Should I go to A and E?

[Mama48]

I have had two ablutions for AF, I have since been diagnosed with atrial tachycardia, I was due to have an ablation for this at the end if March. Since last Sunday I have had tachycardia, pulse 125 bpm, I have been taking sotalol40 mg bd, but pulse has remained rapid. I spoke to the arrhythmia nurse at Barts and she has suggested I go to my local A and E. I’m very reluctant to do this (and I’m not telling my husband) am I being stupid? I’d appreciate others thoughts, thank you, Mary

[jeanjeannie50]

How are you feeling with your heart at that rate?

[Mama48 in reply to jeanjeannie50]

A bit dizzy at times, it seems to vary, when I’m dizzy I go and lie down for about an hour and that generally helps. I try to live according to how I feel and to not measure my pulse too often.

[pottypete1]

I think you should take the advice of your Arrhythmia Nurse and go to A&E.

I had Atrial Tachycardia for about 4 months at >120bpm resting.

My EP told me that it was not good for my heart to stay in AT for too long and he arranged for an ablation relatively quickly.

If you have a non COVID19 problems the hospital would treat you in a totally separate part of the hospital.

Pete

[Mama48 in reply to pottypete1]

Thanks, the fact that you had tachycardia for 4 months makes me inclined to sit it out a bit longer though! But it’s reassuring. My husband has lung problems and we’re both 72, I feel a bit torn in two.

[pottypete1 in reply to Mama48]

Yes I can see what you mean and can totally understand your reluctance to endanger you and your husband. However, it took 4 months wait to get the ablation.

Maybe it would be a good idea to explain to the Arrrhythmia nurse your personal circumstances and and see if that changes his/her advice.

As BobD says they might offer a cardioversion if you are anticoagulated.

Pete

[BobD Volunteer]

Only if you are on anticoagulants I would say. If not they would be unable to offer cardioversion which is the normal treatment for AT. They may change sotalol (actually quite unusual in UK ) to flecainide to see if it will chemically convert. For what it is worth I had an ablation for AT last August since which my rate has been between 80 and 100 constantly which is not considered dangerous. Typically my AT ran at 140-145 when active.

[msharon in reply to BobD]

My husband has had three ablation! Went into af, sat around for 11 days, finally went to A&E... Cardioversion.. Home in 10 hours. They won't keep you any longer than necessary. You must be on bloodthinners to get cardioversion though. Good luck!

[BobD Volunteer in reply to msharon]

My point as above. 11 days is a long time as I have always been done inside 24 hours but then my EP shouts loud and I have been anticoagulated for sixteen years. lol MInd you I don't fancy another DCCV as the last one in 17 nearly killed me. Literally. Lots of CPR and cracked ribs, many days in ICU on morphine and months recovering. It is not without risk.

[jeanjeannie50]

If you've had a steady pulse of 125 since Sunday I too think you should go to A&E. Failing that see if your GP can fit you in for an ECG this afternoon.

[Hidden]

I think if an arrhythmia nurse said to go to ER, you should go.

[Mama48]

Thanks for your comments, I'm now sitting in a&e, had my temperature taken twice, on the green side, hopefully they'll be able to sort it.

[jeanjeannie50 in reply to Mama48]

How are you?

[Mama48 in reply to jeanjeannie50]

Now home, was monitored and had bloods taken, couple of ECGs, and yes I have got tachycardia! Keep on taking the sotalol( which hasn’t helped at all) I could stay in and be monitored over night and see a cardiologist in the am. I’m afraid I decided to come home, the patient in the next cubicle was being swabbed for “the virus” and another was being sent to the red zone, I didn’t feel happy in the green zone and felt I’d be safer at home. Hopefully my heart will calm down as it usually does. Thanks for your concern.

[jeanjeannie50 in reply to Mama48]

I can understand your reluctance to stay in hospital overnight and A&E is certainly not a good place to be right now. Sotalol didn't work for me either, but Flecainide and Metoprolol does. Did they send a copy of your ECG to your EP? You must feel worn out?

[pottypete1]

Best wishes I hope they can help you without too much stress and that you are soon back to your old self.

Pete

[SophieBella]

I had this a couple of weeks ago, waited, took extra betablocker, in morning had very low blood pressure, drank loads of water, waited several hours, but nearly passing out. Called 111 they then sent an ambulance. Went to A&E tried various drugs, transferred to another hospital and 2 days later had a further extensive ablation. If you are feeling poorly call 111.

[15sunbe]

I have a long history of 'ticker-tachy' and meds not working, or only minimally. Less than a week is really not long, in the grand scheme of things: and in my experience, the heart can right itself. I've had episodes lasting from a few hours, to several weeks.

The thing is - what would they do in A and E? The condition isn't in itself life threatening, and 125 bpm is not off the scale. In the current Covid Crisis - hospital visits are a risk. Barts Heart Centre are currently running a skeleton service, but before the lockdown I was advised by an experienced arrhythmia nurse not to go to A and E, unless I really felt unwell. Who is your consultant at Barts? You could contact the secretaries for an email address - for an email (marked high priority!) to be forwarded to the consultant I am currently in a similar situation - with ablations being on hold, due to Covid. Hope this helps.

[15sunbe in reply to 15sunbe]

Sorry, my reply was 'behind the curve', as all that appeared initially was your post, without all the responses, including yours. Hopefully your heart will settle - as you say it normally does.