Time for A and E

[trixie100]

Not in af at the moment. Just a query about further episodes I may have some previous ones have lasted more than 2 days

[Hidden]

If you are asking whether or not you might experience further episodes that would be impossible to answer. Unfortunately AF doesn’t work to any form of rules, it’s very much a law unto itself. Pleased to hear that you are feeling better.

[BobD Volunteer]

If you mean how long do you wait before going to A and E for many of us we never go. AF is neither an accident nor emergency and should be treated by your normal medical team (GP and /or cardiologist/EP.) The exception is if you have any chest pain or are having fainting episodes in which case seek medial attention asap.

[Rossdkemp in reply to BobD]

There are some exceptions to this are there not and does it not depend where you are in the AF journey? In my experience of Af I have held long periods of NSR drug free but when it does go funny the first option is pill in the pocket and if unresolved for a few hours up to a&e for a cardio version. I’ve been told that the longer you stay in an abnormal rhythm the worse it is for you in terms of the heart using those pathways on a more permanent basis. I know it’s not ideal using A&E resources but if you wait beyond 48 hours I.e going through gp etc you’re then on blood thinners for a month before they can do anything about it (assuming you don’t revert and aren’t on thinners as standard).

[BobD Volunteer in reply to Rossdkemp]

I know from most of the posts here that cardioversion in A and E is extremely rare. Most people find that they are left for hours on observation before being discharged to home often still in AF. You may be lucky to have a cardiologist on duty who may prescribe drugs but I also know that many A and E protocols are highly restrictive in this regard. If you have been so lucky as to receive such treatment you are one of few I fear.

It may also depend on where you live. A major regional hospital in a large conurbation may have more facilities available whereas a smaller district hospital could not deal with a DCCV at such short notice.

On the odd occasion when my EP has requested such at my local hospital I have had to wait until the end of the day's surgey before being taken to to the recovery room alongside theatre where the anaesthetist was available to provide the fairy juice to knock me out. One must also remember that DCCV is not without its risks as I discovered when one of mine resulted in PEA (Pulseless electrical activity- the darned thing stopped) requiring CPR with attendant cracked ribs etc. Not my finest hour!

Regarding anticoagulation since having AF signals a risk of stroke, that risk doesn't end if the AF terminates which is why so many of us would never stop taking our anticogulant even after several years with no AF.

[Rossdkemp in reply to BobD]

Interesting how a lottery it can be. Mine is just a small regional Scottish hospital. Care has always been amazing. Appreciate your point re anticoagulant and cardioversion risk.

[Buffafly]

A few months ago I had an episode lasting 7 days. After a few days I phoned my GP surgery wanting an ECG because I was hoping to ‘see’ a cardiologist to answer some questions, including yours! I was referred straight to 111 who sent me to A&E where I was given a few tests then sent home. The cardiologist I eventually ‘saw’ said that in my case it was no use going to A&E unless I was so ill I needed a cardioversion ASAP but that only applies to me because of other issues. So it’s very individual depending on your general health and what your local A&E are likely to do. Probably the best advice I had was ‘Come in if you don’t feel well, we don’t mind’ which makes sense because until you have a few tests there’s no way of knowing if the episode has a single treatable cause. Having said that I wouldn’t go near A&E at the moment if I could possibly help it 💜

[Sfhmgusa]

I agonised with this as my af episodes got longer and longer ( 2 then 4 then 8 then 14 days) I was lucky to be able to speak directly with my cardiologist/EP during the longer episodes.Everyone is different , but in my case , having had a ct scan and echocardiogram of my heart, which other than crazy rhythm , was/ is in good shape, his advice was this

Any chest pain, dizziness or breathlessness when resting .... go to a and e don’t wait just go or call 999/911

Otherwise no need to go, rest and be careful but ( for me) don’t sit doing nothing,

I’m not a great accommodator of beta blockers but he gave me guidelines on what to do ( effectively gradually taking more during the course of the day to agreed maximum levels ( that I never needed) this brought the rate down but did not do much for the arrhythmia

For me the rhythm control ( flecainide) was never really that effective so I took ( max) 100mg twice a day, but latterly 50mg or none

I tried digoxin and it seemed to have more effect but soon after had a second ablation and since then ( touch wood) been in NSR

So in summary I think unless you feel unwell you don’t need to go to a and e but need and want are different things! So in normal times it is absolutely ok to go when you have “ had enough” just to be reassured and poss cardioinverted.

Right now I think because of covid I think only go ( but go right away) if you have chest pain etc as above

Sorry this is a bit long winded

Steve

[AFCyclist]

I have had 3 cardioversions. The last one was done in AE in Sheffield. I normally wait a couple of days to see if I can get back to nsr myself. Which I normally can. If I have no success myself I go to A&E. I have asked them and they said if you are feeling poor and anxious then come in. Particularly if you have chest pain.