When do I rush to ER

I hope this isn't seen as a 'stupid' question. We very new into this AF. My partner has PAF, and he never aware if his heart is racing, but has a fitbit which I get the recording sent to my mobile. He sleeps well and I watch his heart rate all through the night. Some nights it's as high as 155, others hovering at 120-124. When is it necessary to get him to hospital, remembering he is never aware or feels anything. Maybe I am just very concerned as its all too new to us. Thanks for listening

[BobD Volunteer]

My personal view is that unless he has chest pain, nausea . fainting or feels similarly unwell then you are fine riding things out at home. Atrial fibrillation is a chronic condition not an emergency. You need to discuss your concerns with the team treating him as right now you are worrying more than he is by the sound of it. AF wont generally kill you they always say. Again my personal view is that these devices only increase worry and exacerbate the situation. A Kardia device to record ECGs (EKG to you colonials across the pond) may be useful in obtaining a trace to show the doctors but again far too easy to become obsessed.

[Hidden in reply to BobD]

Thanks BobD - very grateful for a reply. Yes I guess I am a worrier. We had to get this fitbit to track and record the days he isnt too good - cardiologist needs to see our recordings - as he is fine when whenever we have an appointment with the cardio. Its such a stupid 'thing'. But thanks for that- I certainly am grateful to get your thoughts.

[dmac4646]

Hi, would agree totally with Bob here, had bad chest infection at Xmas and was at Drs to get antibiotics pulse was 180 and had been for 12 hours - I was happy ride out at home but he said no get into "acute care" - result was a sat around all day there and all they did was put me on a saline drip and gave me more Flecanaide - as usual it resolved but with a lot more hassle....

[Hidden]

I never went to A&E with mine even though GP said ring an ambulance. I just lived with it everyone different. I agree with Bob regarding other symptoms

[CDreamer]

My GP gave me clear guidelines as to when to seek emergency help - similar to those Bob outlined.

It would also depend upon whether or not your partner is taking anti-coagulants?

[Hidden in reply to CDreamer]

Yes he is. Id like to hear about the guidelines you were given.

[CDreamer in reply to Hidden]

Pretty much what everyone else has said but as everyone has very different circumstances it is better to ask your doctor. Mine were:-

Syncope (fainting) - I had POTS and low BP.

Chest pain (always needs checking but also look up other signs of cardiac arrest - different for men & women).

Feeling generally very ill - cold and clammy.

If in fast AF for more than 48 hours.

If HR approaches or exceeds 200 for more than a few moments.

Any other symptoms which caused concern and differed from a 'normal' (for me) episode.

My experiences were that whilst you might feel reassured by being observed in A&E, no treatment was ever given, apart from once when I was very ill and spent 3 nights in acute cardiac unit because I couldn't lift my head off the pillow and my BP crashed and my HR was 180+ but very variable. Still just observed, no treatment and eventually everything settled again and I was discharged. After that I just stayed at home and monitored myself.

AF is often not considered an emergency, unless accompanied by other factors.

[Hidden]

We all react differently to heart rhythm. I have a very low heart rate when sleeping but cardio in the gym can send it over 200 bpm. I'm not aware of this unless I'm monitored or wear a heart monitor in the gym. I have never gone to the hospital or a doctor during AF- one GP in the practice classified 95 bpm as AF - but that not to say that is the right for anyone who has AF.

[Pikaia]

I was given the guidelines of heading to A&E/ER if I have a dull or sharp pain in my chest, shortness of breath, pain spreading in waves outwards from my chest, and/or nausea. No one is going to complain about wasting their time when it comes to your heart. Far better to be safe.

If you do end up going to A&E, take as much info as you can, as the doctors/nurses there may (understandably) not be familiar with the intricacies of AF.

Using the FitBit you'll be able to tell what is 'normal' for your husband. My advice is to only be concerned when there are deviations from this. This is just my personal view of course. If in any doubt, call an ambulance.

[Buffafly in reply to Pikaia]

Add to that dizziness or cold sweat, also pain may be felt in neck, jaw or arms instead. I was in hospital for a few day with AF and everyone kept asking if I had chest pain, no, but I did not realise the pain in my neck was worth a mention!

[Alli58]

My cardiologist and gp told me if my attacks of AF went past 20 mins to head for A & E ...... I ended up in hospital for 11 days in heart failure in 2012 with SVT which had been going on and I was unaware of it took me months to recover then I had an ablation in 2013 which was successful but Af returned in Nov 2016 and I've been in hospital 4 times since then trying to get meds correct now on Solatol and Apixaban and keeping fingers crossed also dropping to 40mg as horrible side effects but onwards and upwards and determined to conquer this mad condition 👍😀

[Walker1234]

Hi...The cardio told me last week that my Fitbit didn't match my heart...when I was there the Fitbit was reading 65..but my heart rate was 155.??

[Hidden in reply to Walker1234]

If you were in AF at the time it won't register it correctly. It only registers your pulse in sinus rhythm.

[Walker1234]

Ok..if your not in AF...then the Fitbit should register your heart rate ?? He just said there NO good ???

[Hidden in reply to Walker1234]

Yep. I have one and compared when on a heart monitor and it was spot on. It just can only record sinus - it either gives a false reading or will show no reading and when you look at the overview it will show a gap. I find it great to see what's happened over night and keeping an eye on the resting heart rate. To record AF you need Kardia which is a mobile ECG but this records on demand not throughout the day.

[Walker1234 in reply to Hidden]

Hi

On Thursday I have to have heart monitor on for 7 days see what happens then

Ive never had the fitbit on much since the cardio doctor said that there no good

put it on last night when in bed for a while and my heart rate went down to 58/69 ?...don't know what my resting heart rate is..

[Hidden in reply to Walker1234]

When you download your Fitbit to the computer / phone it tells you your resting rate!

[FyldeWhite]

I have the Garmin equivalent of the Fitbit and agree it's fine when in NSR but other than as a guide to say my HR isnt normal when I've been in Fib or flutter it's no where near an accurate reading and has shown both high and low compared to either Kardia or hospital monitors. I wouldn't get yourself worked up about it if your husband is sleeping happily.

For me HR of 250, sweating like a mad man and not being able to move much I consider A&E but only if it lasts longer than 30 minutes as usually I flipped back by myself BUT your husband needs to figure out what suits him and it will change as you both come to terms with his condition.