AFib again at night...

Woke up half an hour ago (0330) to discover that I am in Afib again: 80bpm. Not supposed to warrant an ambulance, but will call 111 for advice.

[pottypete1]

As you have already been referred to Barts I suggest you try and get some advice from them regarding the management of your PAF during this waiting period prior to your ablation.

Incidentally I am surprised that you are taking Sotolol as my understanding is that it is somewhat unusual for this drug to be prescribed in the UK. More commonly Flecainide for rhythm management and Bisoprolol for rate control are prescribed. Of course we are all different.

It is clear you are very anxious about your condition and for this reason I think you should take a more proactive approach to establishing when you can be seen at Barts - a centre of cardiac care excellence. My EP worked there prior to moving to my hospital and for me that has given me considerable confidence.

Pete

[Hidden in reply to pottypete1]

I have taken a very proactive approach- have made various approaches to Pals, St Barts, local hospital. Probably 15 calls and multiple emails. I had a call from the consultant who says the referral has been sent twice. St Barts denied having received it however. Afib has now subsided and I am going to work (against the advice of the ambulance crew who said I should see a GP this morning). But from previous experience there is little they can or will do. I wil try to see one this evening.

[pottypete1 in reply to Hidden]

Keep pushing for your appointment at Barts.

I can understand your reluctance to go to your GP this morning after reading your previous post.

Regarding 111 or Ambulances, in future you may be better to try and give it a bit more time before you call for help. I know it is worrying and that AF causes mind games. I always wait at least 10 - 12 hours before I accept that it is unlikely NSR will return without help.

The big caveat being that if you are significantly short of breath, have chest pains and or feel faint you seek help.

Because I believe that you are not anticoagulated cardoversion will not be an early response by the hospital.

I hope you feel better today particularly as you have gone to work.

Pete

[Hidden in reply to pottypete1]

Thanks for these replies which are a very accurate description of the problem. I never have much by way of physical symptoms, more a feeling of “not again” coupled with anxiety. And the Afib always happens at the most inconvenient time (usually at night). Seems to happen when I am seated or at rest and , as someone has suggested, may be vagal.

[Slim2018 in reply to Hidden]

I have a feeling my Cardiologist does two days a week at Barts, so if you get Dr Till you are in excellent hands.

[Hidden in reply to Slim2018]

At the moment I am still waiting to hear. No response from Barts yet to the referral made about a month ago.

[CDreamer in reply to Hidden]

I am afraid waiting lists everywhere are extensive and you may have a long wait, I would suggest writing a formal letter and asking your GP to chase. Unfortunately there are too many Patients and too few appointments. Letters cannot be ignored by NHS - phone calls and emails can be. You could of course try see if you can get a private consultation which many of us have had to resort to.

In the meantime you may need to develop a plan as to what to do if you have AF episodes - which tends to be very personal. If you are very scared, some people find that going to A&E is reassuring - but having sat in many a waiting room for hours on end without receiving any monitoring, never mind treatment I can honestly say it only increased, not decreased my anxiety - so I developed my own protocol which helped me to sit it out at home where I could stay calm. I also developed a protocol with my GP of WHEN to call an ambulance:- chest pain, feeling very unwell, syncope or pre-syncope (fainting or feeling as though about to) feeling very clammy and unwell, having a high heart rate of 150+ for more than 24 hours.

Just having gone through that process helped me to sit out episodes. Hope that helps.

[Kaz747 in reply to CDreamer]

The more I read about the state of the NHS the more thankful I am that my parents brought me out to Australia as a kid 🧒 I can’t complain about the health care I’ve been getting.

[Hidden in reply to Kaz747]

The NHS may struggle on the waiting lists and other fronts but goodness it also provides such a wonderful service and I'm extremely grateful.

We can pay up not a huge amount for a speedy private appointment if we choose and then slot back seamlessly into NHS care again.

[Kaz747 in reply to Hidden]

We have a public and private system too. My health insurance company has paid out a fortune for me in the last couple of years so I can’t complain about the premiums 😃 The public system here is very good but, like the NHS, if your problem is not life threatening, there are waiting lists.

[Hidden in reply to Hidden]

I liked the Australian system when I was there - 1971 to 4. But let's not get off topic here!

[Hidden in reply to CDreamer]

Their plan seems to be simply : over 100 ring for an ambulance after 20 mins; under 100 take an extra Sotalol and wait it out.

[Hidden in reply to CDreamer]

I saw a doctor at the out of hours service-my practice had no appointments available in spite of the ambulance crews insistence that I see a GP a today. The OOH was very uninformative and suggested that I speak to my GP or go back to the consultant.

[Hidden]

I wonder if you have become trapped in the notorious positive feedback loop of AF and anxiety. You appear to have frequent episodes of AF without any physical symptoms.

You clearly have knowledge of self management of anxiety. Perhaps professional input would be helpful to break the loop.

I have noticed that during periods of high anxiety, my judgement is compromised and the process of information gathering leads paradoxically to increased indecisiveness.

For me, long term use of an SSRI has been transformative.

[Hidden in reply to Hidden]

It’s difficult to say whether anxiety plays into the AF. Last week I had an episode and felt relaxed and calm before. Early this morning I was woken from sleep with it. As one or two others have said, it may have something to do with the vagus nerve. I am still awaiting a call from the “duty doctor” who will call me in on for a visit to the surgery this afternoon (or not). I have to say I am very pessimistic about the whole thing. I see the current AF as the opening shots in something which will progress and, perhaps, end very badly.

[Rienij70]

Hi, I do know that feeling. Happened to me two nights ago.

[Hidden in reply to Rienij70]

Absolutely horrible feeling. Then afterwards as if nothing had happened.

[Ianc2]

I find sleeping on my left hand side is a good way of starting afib, the catch, of course, is that position I go to sleep in, on my right hand side is not the same one I wake up in.

[Hidden]

In theory it should be possible to have some sort of electronic device or special bedsheet (perhaps with some sort of very rough texture) which would detect this. But then, you would be woken up a lot at night.