Should I call hosp in a fib? - Atrial Fibrillati...

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Should I call hosp in a fib?

Stb1968 profile image
64 Replies

I had my only case of a fib in Sept and was in the hospital for a couple days. Am on eliquis, and 200 mg of flexanide pill in pocket. I went into a fib 1 1/2 hours ago, took the flec. And per my kardia, my heartbeat is fluctuating between 116 and highest 162. Should I stay home and relax and ride it put or call hospital? Am scared because I am not experience with this.

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Stb1968
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64 Replies
rebecca70 profile image
rebecca70

Hospital Asap! Are you on antocoagulant? Better safe than sorry.

Stb1968 profile image
Stb1968 in reply torebecca70

Thank you Rebecca. Finally got call back from cardiologist and he gave me some sorely needed information and words to follow. I AM on an anti clotting med. Dr said a fib is more scary than dangerous. Told me time and heartbeat perimeters to follow.Thankfully the flex window kicked in and my last reading was ok. After this episode I feel more prepared.!! I have to say,this site is a Godsend!

in reply toStb1968

Hello Stb, this is always a difficult question to respond to because we know how frightening it can be when an episode occurs. Here in the UK, the general advice is that if there are no chest pains or signs of fainting then it is probably better to sit it out in the comfort of your own home. It’s not something I have personally experienced so I can only say what others have said on the forum. We can also make a “non emergency” (111) call over here which puts us in touch with medical support and generally, they will advise on what to do. Rates above 130 can be alarming but Flecainide as a PiP is generally effective so personally, I would sit it out……..

Stb1968 profile image
Stb1968 in reply to

Thanks FllapJack! That's exactly what I did. AF gone this morning, but I'm tired . Think I over did it at the gym yesterday! This site is so comforting, and helpful,,,like a good friend!!.

CDreamer profile image
CDreamer in reply toStb1968

That could do it. Learning to pace oneself is the hardest lesson because with AF you may get a delayed reaction. Glad you got the reassurance you needed.

Stb1968 profile image
Stb1968 in reply toCDreamer

I go to cardio rehab and the therapist jacked my speed and incline up considerably, on the treadmill Friday and again Monday. Funny thing was while doing the workout my BP was low and bpm only got up to 103! This affliction is a puzzle to figure out!!

CDreamer profile image
CDreamer in reply toStb1968

Low BP would do it, is that usual for you? Do yo take BP lowering meds?

Be sure to give that feedback to the therapist & explain that you think you need to increase your exercises more slowly. They may have increased to raise your BPM but your body was in conflict because of meds, lack of hydration or electrolytes.

Low BP is often a sign of lack of adequate hydration and electrolytes. If exercising I would suggest you load up prior to exercising & take a good, natural electrolyte drink for after such as Pure Coconut Water.

PS I gave up going to A&E unless chest pain, very high HR ie 170-200+. I’ve sat in too many waiting rooms for too long and you really don’t want that if can be avoided. If you feel very unwell do not hesitate to call for Paramedics - they can take an ECG. - send back to cardiologist who can then decide whether you need to be seen.

MissTia123 profile image
MissTia123 in reply toStb1968

Hope you feel better soon, its a hard call, home is more comfortable than Emergency. Call your Doctor and ask, if you are worried call a friend to stay or check on you in the morning. If you have chest pain dizziness or breathlessness - off your go!

in reply to

I've been given different advice: if the heart rate is over 100bpm (one cardiologist said 90bpm) for more than 20 minutes then an ambulance should be called. Also, if there is anything new or unusual about the AF.

CDreamer profile image
CDreamer in reply to

I wouldn’t be out of the ambulance if I called one every time I was over 100bpm but I wonder if that advise was given is because of individual circumstances?

I was advised not to call an ambulance unless feeling very unwell, had chest pain or HR exceeded 150 for more than 24 hours. Different advice from different doctors for different people can make life confusing for newbies. It took me some years to know when to get help and when I could ride it out at home.

in reply toCDreamer

The advice was generally given in response to my specific question: "When should I call an ambulance?" I have heard it from cardiologists, GPS and nurses. I suspect that this is the medically correct answer, but is stated partly to cover themselves; I'm sure they are aware that if everyone took the advice literally it would overload the ambulance service. In practice, most people will make their own decision based on their history and perception of the risk. It's also necessary to factor-in the risk associated with attending a hospital during Covid.

