I think it's flutter and not fibrillation because the heart rate is steady, but fast at 150 bpm.
How long do I wait to go to the ER in this time of COVID???
And if I go to the ER, are they just going to have me sit and wait again until it lowers by itself like what happened 1 time before, earlier this year? No IV meds, no electric conversion, no other meds Other than what I had already taken that day. They had me lay in a bed and wait it out.
How long does it take for a heart rate to get back to normal sinus rhythm instead of 150 beats a minute? I
Does anyone else have a trigger of getting too hot and then !bam! you're either in a fib or a-flutter?
I new at this and eventually I have converted to normal sinus rhythm on my own, but it's taking more and more hours of being in flutter , I think it's flooded, before I get back to normal sinus rhythm. Thank you for any help and input.
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Hi, Padayn01 & thank you for your welcome & quick reply!
I've tried a number of interventions & so far nothing has helped.I've tried coughing really hard, drinking ice water, curling up in the fetal position and "straining", I had some low sodium veggie juice for the Mg or the K (I forget which it has), I put an ice pack on the back of my neck and the sides of my neck, I put a gel ice pack on the tops and bottoms of my feet. I
I'm pretty sure the trigger was over heating (really hot day!!) so I sat in front of the fan.
Please tell me more about the use of coconut water! Thank you!
Well I’ve heard it’s got people back into NSR as it replaces electrolytes so does water melon, we had a very hot few days a couple of weeks ago where it was 33 degrees heat my heart went into playing up during the night as I was so hot so I fully understand the heat can be a major factor with the heart playing up how long have you been in 150bpm?
I went into Flutter one Saturday night (it was the first time so I didn’t know what it was - I had SVT previously). My heart rate was 150. It stayed the same Sunday and on the Monday when it was still that rate I went to my GP who called my cardiologist who admitted to hospital straight away. At the hospital they diagnosed Atrial Flutter and that afternoon they tried a chemical cardioversion with Adenosine (the drug also known as impending doom). My heart rate momentarily dropped to 80 then bounced straight back to 150. The next day they did an electric cardioversion.
I've had SVT but thought it was atrial fibrillation because I didn't know the difference. The emergency room did the electrocardiogram & said SVT. I had no clue what that was. I also got Adenosine and that converted me to normal sinus rhythm but they kept me For 6 hours to make sure I stayed in normal sinus rhythm.
My local hospital told me anything sustained over 130bpm go to A&E. (Pre covid age.). My interpretation - over 12 hours is sustained
If you have a heart rate of over 100 bpm for more than about 20 minutes the medical advice is that you should call for an ambulance and attend a hospital emergency department, because of the elevated stroke risk. It’s impossible for the hospital to predict when your heart will go back into sinus rhythm- a rough guide might be how long it has taken in the past.
The hospital is right not to intervene immediately with, say, a cardioversion-this would only be undertaken if you remained in fast flutter for a sustained period (I don’t know exactly how long this is but I’m guessing it might be around 24 hours). It’s stressful and unpleasant going to hospital emergency departments, but my view is that you should attend *with a view to getting them to refer you to a cardiologist as soon as possible*. He would, likely, undertake tests and perhaps change/adjust medication. It would seem that this is essential to get this situation resolved.
I think if we all called for an ambulance every time our heart rate exceeded 100bpm for over 20 mins the whole system would collapse! ( I had a heart rate in AF approaching 240 bpm earlier in the year whilst at the GP surgery and doc advised my husband to take me to A&E ....would be quicker than an ambulance 🙄)
The advice I received from doctors and EPs was to call an ambulance if a) the rate is 100 bpm or above (one said 90 bpm) and b) this lasts for more than 15-20 mins. If everyone did this at the same time it would overload the service, but since the probability that that will happen is minuscule, it isn’t imo a reason for an individual not to follow the medical advice.
Where do you live Sam? I would be calling an ambulance all the time if I went by your rules? My GP in the UK told me to seek help if my pulse over 130.
