Confused

[Rachelanx50]

Hi everyone i was diagnosed with peroximal afib 2years ago in August i recently had another episode 2 weeks ago i took myself to a&e with a pulse of 170 (i was advised by my cardio nurse to go to a&e if it went over 130) however i sat in the waiting room for 7hours by the time I saw a doctor i had gone back into sinus rythem my problem is that i suffer from chronic health anxiety agoraphobia ect so it was really traumatic which I don't think it helped the situation do i really have to attend a&e during an attack. Thanks for reading

[CDreamer]

Your experience reflects my experiences of A&E. GPs & nurses refer you & A&E don’t see it as an emergency so the answer no UNLESS you feel very ill, you have chest pain, a very high HR ( over 200) or a high rate of over 120 for more than 24 hours. BUT everyone must do as they feel appropriate for themselves and do take advice from your specialist.

Treatment are normally organized through Arrythmia clinic as outpatients.

You will find a very wide range of experiences & some people do go to A&E but I now don’t.

Are you taking any-coagulants? That is important.

Best wishes CD

[Rachelanx50 in reply to CDreamer]

Hiya cdreamer thank you so much for replying you have been very helpful in my situation i am going to take your advice on board it makes so much sense i just needed to hear it from a fellow sufferer thank you

[Hidden]

I am really surprised that you were not prioritised at A&E. When I go I have always been put to the front of the queue and well looked after. I think my maximum wait has been 15 mins.

I try to sit it out at home but when I feel very compromised with rate 170/180 I phone for advice and paramedics have been sent. They have always been insistent that I go in and read the riot act if I resist! Of course once the rate goes 240 + you couldn't keep me away! I've always been told that I've done the right thing in presenting at A&E. However I always feel guilty...due not least to some of the comments on this forum !!😁

PS perhaps I should add thst my AF is almost always persistent

[Rachelanx50 in reply to Hidden]

Hiya thank for replying but my a&e may be different from yours as i said i waited 7hours to see a doctor i think you are extreamly lucky you didn't but i didn't have that experience

[Hidden in reply to Rachelanx50]

Yes I think they do vary considerably. I consider myself very fortunate that we have a very well run A&E dept at our local hospital which , like the majority, has to contend with an ever increasing number of people attending.

I've had a total of 19 electrical cardioversions performed as ' emergencies 'resulting from presenting initially at A&E.

If you know from experience that you will convert to sinus rhythm and are unconcerned then I can see that a visit to A&E is not necessary.

In the end it is a personal decision based on how YOU feel. I have to say that I don't know how I would feel if I had to sit in A&E for 7 hours ! I would probably have agreed to an ablation much sooner than I did for a start and maybe a pacemaker....who knows?!

[PhyllisK in reply to Hidden]

Hi Yatsura, I noticed that you have had many cardioversions. I am booked in to have one on the 12th October but am worried about the success rate. What do you think?

[Hidden in reply to PhyllisK]

Phyllis..nothing to worry about here. They either work or they don't and there's not much you can do either way. Have a couple of banana s on the day before to help keep up your potassium levels.

My dccvs have been spread over 25+ years ..one or two have lasted 3/5 years, many 12 months and latterly 4/6months .

My last one was in April. They give an instant feeling of relief if they work and mine have always done so.

Good luck !

Sandra

[PhyllisK in reply to Hidden]

Thanks. I will also take on board the tip about the banana’s. Stay well. Phyl.

[CDreamer in reply to Hidden]

It’s very personal & I’ve had paramedics called & similar scenario but my record was 9 hours in A&E with no monitoring & no triage, once when I got a bed - I was turned out 10 mins later & that was purely just so many people coming in & being swamped.

[Hidden in reply to CDreamer]

That is so bad CD...see my reply above.I don't quite know how I would cope.

[CDreamer in reply to Hidden]

Didn’t have a choice - had to cope. Sent you a message.

[radagast58 in reply to Hidden]

My experience has always been similar and I've always been "triaged" as high priority

[jeanjeannie50]

Hi Rachel, like Yatsura I've always been prioritised at A & E and have never had to wait long. I've always been sent there by my GP or taken by paramedics. Each time, I'm very quickly connected to a heart monitor and have an ECG. Once I had an oxygen mask put on too, which made my daughter panic! One time when admitted they wouldn't let me be wheeled to a ward without first getting a rather large portable heart monitor to wear during the transfer. I think you were right to go to the hospital with such a high rate, I usually take pills, then wait a few hours to see if they help and if not seek advice. The paramedics have assured me I must call them, but I never have.

Always ring the NHS 111 number for advice, if they think you need it they will get you an ambulance.

Jean

[Hidden in reply to jeanjeannie50]

Yes jean ...ive always had portable heart monitors following me when moving wards as well !