CDreamer profile image
CDreamer in reply to

I agree but what I think confusing is the difference in opinion. My own experience was:-

GP to me ringing out of hours on insistence from OH - been in fast AF HR 140-180 for 5 hours

GP - I’ll ring an ambulance

A&E - what do you want us to do? No Cardiologist in the department and they wouldn’t treat because I was being seen in Outpatient Clinic.

Saw specialist who then said - next time get them to call me.

Next time: Sorry, they’re not in the hospital.

Forgive me for being somewhat cynical.

in reply toCDreamer

I suspect that it's less about a difference in medical opinion than the practicalities of the situation. A and E who are probably swamped with patients will prioritise being able to cope with patient flow. I don't know to what extent this issue arises in other countries such as the US or other parts of Europe. Clearly, the situation depends, at least to some extent, on the health service budget which is inadequate at present.

Ablation7 profile image
Ablation7 in reply toCDreamer

I would also be at ER every day. Basically, if I’m moving at all, heart rate is over 100.

Karendeena profile image
Karendeena in reply toCDreamer

CDreamer, I'm with you. My EP told me not an emergency unless I havd chest pains or feel really unwell.

DawnTX profile image
DawnTX in reply toCDreamer

Absolutely confusing about the heart rate. When I had my permanent, a fib with tachycardia, and a typical flutter, I just started to roll with it, knowing I couldn’t be running to the hospital all of the time, especially with the co-pay cost unless they put you in the hospital and then of course they charge you for everything else. my a fib etc. made me swear I was having a heart attack. I read like the list of symptoms right down to the sweating. I would go to the hospital the next time if I blacked out again, I was really stupid that I did not. And I truly feel like I have a family with all of you here, because even though we are all’s different many of these problems we have all had at one time or another my question is what they would do for me if I did go to the ER. To have a doctor that is not familiar with my 2 1/2 years of complications just doesn’t make any sense to me. If they are only going to give me a pill I have at home I might as well stay at home, so that is what I have always done.

in reply to

Cannot add much to what CDreamer has said other than we are told normal range is 60 to 100bpm 🚑🚑🚑🚑🚑🚑. The ambulance service would be crippled !

in reply to

Yes, the ambulance service would not be able to respond if everyone followed the strict criterion which I described in the last email. But since not everyone will follow that criterion that situation is unlikely to arise. The point is that a purely medical assessment may conflict with the practicalities of the situation. Whether one follows the former or the latter is a value judgement.

DawnTX profile image
DawnTX in reply to

I have never gone to the ER for any of my events but then again my events became permanent so I would probably be living there at this point. There are certain feelings that you may get that will tell you to go to the hospital it may take a while for you to recognize your own a fib symptoms as far as how long they last. For over eight months I had a heart rate of in the 150s only broken up by a cardioversion for 3 1/2 weeks and then back to the 150s. I’m afraid it became normal to me but it was always frightening because my symptoms read exactly like a heart attack. That’s the problem many of the symptoms they tell us to watch for can fit so many things. Try not to overuse things like your Kardia unless you have a very concerning thing going on and you want to record it for your doctor. Our bodies fluctuate so much and so fast that you could scare yourself just with checking out all of the time. I compare it to my blood sugar, which can do the same thing. Even the best athlete can have crazy heart rates and probably does have them sadly, there is nothing normal about a fib, so unless we get a crystal ball for it, we just have to be careful follow your heart whether to call or not.