I’m in the UK. I asked just about all of the doctors and consultants directly what to do in the event of a PAF episode and they all said the same thing- that there was a stroke risk. I’m not sure if there is anything in the NICE guidelines about it. It’s possible that some doctors might relax this rule a bit if they know that someone has been going to hospital, say, every day, or if they know that the fast rate is recurrent. Or they might have received comments from the local hospital about frequency of AF visits.
I can go into fast flutter occasionally, and if I hold my breath it usually stops it. May have to do it a few times but always seem to work.
My flutter is about 240bpm and as you say, very regular, like a little machine gun going off.
I normally feel terrible when in SVTachicardia and have been cardioverted chemically within 30 minutes of being admitted into a ward. All were successful.
The problem with SVT is that the signal travels from the Atrium to the AV Node where the refractory period should delay it before it carries on into the Ventricles.
Instead of doing this it would also split and go back up into the atrium and pulse it before re-entering the AV node. This cycle feeds itself and needs to be interrupted either with vagal manoeuvres or a break in the pulse to revert into NSR.
This is your common AVNRT or Atrio Ventricular Node Reentry Tachycardia.
I fully sympathise with not wanting to go to A&E if you don’t think they will do anything. I think the problem arises partly if they count the time from when you arrive, not when you say it started, also if you are ‘haemodynamically stable’ ie circulation working sufficiently well they don’t need to act urgently. But you are in a safe place at least.
This is where a Kardia comes in useful as you can show when the episode started and what it was like when not under obs.
My cardiologist’s reply when I asked at what point to head for A&E was ‘Come in if you don’t feel well, we don’t mind’ which shows the huge difference in attitudes!
Sorry, I meant that I think different A&Es may have different policies. I didn’t think there was a time limit if you are anticoagulated? Something we need to know then 🙁
Thank you everyone for your kind and encouraging replies.
I'm calling my electrophysiologist as soon as his office opens in 20 minutes, and I'm dressed & ready to go wherever I'm sent. Hubby will drive me.
I've had no food since last night at 11:30pm, and have been on a blood thinner for about 2 years, so hopefully treatment won't be delayed & that will maximize my getting treated.
You've had many responses here and I hope all goes well for your outcome. My experience is in line with others here who say they don't go to A and E automatically if HR is over 100. My GP was quite specific that it ought not to be necessary although this was in relation to AF not flutter. His advice was to wait it out if possible. If I started to feel very faint, difficulty with breathing or chest pain, then I was to call an ambulance. I've had an episode today as it happens. Even taking an extra dose of my pills didn't work. I managed to talk to the Practice Nurse at our surgery and we agreed I could take 1 more dose (it's still within safe boundaries) and that did the trick. With my AF I always go above 100 BPM and have been up the 144 and stayed away from hospital. I'm still here.
Thank you all for ringing in here, I really appreciate each and every answer. I ended up going to the emergency room this morning, after 24 hours of a heart rate averaging in the 140s. My Kardia 6 lead did not show the same amount of details as the 12-lead that was in the emergency room.
The doctors in the emergency room discussed a number of things to do, and I was a respected component of that decision making.
We had a plan of trying this, then that, then perhaps one more option before just cutting to the chase for cardioversion. Thankfully the 1st thing tried worked, which was a beta blocker and although everyone is different, that first step got me to normal sinus rhythm.
However, with all the testing and a number of EKGS taken at different times while I was there, the diagnosis was not really determined. It was either SVT or it was atrial flutter. I'm hoping my electrophysiologist will be able to determine a definitive diagnosis based on my lab work etc and then we can reevaluate my medication regimen if need be. Again, thank you everyone!
I would base it on how you feel. Besides being anxious... do you feel lightheaded or faint, nauseated, extremely fatigued or have chest pain. If you are feeling ill besides the fast heart rate, then I would seek medical help.
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