As reported earlier, I had a lot of ectopics over the weekend. I took my usual Sotalol at 2045 and about 45 mins later went into PAF with Kardia showing over 100 bpm. Took another Sotalol and called an ambulance as discussed. Went back to rhythm by about 2330. Crew said it wa my choice whether to go to hospital - I opted not to. They said that my ECG showed no P waves including when the heart went back to rhythm. Was this a misreading ? Does a P wave have to look quite pronounced. This is my first clear episode of PAF since 22nd November.
At any rate going back to work. Train late, so had a couple of palpitations and v mild discomfort around the heart. Long day ahead and rather worried.
The lack of a P wave is definitive in diagnosing AF. If you go to the learning library on your Kardia app you will see an explanation of exactly what it means and a picture to show you the difference of what NSR with P wave and AF without a P wave.
Normally if you pr HR is less than 120 and you do not feel very unwell there would be no need to call an ambulance. If you are on your own - is there someone you can call or someone who can come sit with you? I do understand that AF is very scary but also bear in mind that the ambulance service is under tremendous pressure for immediate life threatening, conditions.
Thanks for the reply. All the doctors I have spoken to said I *must* call an ambulance if the pulse says above 100 for more than 15 mins; I am actually reluctant to do this, but they insist. On the P wave question- does this mean that Inwill have no P wave even when not in PAF? I will look at the Kardia documentation a bit later.
When you are in NSR you will see the P wave - it’s a little bump just before the big inverted V.
Advice varies from doctor to doctor - my GP’s want to call an ambulance whereas my consultant is happy for me to not unless I feel very unwell. I was having AF every other day in autumn, bouts of 5-6 hours of HR 150+.
Have your doctors explained why they think you should call an ambulance in those circumstances? The usual advice is that you don't need medical assistance/supervision with AF unless you feel extremely unwell because that shows your heart is being overworked which is damaging long-term. So I am wondering why your advice is different - probably panicked you now.
I was told independently by three doctors (2 GPs and a doctor at the hospital) as well as various cardiac nurses. So far as I know this advice is standard. The fact that I am not anticoagulated perhaps makes this more necessary.
I remember about your decision to stop anticoagulants. I know your Chads2 score is 1. If your left atrium was enlarged on the echocardiogram, would that be a basis for changing your mind? Only asking because you seem to be subject to a fair amount of anxiety like I used to be which I think fed in to my raised BP and enlarged left atrium, when I had only had two episodes of AF.
in reply to
My left atrium *is* slightly enlarged. I have decided to wait until the Barts appointment at the end of the month and discuss the issue. I have just discovered that ablation is not known to be effective for vagal AF, which is what I have. So I don’t know what the outcome will be.
I suspect they're just covering themselves. I used to get AF every 3 days, should I have called an ambulance every time? A&E would have been full of Afibbers! AF is a chronic not an acute condition.
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