AFIB ATTACK

[Electricblue1]

Hi, I’m in AFIB attack , have been for 10 hours now, HR is between 98/137 , I usually go hospital but should I if HR is low.I’m confused as I worry about stroke , I was told to take extra beta blocker but it did nothing.

Can anyone advise please.

[BobD Volunteer]

At those rates most people ride it out but why are you not on anticoagulation for stroke prevention?

[Electricblue1 in reply to BobD]

Hi, I’m on beta blocker and flecainide, I was on blood thinner but the cardiologist told me my risk was low and should not be on it as it can cause brain bleed.I have had three different cardiologists tell me three different things regards medication.

[BobD Volunteer in reply to Electricblue1]

OK but what has your Electrophysiologist (EP) said or have you never seen one? These guys are the experts in AF and sadly many doctors are unduly risk averse where anticoagulation is concerned.

The flecainide will do more for stopping your AF than beta blockers which are only there to control the flecainide. Depending on your dose of this drug you need to discuss with your EP the possibility of taking extra when events come on always remembering the maximum dose in any 24 hour period of 300mg.

[Electricblue1 in reply to BobD]

Hi , I have never heard of a EP, I’ve just spoken to cardiologists, it’s conflicting advise though, I once took 3 flecainide when in an attack and the hospital had a go at me and said it was dangerous and yet the advice to take 3 came from a different cardiologist.I’m waiting for an ablation but it won’t be until November time as waiting list is so long .

The odds going wrong for ablation are 1 in 200 so that didn’t feel me with confidence.

[BobD Volunteer in reply to Electricblue1]

Having had four for different reason and being a devout coward I would say the risks are over stated. The ablation will be done by an EP by the way so if you have been selected it is likely you have seen one without knowing. They are the only people of whom I would take notice..

[10gingercats in reply to Electricblue1]

I would not worry about 1 in 200 going wrong. I had odds of 2 in 100 of losing an unborn baby during an amneocentesis test (and no second chance for me either).That was a bit worrying.

[Sfhmgusa in reply to Electricblue1]

I ( likeBob) am a big coward too, and have had two ablations . The U.K.has excellent facilities and my EP told me the statistical risk of death is 1 in1000 . It is well worth having done I have got my PRE afib life back after my second ablation. On another point I think you need a second opinion on anti coagulant I still take mine ( apixoban) it has, for me, zero side effects and is a great insurance policy against clot formation/ stroke

Steve

[Karendeena in reply to Electricblue1]

Go see an EP

[Jalia]

How are you feeling ? Are you breathless , dizzy? Extra betablocker would hopefully help to lower your rate. If, in spite of trying to remain calm, your rate increases and you feel breathless, dizzy or any chest pain, then do phone 111 fir advice.

[Electricblue1 in reply to Jalia]

Hi , I feel a little light headed standing up but ok.I think because I have family history of stroke it worries me a little.

[Jalia in reply to Electricblue1]

See how you are tomorrow and explain worries to own doc or 111. Hopefully you will be back in NSR

[Rubymurray25]

I would 100% call 111 I have always found them very good and reassuring and if they often get a specialist Dr. to call back and can get your name down at A&E to streamline your registration. I have had 2 ablations and although like others being on the cowardly side of things wouldn't hesitate having a third if my current Cardiologist suggested it! Hope all goes well.

[Singwell]

Hi, hope things have improved now for you. I second what Bob says about the Flecainide. Hospital A and E departments are usually not very well up on Arrythmia conditions so they don't know much about the drugs used. I've had the same thing with Flecainide - naughty (old) woman taking extra meds. Even though this was on advice from my EP. And they were wrong too - the problem I had that day wasn't the Flecainide. You definitely need to push to see an EP - cardiologists are not specialists in electrical problems. Talk to your GP and dig your heels in.

These HR you describe don't indicate it's worth going to A and E unless you have other complications or, as Jeanie says, you feel dizzy and faint.

With AF so much of it is about management - all of us have to learn how best to manage for ourselves and what makes us able to cope. It sounds like you haven't yet got the right management system. Talk about this with your GP too.

Finally - I was the same about ablation risks - and having read some people experience a few weeks of unpleasantness afterwards. But honestly - totally worth it - even if it improves the AF rather than sending it off for ever. I'd do it again if needed.