[CaroleF]

Oh my word! Poor you stuck in A&E for 7 hours particularly given your anxieties. I've only ever been taken to A&E by ambulance (once summoned by an off-duty nurse and the other by the GP) and taken straight through to resus. Whether it would have been any different if I'd gone under my own steam I don't know.

Now I would only go there if I'd fainted, had chest pain or a very high HR (200+) . If those things don't apply then I just go to bed and sleep. That usually works for me, though I know others have different strategies for coping with an AF episode.

[BobD Volunteer]

I have been sent to hospital expressly for treatment like cardioversion on only two occasions via A and E by appointment. Even though they were expecting me it still took a very long time before I was moved to MAU for treatment during which time I was amazed to be asked if I was subjected to any domestic violence! Apparently this was a new initiative and all patients entering A and E were subject to this grilling.

Never in my 15 years of this game have I voluntarily gone to A and E as AF is a chronic condition and neither an Accident nor an Emergency. The caveat of course is that if you suffer chest pain (as a few AFers do) or feel faint or are passing out then obviously you call for assistance.

[Buffafly]

That's terrible, maybe they thought if you were well enough to come in by yourself you didn't need urgent care but they shouldn't make that assumption. I have decided not to go to A&E from home even though I can't do anything but sit or lie down once my heart goes up to 150 because I'm much more comfortable at home and now I usually revert in 4 hours or less. I'm sorry you had such a bad experience 💜

[doodle68]

Hi Rachel I really can empathise with you anxiety which is exactly why I never go to the local A&E (which has a poor reputation) during episodes of P-AF.

Although symptomatic with breathlessness I don't consider myself to be 'an emergency' . I know if I do go to A&E I can expect a wait of up to 15 hours before getting any attention which won't help my anxiety or AF.

I ask myself this, what can they do if I go to A&E. All they can really do is try to return me to normal SR with meds or cardioversion if they think the episode has gone on too long .

So what is too long. My episodes so far lasted no more than 15 hours, I have discussed this with a doctor at the arrhythmia clinic and agreed that if I can't get back to NSR on my own after 24 hours I will risk a trip to A&E. Of course If I was experiencing chest pain or my breathing becomes compromised I would go to A&E straight away.

We are all different and have to do what is best for our particular circumstances.

I know the best thing for me during an episode is to try to stay calm and quiet so I settle down with some distraction like the radio and do breathing exercises.

If you live alone as I do and decide to sit it out it is a good idea to inform a family member or friend that you are having an episode and might need help .

[Hidden]

The problem has been with my episodes of AF is that I always suffer chest pain and the medics have never been able to decide if it is angina or spasms from my oesophegus. I have found over the years that not going to a &e has actually made my episodes easier to bear. The quietness of home seems to make them shorter and the only times I have to resort to hospital is if I feel as though I am going to pass out. The cardiologist was ok with this approach when we discussed it. I think you have to use your own judgement on this issue but I do understand that the first time you decide on this approach takes a bit of nerve! Best wishes🌻

[Hidden in reply to Hidden]

I agree with your comment about staying home being calmer. With my pacemaker I no longer have had reason to go to to the ER (A & E for a-fib at least. In the US emergency rooms are often crowded with 'non-emergency 'patients who have no health insurance and can only get care in the ER (earaches, infections, illnesses that could be handled in a doctor's office if they had insurance.)

It is one of the big shortcomings that our (US)healthcare system excludes good care for people too poor to afford proper healthcare coverage. I understand why they seek out the ER but it also makes it a very anxious, unrestful waiting room experience. People often bring their kids as they may not have anyone to babysit, The noise level and chaos of kid running around not properly supervised can be overwhelming.

This makes for a chaotic, high noise level environment and makes, for me, a very stressful waiting room experience. So I now avoid and try to see my doctor before waiting too long creates a necessary ER visit. Also it's like packing for a trip. Bundling up my C-Pap machine in case theirs are all in use if I get admitted, bringing my own healthy snack foods (nuts, fruit) because hospital food here is so unhealthy. It's a wonder I don't bring my passport.

Also here hospitals are wonderful places for picking up illnesses you weren't planning to experience.

Welcome to the US hospital experience of 2018. I say stay home if we can.

[Bagrat]

Once I rang emergency docs and they said I could go down and they would reassure me but didnt have ECG machine!! I suggested I would ring coronary care unit as they had told me to present myself if it happened again (PAF) Doc asked if they had open door policy I said no but I had a phone!

C care said go to A&E husband drove and as soon as I'd booked in I was called straight through having been asked if I was the one who phoned and treated (didn't work!!) Went into sinus rhythm about 5 hours later.

[Chris1945]

When I was first diagnosed with PAF, I always called 111 and after answering their many questions and advising that I had no pain/dizziness etc, I was still advised to go to A and E. Which I did until I had the dubious pleasure of being told by one of the A and E docs that 'he could walk me round A and E and show me people who were in a worse state than I was and that I shouldn't be wasting their time'! On the few occasions I've felt it since then I don't even bother calling 111 any more, I just sit it out for an hour or so and it either goes by itself or after taking flecainide medication. However, as stated by others here, any pain or light-headedness involved should make you get yourself to A and E right away.