JaneFinn profile image
JaneFinn in reply toStb1968

It’s so good to hear you’re back in rhythm and feeling good :)

Can I ask what advice parameters you were given, re time and heartbeat? I know everyone‘s medical circumstances is different (as is every cardiologist!) so one person’s advice can’t be applied generally, but it’s interesting to know :)

Thanks! Jx

Stb1968 profile image
Stb1968 in reply toJaneFinn

Doc said if heartbeat was between 200-250 get to hospital. Mine ran between 112-167 . I finally went to bed after 5 1/2 hours.. Doc said if I had ANY pain in my chest to go to hospital also, but if not at those limits, try to ride it out. Panic attack along with AF is also trip to hosp. I bought the little Kardia gadget, and it has been the best $89 I've ever spent.

JaneFinn profile image
JaneFinn in reply toStb1968

Oh thank you, gosh yes that’s a high rate he quoted! It’s great you had such a quick response - and even better that NSR kicked in without intervention.

I agree, I’m very thankful to have my Kardia. I only dig it out when in PAF to check the rate. It helps my EP be better informed for treatment advice during appointments. Jx

CDreamer profile image
CDreamer in reply toStb1968

My dos accepted the traces I sent through from my Kardia - best money ever spent on any gadget.

Nowadays I have a Pacemaker which is linked to an app on my phone. It monitors and sends a report through to the clinic so I only need to go into the clinic once a year unless it picks up something alarming so I hardly use Kardia any more. I do think we are moving toward remote monitoring for more conditions and I for one am quite pleased about that.

Stb1968 profile image
Stb1968 in reply toCDreamer

I agree!

C66t profile image
C66t in reply toStb1968

Hr of 200 is so scary Im not sure about that advice. Its so confusing all the different opinions. When afib sets in Im very symptomatic dizzy,chest pain,so I call gp or out of hrs doc. Always sent to hospital. Thankfully no prob in 18mths pg afib has done a bunk😉 I take eliquis and sotalol.Best wishes with everything.

Stb1968 profile image
Stb1968 in reply toC66t

Well from all your responses, general consensus is bon 200 is way too high. Hmm..

MissTia123 profile image
MissTia123 in reply toStb1968

Kardia gadget is the best!

DawnTX profile image
DawnTX in reply toStb1968

Between two and 250 is he kidding? I hit 300 on the table and they had to paddle me. I lived with it in the 150s for over eight months I could not even stand up without excruciating chest pain, dizziness, nausea, loss of eyesight, and more being in heart rate, like that, for as long as I was, was the cause of my heart failure. Everyone is so different also, I am still relatively healthy except for this. Not everyone is as healthy as I was when it hit me therefore could be very damaging to someone else. It really bothers me that there are so many discrepancies. I will never understand why 100 it’s OK. 100 is tachycardia for me and it’s all downhill from there or possibly down to the floor.

Several cardiologists and GPs have advised me that if the heart rate is above 100bpm for over half an hour and/or there is a new or unusual pattern to the AF, then an ambulance should be called. This is precautionary.

Stb1968 profile image
Stb1968 in reply to

My cardiologist said 200-250. Amazing the differences of opinions,,,,quite a difference in numbers!!

Oldiemoldy profile image
Oldiemoldy in reply toStb1968

I have ridden out many long nights with heart rate over 150 and avoided emergency room where the tend to overtreat. Finally got on a Flecanide regime which is working. Kardia is reassuring and so is my cardio’s night service. And of course I stay on my anti coagulant. But I agree it is scary and very uncomfortable and tiring.

Stb1968 profile image
Stb1968 in reply toOldiemoldy

Sounds like we're in the same boat. I'm starting to believe my a fib and airway/lung issue was caused by my radiotherapy, because both issues started halfway through my treatment.it is reassuring to hear other people's experience. Doesn't make me feel so alone!!!

Rubymurray25 profile image
Rubymurray25

Flecainide as a PIP has worked wonders for me and the feeling of avoiding the trip to A& E was one of true triumph! We are all so different but at least I know I have no option now if flecainide doesn't work within 4/5 hours and that is straight on the phone to the UK 111 service who normally call A&E to tell them you are on the way. Once there it is either a Cardioversion if an intravenous dose of Amiodarone ( or similar) doesn't work , but comforting to know there is some sort of Plan B . Hope you avoid another episode.