[momist]

So, what would you expect the hospital to do? I ask because the only two times I have gone to the hospital in AF, to the Accident and Emergency in an ambulance, they have done nothing whatsoever which helped in any way. Yes, they've monitored my heart with a twelve lead ECG, and then put me on a three lead heart monitor and blood oxygen monitor which they keep under observation for hours and hours. And I'm in the right place already, should anything else happen. But hours and hours on a trolley in A&E is no fun, and you will not be priority for an actual bed on a ward.

I've 'ridden out' many, many attacks. Usually, trying to stay calm, resting and occupying my mind with other things have helped the most. Sometimes, going to bed and sleeping has been the best solution, but only at my usual bedtime.

It's easier for me, when in AF, to get absorbed in a good movie or a sporting event on TV than it is to get lost in a book. But then, reading a book that you find engaging can work nearly as well. Knitting works well also, as does music, maybe it's the rhythm thing.

There is only a need to go to A&E if your life is in danger, or you fear that it is. Not being afraid of what _may_ happen depends on understanding what may happen, and what are the chances? You really need to talk this through with an EP (Electrophysiologist). Also, read everything you can on this forum, it's very instructive even though we are not medically trained people here.

[Electricblue1 in reply to momist]

Hi, on the times I have had to call an ambulance my heart rate has been over 200 bpm and when in hospital they give me meds intravenously , I stay there for about 5/6 hours then go home.It is all very annoying and inconvenient all this isn’t it.

[momist in reply to Electricblue1]

Yep. On my last visit to A&E they gave me metoprolol intravenously twice, to no avail. It made absolutely no difference to my AF or to my heart rate which seemed stuck around the 140bpm mark. They then tried a 2.5mg bisoprolol tablet, on top of the 1.25mg I was taking twice daily, also to no avail. You might say I've lost faith in their approach.

[Electricblue1 in reply to momist]

Hi, yeah I know what you mean, I think I’ve felt disappointed because different cardiologists have told me different things so I’m even more confused.

[momist in reply to Electricblue1]

Don't get me started on cardiologists vs EPs. I've only seen two cardiologists, but they both ignored the AF issue entirely and concentrated on the pumping mechanism and the pipes it uses. I ended up asking my GP for a referral to an EP.

[Fibber222]

On the 2 occasions I went to A & E they gave me bisoprolol and I rested until it went back to normal. If you have paroxysmal af then it should return to normal. Try not to panic. If you can’t stand it and have chest pain & going dizzy then ring 111. I cope with my episodes at home now. The longest one being 14hrs. Once mine had started to slow down it usually righted itself after a while. Hope it stops soon for you- it’s horrible while it’s happening.

[splashrollandplod]

My understanding is that SYMPTOMS are the big indicator for when to seek medical help - my rule of thumb was lightheadedness is ok, minor loss of power ok but seek help if more than minor, dizziness, fuzzy vision, any chest/limb pain and I’d be 999. Also depending on previous advice I’d be seeking help if AF persists (mine tend to be momentary or less than 3 hours). An EP is an electro physiologist - my cardiologist is that too. In terms of understanding risk, my take on it is ….. I am 65, an average 65 year old man has a 1 in 70 risk of dying of any cause in the next year. So the risk of death from the ablation I had last week was like having an extra month in this year (death risk from ablation is 1 in 1,000). Just my contextual assessment. I was happy with that risk especially as AF gets ever worse, mine has over two years (from twice a year & only after intense exercise, to 3 times in a week after no exercise).

[Karendeena]

Hi Electricblue1, When I take an afib attack my heart rate can go up to over 170 bpm. I am now being looked after by a top EP who has told me quite confidently that unless I feel unwell I should 'sit it out'. I usually continue like this for up to 48 hours but eventually it stops, a cold shower often works! Are you on anticoagulants? If so I wouldn't over worry about a stroke. My EP told me afib is not life threatening but thd consequences can be (the stroke and heart failure) the latter not over likely if your afib is well controlled. I was also told to take an extra Sotalol which can help slow the heart rate . Thd best advice is try not to panic and take long ow deep breaths