[doodle68 in reply to Chris1945]

Hi Chris what an uncaring and unnecessary way for a doctor to behave .

I have further been dissuaded from attending our local A&E after a young member of my extended family went there a few weeks ago. She had what turned out to be viral meningitis and was semi-conscious but had to sit on a chair for hours propped up by her mother because there was no bed or even a trolly to lay on. The staff apologised profusely but said there were people in a worse condition who needed a bed and couldn't get one . She was eventually sent home to the care of her GP , her own bed and a darkened room . Her husband nursed her and had to carry her to and from the bathroom.

We have had deaths in my local hospital from lack of treatment and waiting in A&E, when I went with someone else it was full of drunks and scary people. I feel much safer and calmer coping with AF at home .

[Hidden in reply to doodle68]

Dreadful experience. No wonder you avoid A&E

[radagast58 in reply to Chris1945]

That is appalling.

[Hidden in reply to Chris1945]

Chris, that was so wrong of the medic. He must have been really stressed. This contrasts sharply with my experiences.

I was seeking advice from a locum doc at my surgery a year or more ago as I had been on fast AF..abour 150 ish for 24 hours. He was adamant that I should go to A&E. I explained about my concern in taking up A&E bed in view of publicity given to inappropriate attendees. He said that he had spent considerable time as A&E doc and it was very appropriate for me to attend. Further he wanted an ambulance called and the paramedics would decide whether I needed taking to the Cardiac Centre further afield. Yikes! Enough said....

I also queried with A&E nurses/ medics who cardioverted me in Resus a few weeks ago. Same response....very right that I should be there. The other inmates nearly all appeared to be off their heads on alcohol/ drugs. One was being transferred to CCU after overindulging in cocaine by all accounts .

[momist]

Oh what a horrible story! I feel so sorry for what happened to you. I only went to the hospital the very first time it happened to me, and I knew nothing about AF. Since I went in an ambulance, I wasn't sat in A&E, but I did lie on a trolley for about an hour before being assigned a small cubicle where they could monitor me for about the next ten hours, still on a trolley as they had no beds.

I've shunned the A&E route since. As BodB and others have said, it's not an emergency or an accident.

But, what you need to take this view is confidence that you know what is happening, and that it will come to an end. Obviously, if there are accompanying problems, like chest pain or some other physical distress, then you need medical help, but not just for the erratic and fast heart rate and weak feeling. Take care of yourself first and don't worry about others.

[Hidden in reply to momist]

Unfortunately it doesnt always come to an end without assistance from drugs administered by hospital or dc cardioversion . If you know your AF is paroxysmal then ok if you are coping well.

[KMRobbo]

First time I got AF i was at 165 bpm I waited all night before ringing 111 and asking for advice. They sent an ambulance (the medical personnel at 111). On another occasion I could not get rid of it despite taking more rate control drugs , 111 told me to ring an ambulance. I did not but that was the medical advice. I have been told at my local hospital on more than one occasion anything over 130 go to a&e. If have always taken this to mean if it is consistently high and you have exhausted your own options to control the high rate.

In July 2017 I spent the best part of 8 days at high bpm 120 to 190, and it did not do me any good and I do not believe it was good for my heart. I was at a&e 3 times in that period and was kept in overnight twice. If the doctors think it is important enough to admit you then it must be important. If you do not attend how will they know to make that decision? On that occasion i ended up on the coronary care unit having a flecainide infusion to stop the highrate and get back to nsr. That lead to me having an ablation which has (So far) stopped the AF.

[heartbeats]

It's ok for some folks on here to say don't go to a&e but some people handle it different and are scared and don't know wot to do

I've sat it out many time then gone to my gp who said I should have gone to a&e, I agreed it's not good to be waiting all trust time but you are in the right place that will help you calm down

From my experience I get it most of time when I'm in bed and then you just sit there thinking about it and stressing your self, so what I'm trying to say is do wot you thinks right at the time

Just find a happy place and as every tee shirt says stay calm

Hope your feeling better

[10gingercats]

Even treatment in a Gps surgery can be worrying now and for the GP. Yesterday my GP was mildly threatened and you could see he was really worried and quite anxious when I saw her. This should not happen.I got a very short and uncomfortable few minutes with him although he usually great.

[Rachelanx50]

Thanks everyone for replying to my original post confused. Whether to go to a&e or not. Im thinking that it all depends on your own experience and knowledge of the condition I'm a virgin to it all and suffering from health anxiety and agoraphobia to some of you who can wait it out at home I struggle because of my anxiety I feel that I'm in afib attributed with panic attacks xxx