When to go to the emergency room?

[Samuel68]

Hi all, Im new to this AFib thing. My question is, does everyone go to the ER everytime they go into afib? I had my first afib 4 months ago, havent had it since, well i dont think i have anyway. I have panic attacks which feel the same to me.

[Hidden]

Welcome to our world, Samuel. It isn't as bad as it feels when you first discover it!

The answer is yes and no. I think most of us tended to do so to start with but once we know more about our own brand of AF (it is very personal) and get on top of it, we don't bother any more. Some people have AF all the time and just get on with life.

ER in the UK is A & E - Accident and Emergency. AF is neither of those - it is an ongoing condition. When it occurs every now and then it is quite often mis-diagnosed as a panic attack. There are three things you should know about it:

Usually

- it isn't fatal

- it won't kill you

- you don't die from it.

[Samuel68 in reply to Hidden]

Thank you so much for the info

[BobD Volunteer]

One member once said that if he went to A and E every time he had an AF event he would need a permanent bed there 24/7. It is a chronic condition not an emergency BUT if you have any chest pain, breathlessness or fainting then yes go.

[Hidden in reply to BobD]

Agree with Bob I never went/go

[Samuel68 in reply to BobD]

Thank you for the info.

[seasider18 in reply to BobD]

In your opinion what should a person with an AF episode do or not do during it ? Carry on with what they are doing, go shopping, go to work or just sit back and relax ?

Presumably the type of AF is a consideration with it having so many causes.

[BobD Volunteer in reply to seasider18]

Very individual. I once drove to mid Wales from Devon, took an engine and gearbox out of a rally car (assisted by my 16 your old son) put it in a van and drove home again whilst in AF with a HR around 150. Tired does not come close to how I felt but needs must. I know of an EP who went into AF whilst he was performing an ablation. Some people can't function whilst people in permanent AF live their lives despite it. I repeat my usual caveat. Any chest pain or passing out needs investigation.

[seasider18 in reply to BobD]

I know the tired feeling from my insomnia. I tried Nytol and instead of wakening every two hours I was waking every hour. Perhaps I should try Night Nurse. When my late father in law took it he slept for 36 hours and thought it was just the next morning when he woke up. Perhaps that's why they are now advertising Day and Night Nurse

I wonder if the patients Ablation was successful despite the EP ?

[Finvola]

Welcome to the forum Samuel. Each of us has different symptoms and reactions to episodes of AF and it really has to be a personal decision whether to seek help or not.

My 'rule' is: no pain, no extreme breathless, heart rate manageable - lie down on the right side, think good thoughts and breathe as calmly as possible. My A&E is about 35/45 minutes' drive, so I take that into account too.

Although I fear episodes of arrhythmia, I tell myself that they will occur again but I am prepared to cope with them. This takes away some of the power which AF can exert over our thoughts - shove it into the background of your life and meet it head-on if you have to.

Best wishes.

[Samuel68 in reply to Finvola]

Thank you, i am trying to get ahead of it so to speak in my mind. All of you have been wonderful

[CDreamer]

Short answer no, it isn’t an emergency unless you have other conditions which worsen with AF, your heart rate stays very high ie- 200+, you are feeling very unwell and are concerned and of course if you have any chest pain, BP is abnormally high or low.

Mostly if you go to A&E you may (or in my case mostly not) be monitored until your episode ends and you are back in NSR.

Takes a bit of getting used to. Best ask your specialist for guidelines of when.

Personally the last place I want to be is A&E with AF.

[Samuel68 in reply to CDreamer]

Thank you, Im just trying to figure this out, i think it makes me more nervous than anything .

[CDreamer in reply to Samuel68]

That’s normal, it takes some getting used to!

If you can find ways of dealing with your nerves that will help as anxiety only makes things a lot worse. Distraction is good tactic - I found puzzles, audio books, meditation & breathing exercises all help. Our minds like to keep busy so when it idles the worry thoughts kick in.

[Samuel68 in reply to CDreamer]

Thats sound about right, trying some breathing techniques and self talk, you possitive things and repeat,

[seasider18 in reply to CDreamer]

Especially when they say you can go home at 2am in dense fog as I once had.

[UScore]

I went the first two times, when I didn't know what it was. The first time it stopped before they assessed me so I didn't know what was happening until the second time. Then I went again in the time between being diagnosed and actually seeing a cardiologist. Then I went another time, when the initial medication prescribed didn't work.

I am hoping that I now have the right medication and will no longer be disturbing the A&E dept.

[Samuel68 in reply to UScore]

Thank you for the info and I am learning that I can wait it out unless I am having chest pain and breathing problems.

Thanks again

[doodle68]

I have never been to the 'ER' (A&E here) I think laying on a trolley in a corridor for up to 15 hours waiting to see someone in my failing local hospital won't do my anxiety or AF any good at all.

Unless I have chest pain I will stay at home as I have done so far doing breathing exercises, lying down and keeping calm.

I think if you are sitting it out and live alone it is a good idea to let someone know you are having an episode and when you are feeling better .

[Samuel68 in reply to doodle68]

Thanks for the info.

[12cupcakes]

Welcome Samuel. I too am new to afib starting this past August. I feel so lucky to have found this group. Their advice, experiences, and support have help me more than they will ever know. And I am sure you will find the help you need here.

[Samuel68 in reply to 12cupcakes]

Cupcake, yeah im rally appreciative of this groip also Stay strong

[Clareowenpearcy]

Was diagnosed with Afib in 2010 although I had it for 30+ years before knowing I had a problem. I’ve never gone to the hospital. I’ve had 3 ablations. Everyone is different and everyone’s symptoms are different too just like everyones coping skills and tolerance is different. You have to decide your comfort level. Remember Afib in its self will not kill you.😉 All the best.

[Samuel68 in reply to Clareowenpearcy]

Thanks its always comfortable when people remind me it isnt deadly

[Ottis in reply to Clareowenpearcy]

I'm like you but I get pains around my heart and sometimes tightness in upper chest but I panic bad and I think I make it worse I sometimes use that spray but I get an headache if I do.I can't lie down aswell because I get the pulpations and feel like I'm going to stop breathing and feel really ill when I wake

[Samuel68 in reply to Ottis]

Yeah i know how you are feeling, my doc started me on a low dose of xanax , wonderful stuff i also purchased kardia mobile and it has been really helpful whe i can tell the difference between panic and afib. We will be ok, everyone here has been very helpful

[UScore]

I've said this before, but I'm going to buck the trend of the replies in this thread.

I have explicit instructions from my EP to go to A&E if my Flecainide doesn't halt AF within 3 hours of taking it. I've also asked my GP what she'd do if I came into the surgery instead, and she said she'd tell me to go to A&E.

I have no desire to clog up the NHS, but what other option do I have? What do others do if their medication fails to restore sinus rhythm? Just wait it out? Why am I being given different instructions to this? Is it because I am younger than the average person with AF, at 40?

In addition, on all my trips to A&E, I was quickly taken in, and taken seriously. If the Flec hadn't fixed it, I was to be electrically cardioverted on that same day. From my pre-AF experience the A&E department are quick to get rid of you if you shouldn't be there. I made it clear I had no chest pain or dizziness, but I was whizzed through triage nonetheless.

Like I said, I don't want to be an unnecessary burden, but at this moment in time I intend to follow the unanimous instructions of all the experts I've spoken to on this. Perhaps if and when AF gets more established, and frequent, and Flec no longer works, the advice I'm given will differ. I intend to have gone down the ablation route before that point, so hopefully that day won't come!

[Samuel68 in reply to UScore]

Thank you for the info, i hope the ablation works for you, i have thought about that as well.