecor to record through the episodes too really useful device to have I've found.
Hi ange
Yes had my pre-op on Wednesday just gone, good advice about letting them know I will send my EP a message tomorrow.
Best of look with your ablation next week, we will have to let each other know how we get on. What hospital is yours being done at?
I'm at LGI (Leeds General Infirmary), has a good reputation and a very good Heart Centre. I am hopeful of getting my life back. My AF has been very symptomatic and escalated rapidly. Was in as as inpatient after A&E admission for AFib chest pains/clammyness last week for 5 days, they did Angiogram and the heart was doing some weird drops to 20bpm and then pausing for 8 seconds when coming out of Afib. They decided I needed Ablation asap and I got the next available slot, which luckily for me is this week.! it's all been a bit of roller coaster, but I am pleased it's being done so quickly. The usual wait here they've told me is 8-10 months. I'm sure we'll both be fine. Where are you having yours done?
Hi ange1960, I was in AF went to see gp and she did ECG he 150+ she sent for ambulance and I went to pinderfields hospital. My stay was 5 days with the fluctuating between 100 and 200 BPM. Medication didn't work even fluconaide. Had cardioversion 3 weeks previous took 5 shocks to get into nsr, even though didn't feel better. Obviously didn't work for very long. Discharged from hospital even though still in a and rate all over the place with a view to ablation at Leeds general. Dr said waiting list 6 - 12 months. This was in may this year. I have just got an appointment for august this year to see consultant. Still suffering with severe AF symptoms. Hope ablation works but reading posts on this forum not certain it will. Diagnosed 2 years ago with persistent AF. Fed up at sufferer. I too don't know whether wasting time in a & e. Been to see GP 3 times now and been sent to hospital on blue lights. I feel a fraud because constantly told it won't kill you by a & e staff. Don't know what to do when feeling really I'll and hr high.
I know how you feel Millie, I've been hospitalised through A&E 5 times in last 7 weeks. I hated going in every time. Sometimes there seemed to be the attitude oh it's you again, (not often though). There was a query with one of heart valves after a stress echo, so the deal with doctors was if in Afib and chest pain too, if GT spray didn't stop pain, go to A&E. First thing I do when I get to A&E is ask them to contact Cardio for a consult. Usually takes few hours, but end up going to cardio ward. All my treatments and appointments have happened from A&E visits. My first proper cardiologist appointment should have been Thursday just gone! But through emergency admittance I have ended up seeing an EP rather than Cardiologist. (Which I requested), they organised tests, changed heart meds, and all the time waiting for my 'proper appointment'. Things just escalated really quickly the last 2 weeks and I got really ill with the drop in heart rate and big pauses. If I were you, and if it's possible for you. I would go to LGI next time you are in AFib. You will be seen by the cardiologists who ultimatley will be discussing Ablation with you. There are 6 EP Consultants at LGI, all really good and chances are if you come through their A&E it will speed along your appointments. You shouldn't still be feeling that ill with constant AFib and high heart rate. Good luck and hope they can find a solution for you soon.
Good luck with your ablation at LGI...I am just out of the cardiac ward there. They are very good and attentive!! Af/Aflutter and RBBB has just returned after 2nd ablation two years ago. Who is doing your ablation?
Andrew Hogarth, 'he's doing a Cryoablation. He had an unexpected slot, this week so I got him. He's a nice bloke, and seems to know his stuff and is very into the hearts electrics! I've spent a lot of time on L19 & L14 over the past 2 months.. Hope they get you sorted soon, and I am really hoping this ablation works, even though I know stats are that a 2nd may be needed. Hope you are feeling better after your stay.
I hope the cryoablation works for you, it is good to have an ablation and get your life back. I have read that they have a good results. Keep positive, but be kind to yourself after the ablation and rest!! I was on L19 last Tuesday to Saturday!! My man is Lee Graham. Keep me posted!
We must have passed each other. I was L19 Sunday to Tuesday, then moved to L14 for angiogram. small world. thanks for best wishes. hopefully be reporting in end of week that all OK.
I had angiogram from L19...maybe I took your bed!!!! You will be fine on Wednesday, they are a great team at LGI, and you look forward to lots of rest afterwards and not pushing yourself too quickly...just my advice from my two ablations!!
Years ago I was like you and decided to stick it out and not go to A&E. The episodes built up to 12 hours every 9 days or so. They occurred during the night. I was on my own but eventually my partner persuaded me to go in to A&E. She said I must go to get things checked out.
At the time I was only on Sotalol. I went in and they caught the end of an episode. "You should be in resuss and on oxygen" they said. Anyway I was wheeled through but then came out of the episode. The doctor changed my meds to bisoprolol plus Flecanaide and I haven't had an episode since!
Moral - go in if the episode lasts a few hours ; indeed now the advise is go in no matter how long the episode is so they can record it.
Two key reasons to go in. 1) They want to record you. There are different types of episodes and they'll be able to diagnose things better from an ECG. 2) They might change your meds for the better.
in reply to Lcpatrol
Lcpatrol, Excellent post!
Also there are transient conditions that can occur. For instance I have persistent AF but on both occasions I have had to go to A&E by ambulance there has been a partial bundle branch block which has then cleared in 5 to 8 hours. Without going this could never have been picked up since if I had gone to my GPs the next morning it would have just shown the AF.
Hello Steve,
I use Flecainide as P I P.Prescribed by Cardiologist at AF Clinic.300mg when an episode starts.I was told by her that it can take up to 8hrs to work,and I have to go to A&E if not returned to normal by then,but I always go back to normal within 40mins to 2/3 hrs.
Keep well Steve,
Eleanor.
Hi Eleanor, I was also told that Flecainide can take upto 8 hours to work. My dosage is 100mg and I'm a pretty big bloke, so part of my reasoning of going to a&e was to take advice and see if I could increase the amount I take. Fingers crossed my ablation will work, but I will have a chat with the EP to see it I should be taking more if or when it happens again.
Flecanaide apparently reaches maximum impact at 6 hours and half the dose will still be in your system after 20 hours. the 300mg in one go advice is not uncommon - in my own case it generally works after 3 hours but I am on 100mg a day anyway.
Hello Steve,
What I forgot to say is that I have Paroxysmal AF,which is intermittent.
So I can go having an episode once a year,3 times a year,miss a year etc.and only take the 300mg Flecainide,when it comes on,times between I take Beta Blocker,and other heart related medication.I wouldn't go to A&E but have an appointment with your Cardiologist,they will put you right.
Eleanor.
Not what you're looking for?
You may also like...
A&E
I go into an AF episode that last longer than an hour would it be ok for me to go to A&E? I worry I...
A and E Aaaaaaaaaaaaaaaaaaaagh.
(They gave some to me just before saying good bye.
All in all a long pointless exercise in...
Any point in going to A&E?
evening and tested out Flecainide PiP strategy of 100mg followed by another 100mg an hour later....
When to go to A and E?
Been given beta blockers and warfarin. I am due to have a scan this week and a 24 hour monitor next
A positive A&E experience
There has been so much comment about bad hospital experiences that I thought I should report a good...
admitted to A& E with PAF
Allergy, nosebleeds, anticoagulants and A&E
Afib and A&E - Update
