Back in A and E again...

Went to bed at about midnight and about half an hour later woke up with good old paroxysmal afib- most of my episodes have been at night. Initially my heart was beating at about 130bpm, but after much deep breathing it slowed to around 80. Fairly acceptable you might think, but it was still very irregular. I took an extra Sotalol and waited. After about 30 mins Kardia still showed “possible atrial fibrillation” (which basically means “atrial fibrillation”), so I called for an ambulance. By about 0230 in A and E it went back to rhythm. For the first time I was given an x-ray which was apparently ok. Then came the contradictory advice: “call an ambulance if you get an afib ‘flare up’ “ one doctor told me. But my GP and another doctor at the hospital (last time I visited) said that this was only necessary if I felt dizzy, breathless etc..

[pottypete1]

To be honest this sounds like a typical PAF situation. I totally understand how AF plays mind games.

Personally I think maybe you did have a panic attack which I can totally understand but in truth unless you do have chest pains fainting you might well have gone back into NSR without any medical intervention.

Next time I would give it at least give it 10-12 hours. In the day time contact your doctor for guidance. The caveat being that you really feel unwell take yourself to A & E but AF is rarely a case for an ambulance.

In the meantime try relaxing as much as you can taking slow deep breaths. This should make you feel better.

Sotalol is not one of the most popular meds these days in the UK. Have a word with your EP next time you have an appointment to look at alternative medication

Pete

[Hidden in reply to pottypete1]

I felt reasonably calm so I don’t think it was a panic attack. I did a lot of deep breathing and took an extra Sotalol as advised, but the heart didn’t go back into rhythm after about 30 mins as it usual does- it returned to rhythm

in the hospital at about 0230. I didn’t have any breathlessness or chest pain. The doctor at the hospital said to call an

Ambulance if it “flared up” .

[pottypete1 in reply to Hidden]

Yes the doctors are very reassuring in these circumstances.

The only thing I would add is that our Ambulance service is under severe pressure as you know and sometimes in some areas it can take many hours even to respond to what they would term to be non urgent. In those circumstances do try deep slow breathing it helps many including me.

I had chest pains at Midnight on a Saturday about 6 weeks ago and ultimately called an ambulance. I had much care and reassurance and was sent home about 11:00 next day. They found nothing wrong but it was very real so I do understand how difficult it can be.

For AF in my 27 years of suffering the pesky condition it is my experience that it can revert with PIP and a lot of CALM.

I am not being dismissive!!

Pete

[TamlaMotown in reply to pottypete1]

Good grief 27 years....😓

[rosyG]

You need to go to A and E if the rate is high 150-160plus bpm for more than a few hours- and if you feel very unwell with it. We are all different- At 155 plus I feel very unwell but at 135bpm it feels quite manageable. Also if you have any chest pain- at whatever rate. or any other symptoms you feel need checking. It is best to be in a safe place to be monitored but you will get to know when you feel this is needed. (not a medical opinion here - just my own experience)

If you only have AF at night you may have vagal AF and, if so, be aware digoxin and beta blockers are not good meds for this.

Try deep breathing- blow as if blowing up balloon but don't release the air- as this helps to slow the rate and take heart from the fact that yours seems to stop by itself

[Hidden in reply to rosyG]

If you only have AF at night you may have vagal AF and, if so, be aware digoxin and beta blockers are not good meds for this.”

I will ask the consultant about this when I see him. Thanks

[CDreamer]

It is very confusing isn’t it? I’ve so much contradictory advice but as no-one in A&E has ever given treatment and I’ve been at this for so long I’ve never called an ambulance but others have for me because they have been more concerned. I think if you live on your own it is much, much scarier.

I do think it is reassuring to have someone check you over and that feeling of being somewhere safe and I think it is contributory to reverting back to NSR.

I got very into audio books when I was having a lot of nocturnal AF and finding that listening to that human voice had a similar affect - needs a soothing voice though - no horror stories.

If your episodes are only occasional I think it is scary but as mine became so frequent - I’d have been going to A&E most nights and that is obviously not on so I also think it just becomes your new norm.

Obvious caveats apply - feeling dizzy, feeling ill or chest pain - 999.

Best wishes CD.

[Hidden in reply to CDreamer]

I’m still fairly new to this. I expect it’s something you eventually get accustomed to as you say. I’m going to have to get more info from the consultant when I eventually get to see him.