As we have so much experience and knowledge on this site as patients and as medical professionals, I wonder if putting our heads together on this could be productive for doctors and patients.
Given that once in AF a high heart rate may persist for many hours, even days, it would be useful to have guidelines on what is a sustainable upper limit on heart rate and on duration for that raised heart rate, in order to maintain heart health in the long term.
I was thinking about this because although I had many very very helpful and informative replies to my newbie question, there was no consensus re. when to seek attention, and apparently no consistent guideline.
There were a few replies where people's heart health had suffered as a result of obeying the accepted wisdom, for example:
@P0rtnahapp1e replied "...If I hadn't gone to A &E ten days ago my prognosis from heart failure would have been very gloomy. I was fed the baloney about AF not killing you until I believed it. Not so according to my consultant. Damage has been done to my heart muscle because I waited. Meanwhile my poor heart was trying to get rid of fluids and in doing so, causing further damage.
When in doubt seek help. I'm very glad that I made the decision to jump in the car that morning.which could have led to heart failure."
Buffafly 's response to the same post calls into question whether heart rate is the measure for whether to get medical attention: "My cautionary tale is that I was 'toughing out' an episode of AF when my cross GP ordered me to go to A&E, tests showed heart damage and now my ECGs look as if I have had a heart attack. My HR was officially 130 so that is not the test!"
So maybe a guideline based on heart rate, or only on heart rate, is not feasible?
For newbies, here is BobD 's sensible and soothing reply:
"Going to hospital? Why? AF won't kill you even if it feels like it sometimes and as one old friend commented recently if he had called an ambulance for every AF event he would have one stationed outside his house 24/7 and never get any work done as he would always be in hospital. It is really up to each individual but the general advice given is that if you have any chest pain, or fainting (difficult call for you since you do anyway) then a trip to A and E may be in order and maybe if you heart rate is exceptionally high (around or over 200) but other wise not a lot of point. As above mentioned commented, AF is a chronic condition not an acute one and A and E is for emergencies.
Do read all you can from AF Association website and demand to see an EP as soon as possible. You can find one near you from the AF A website under patient information."
(Thankyou again P0rtnahapp1e, @Buffafly and @BobD.
Hope you do not mind my quoting your reply to my post at healthunlocked.com/afassoci... ...)
I started thinking about a formula when one of our consultants said he goes to the gym to get a raised heart rate, so a raised heart rate is not a problem. I thought "Hmm, I bet for you that is about 145 bpm and regular, and has a clear time limit on it. It really is not the same for someone in AF".
At a gym, there is a calculation done to identify a safe higher heart rate to exercise safely. When exercising, people are advised to stay below that rate. It is nowhere near the c 200 or 300 experienced by some with AF.
I assume the formula used in the gym originated in sports science and has medical research behind it.
Would it be useful to use this calculation, which takes age into account?
Would it be useful to refine it to include other factors such as general health, condition, body mass, &c.… ?
Thankyou for reading this. I would be very interested in your ideas and hope some of our medical professionals might contribute.
I would really like to know if given the variables involved it is possible to have a formula which would give a sensible guideline to patients and doctors.
Is there any such guideline in place, or being mooted?
Is it really just simple: don't put up with a heart rate above x , if you have had it for y minutes?
Are there reasons why this is not possible, eg. as @Buffafly said, heart rate is not the thing, or not the only thing, that we should consider in this situation?
Best regards from Boombiddy.