CDreamer profile image
CDreamer

Thing is that anything to do with the heart is prioritised, you can be left in pain for hours and hours leading to all sorts of complications but say you have chest pain……

There is currently, quite rightly, messages all over social media asking people NOT to call ambulance unless there is a life threatening emergency. If in doubt - leave it to 111 to decide.

Our local hospitals are on constant high alert with ambulances queuing so the paramedics coming out to determine whether or not there really IS an emergency is for me the way to go.

beach_bum profile image
beach_bum in reply toCDreamer

Different countries, different circumstance....you call 111 for medical advice, *we call 811* ...911 for emergencies. Here in "the colonies" folks are spread out all over this thinly populated, 10,000,000 sq km country. Half of our 35 million people live in rural areas, and ambulances can take a while to get to you. So, in many cases you and your family and friends are the first responders and "ambulance" service. We are taught at an early age, the importance of advanced first aid training and CPR. In the movies, people just call the free air-ambulance and help is there in minutes, but that is America, not not here. Air ambulances here are reserved for car wrecks, major industrial accidents...the worst of the worst. Time critical life threatening scenarios.

Spangle14 profile image
Spangle14

I would certainly get advice on your gym exercises as you've been diagnosed with Afib - although it is still good to exercise with Afib, something too strenuous could set the sleeping monster off. Regular and gentle is key. Glad you reverted to NSR without a trip to hospital 😊

Stb1968 profile image
Stb1968 in reply toSpangle14

The creepy thing is it was a cardio therapist that upped it to that!!

Ablation7 profile image
Ablation7 in reply toStb1968

That’s so crazy

TracyAdmin profile image
TracyAdminPartner

How are you feeling? If you are at all concerned, have followed medical advice and taken your prescribed medications, and you are still experiencing such symptoms, do not hesitate to contact emergency medical attention.

Stb1968 profile image
Stb1968 in reply toTracyAdmin

Feeling ok, have a couple issues going on,,, I was 10 treatments into a 21 treatment round of radiation for breast cancer when I had my first a fib, and now 4 months after treatment, I'm having issues with my airway.. Radiation caused?????

TracyAdmin profile image
TracyAdminPartner in reply toStb1968

Take care and hope you are soon on the road to recovery?

CDreamer profile image
CDreamer in reply toStb1968

That seems to be a theme as I’ve seen several members post about that a dear friend who is living with the after affects of radiation. You should get it checked though.

Stb1968 profile image
Stb1968 in reply toCDreamer

I did ask about the possible harm to lungs and heart and was told that was kind of a past problem,,not so much now. You can't pin a doc down because they're all afraid of being sued. With that being said I'm dealing with the fallout!!!

DawnTX profile image
DawnTX in reply toStb1968

🙏🏻

dogsneedwalking profile image
dogsneedwalking

Hello there. Glad you are feeling better. I would say every one is different. I myself was first diagnosed with SVT and after numerous visits to hospital and heart scan was then diagnosed with AF. My problem is Adenosine, etc just don't work for me and I had a Cardioversion last time. Paramedics told me wait half an hour then call 999 not 111. I am now on Sotalol and so far the really long episodes have stopped, but, AF is still there most days. Incidentally I live in Scotland. Take care.

Stb1968 profile image
Stb1968 in reply todogsneedwalking

Hi there! Scotland is a country I would love to see!!!I live alone, and am not normally, a scaredy cat, but this AF has me a bit unsettled. Am so thankful for this sige!

Jajarunner profile image
Jajarunner

Personally I'd go because heart rate is so fast

Stb1968 profile image
Stb1968 in reply toJajarunner

I am going to have a talk with them about heart rate. He said stay home unless it goes over 200!!

