A week since DC cardioversion - back in ED - AF Association

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A week since DC cardioversion - back in ED

jedimasterlincoln
jedimasterlincoln
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Last week I reverted to NSR after a jump start (number 21), I'd had some weird "racing away" episodes that went back to 65bmp after a few seconds over the weekend but felt OK, and was going back to work on Friday.

Then Tuesday night (again) went to bed and woke up after an hour or so with like a head rush..... and crushing in my chest.... and then HR skipping around 130-150 and irregular. When I lay quiet in the dark I could feel it pulsing felt like my head was moving.

I'd only taken evening meds 5 hours before, so didn't take them this time. Tried the usual tricks, and failed.

Feeling unwell and a bit worried about the earlier chest crushing I went up to ED. Much busier than last week at this time of night, 36 waiting in the waiting room and an hour just to be triaged because someone fainted with a broken arm, but I knew I was in a safe place.

Got into resus where the reg (a new one to me) said "this is just ridiculous this can't keep happening" even after I told him I wouldn't come if I didn't feel so unwell with it, or it hadn't had associated chest pain at the onset.

He said "I could jump start you but then you'd be back here again in a few weeks" and I didn't argue with that, feeling low and fraudulent as it is.

Lots going on in resus too, a aortic aneurysm in the next bay had delayed the consultant going off shift who said she didn't agree with yet another cardioversion so soon, at my age, and as a treatment because it is a "waste of resources" (in private she said to the doctor it's a "piss take") that I'm in almost monthly (it's been three months since my last episodes this month)

So they went down the chemical cardioversion route, despite it not working before, but not having been tried for a year.

Initially it didn't work and after 2 hours I was still batting away. They got the medical reg down as the next stage would be CCU and seeing cardiology later on today. After a long chat, and the fact I'm due to see my none EP cardiologist on Thursday PM they decided to "jump me" again and send me home, although I overheard the doctor saying he'd already had a thinly veiled threat that shift for going against the consultant's management plan. I also got told what DC cardioversion does to the heart (I know) and one doctor said "if it was me, and I was offered this and it kept me NSR for a year I'd take it, but not 3 in a year" to which I replied he doesn't have to balance being able to walk half a mile to school, a young family and a desperation to keep his job.

As we were talking, the heart dropped down to 103 and I had "P waves" which was cause for celebration between the two doctors who were going against the consultants plan.

I have to say honestly I didn't feel any different, though the ECG confirmed NSR and they sent me home. BUT just getting out of the taxi and walking back up the stairs to bed put my HR back up at 198.... I managed to grab a few more hours sleep but as yet I've not done anything this morning and just lying in bed since 5am my HR has still been around 100.

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wilsond

Oh Jedi whata carry on. Im glad they went against consultabts plan! Which didnt seem to be much of a plan anyway.What a daft thing to say..'this is ridiculous' as if anyone would choose to be zapped if they didnt need it.Irriate!

Hope you settle back down and get sone rest.

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Kaz747

Oh Jedi, you poor thing. I think we should make a tv show featuring the medical and life dramas of us lot on the forum. In many cases though the audience would think it was fiction. Take care x

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Hidden
Hidden

Not a happy tale. You know we understand and sympathise.

Let's hope this will be noted by your EP and move your ablation forwards. Will your GP urge action on your behalf? At the very least an authoritative letter from your EP directing your treatment at A&E would be a help.

I know it would mean expense and a day out but would a private appointment be a possibility?

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Hidden
Hidden

Jedi..i am really so sorry that you are going through this and I really do empathise. I do get it when you say you are feeling low and fraudulent and as for the consultant calling it a " piss take".....they should walk an hour in your shoes.

I know you are young but surely pace/ablate could be an option ?

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I wish I could walk an hour!

At time of writing I'm back in hospital. When I eventually got up this morning, I went downstairs and back up again for my jumper.... massive onset of chest pain and clammy.... crushing in the chest and rapid hr. Managed to capture it at 198-211.

Presented at ED and couldn't even stand up straight after walking from the car to the desk. Same at triage.

Got taken into resus at 190bpm but by the time I was wired up it settled at 110. That's where it has stayed although I can feel the occasional skip.

ECG shows a possibly P wave within a QT interval apparently. Possibly Atrial Tachicardia. Don't fully understand it but the med reg on Medical Assessment has just said I'm in sinus. All captures say resting HR is 100ish.

I feel like I'm battling to get anyone to understand. By the time I see someone and get measured monitored or assessed I've been sat resting for hours.

Not sure what they'll do as I'm in NSR but the HR is rapid.

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Just had a very forthright discussion with the on call cardiologist locally (not the one I usually see nor the EP)

He was going to send me home. I said how I was wasn't normal. He argued that HR increasing on activity is normal. I argued 1) Going up to 190 Just from pedestrian sedentary activity (stairs) isn't normal 2) a resting HR of 110 on 10mg Bisoprolol isn't normal regardless of NSR or not. He had no reply.

I carried on.... that every time I've been assessed monitored or looked at I've been lying or sitting down for a while. So what is captured is not truly representative of my symptoms experienced this morning / at triage.

They're keeping me overnight and contacting my EP tomorrow.

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oyster

Well done for fighting your corner, its not easy in that situation. Had the consultant accessed your digital records?

Chin up.

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jedimasterlincoln

Yep but as we know flutter is very hard to capture... I'm convinced it's flutter back as I caught a glimpse of the ECG and the diagnosis the machine puts on the top.

Don't know what EP will suggest but not leaving here without them talking to him as they have no idea.

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jedimasterlincoln
jedimasterlincoln
in reply to Hidden

Thanks Jo, I did keep myself starved today in the hope they cardioverted even though it looked like NSR. hope the EP suggests something tomorrow provided they can reach him

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oyster
oyster
in reply to Hidden

I have the same issue with my GP. At rest, I am generally in flutter with variable block, rate 60, or 75 approximately. Since he clearly believes this is NSR, I will take some Kardia strips when I see him next week

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Got back in bed last night on the cardiology ward and my hr suddenly dropped to 70.

Of course I hadn't yet been wired up to monitoring. Slept 7 hours straight through.

I still want input from EP this morning even if its a letter pending.

Oh and I omitted my flecanide last night off my own back. Coincidence?

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After waiting all day for them to speak to my EP, I eventually got home at teatime. They've increased my flecanide to 100mg twice a day and I'm to have an ECG in a weeks time to look at my Qt interval and check its not any adverse affects.

Was looked after quite well on the whole, didn't let on I was staff until the very end.

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