Jajarunner profile image
Jajarunner in reply toStb1968

Really! I start to struggle to breathe at 160+, which to be fair is three times my usual heart rate. I hope it settles soon xx

Auriculaire profile image
Auriculaire

I went to A&E in an ambulance with my first ( possibly second) attack of afib and was kept there for 3 days till my INR was ok! This is France and it was a public hospital but I don't think they would be so cautious these days! My heart rate was around 150 - 160 bpm and it was fighting frogs in the chest. I was scared. It was the last time I went. Usually my heart rate starts off between 140- 150 bpm but I don't get the fighting frogs anymore. I take extra beta blocker , some more magnesium and eat a banana if I have not already had one, then settle back to doing what I was doing before it started -usually reading my book . My heart rate drops a bit but only down to about 125bpm and the episodes last about 12 hours on average. But I am no longer scared and going to hospital would be a drag . If I had anything out of the ordinary or the episode went on a lot longer I might go . My one and only trip to hospital was in summer and I was seen immediately. Going in winter in the middle of a covid surge ? I'd have no be convinced I was dying.

CDreamer profile image
CDreamer in reply toAuriculaire

🐸🐸 fighting 😂😂 excellent description of how it feels!

Stb1968 profile image
Stb1968 in reply toAuriculaire

Thank you for your input. I think hearing other people's experiences are soo helpful!!!puts things in perspective for me!

manabouttown profile image
manabouttown

I echo what other people have said about being on anticoagulants such as rivaroxaban. I used to be on a pill in the pocket regime but have switched to taking 50mg of flecainide twice a day plus 20mg of rivaroxaban daily and a small dose of 25mg of losartan ( a blood pressure drug) daily.Your dose of 200mg flecainide pill in the pocket seems to be a bit on the low side judging by various articles on the internet that suggest 300mg, but of course you must be guided by your cardiologist.

manabouttown profile image
manabouttown

youtube.com/watch?v=1-SWiGs... is a really interesting post about a new approach to ablation.

Stb1968 profile image
Stb1968 in reply tomanabouttown

Drat!wouldn't let me play the video! Thanks for taking the time to respond!!!

manabouttown profile image
manabouttown in reply toStb1968

just google afib east texas and hopefully you'll see it

BlueINR profile image
BlueINR

While afib is not a fatal arrhythmia, it could turn into one. I've always called 911 when in afib and hospital has always admitted me. Meds don't work for me and I've always had to have cardioversion. Had an ablation 4-5 months ago, and no afib. So far. Had one or two episodes, in first 3 months and was told that's not unusual. But now things seem to have improved. It looks like there's different protocol in the UK than there is in the US when it comes to afib.

Stb1968 profile image
Stb1968 in reply toBlueINR

Weird! I'm in Oregon, and that's the info I was given . also, doc said anytime I'm overwhelmed or panicked by the af, to come in. With vivid like it is, I'd rather handle at home when possible. Sadly, it sounds like overseas people have a bit harder time getting seen than we do in the states.

Karendeena profile image
Karendeena

Ride it out unless you feel really unwell. J have episodes lasting up to 48 hours, horribly uncomfortable but does go back into NSR eventually.

Stb1968 profile image
Stb1968 in reply toKarendeena

Thank you for the input. It was a long 5-6 hours for me, but maybe it won't be so scary next time. Am trying to lose weight, I do eat healthy, and I work out twice a week,and walk 3-4 times a week. Crud, should be a Rockstar haha!!

Tomred profile image
Tomred

personennly i am in afib since yesterday morning and this is every 8 to 10 days, i sit it out , it is worrying as ep wouldnt prescribe anticoagulants until im 65 , at least you have that protection , i dont like to overload nhs, i used to bring my mother in middle of night to hospital with afib,they would monitor her for 5 or6 hours then send her home.

Stb1968 profile image
Stb1968 in reply toTomred

Wow T, I am so sorry to hear you go through that so often,and that your bouts last that long. I am comforted knowing I'm on Eloquis, and my stroke chances are lower. I didn't know there was an age limit to starting it!

Tomred profile image
Tomred in reply toStb1968

i think its not so much an age limit on starting anticoagulants but it goes on your chadsvascs score of which mine is zero ,so regarded as low risk by ep, but it certainly doesn,t feel low risk when bouts of afib seem ever increasing.

Stb1968 profile image
Stb1968 in reply toTomred

Aha! That makes sense!! Don't know if I'll ever get used to these bouts!!

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