Should I go A&E or am I panicking - Atrial Fibrillati...

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Should I go A&E or am I panicking

mjm1971 profile image
28 Replies

Hi All

Feel a bit foolish coming on here with this as I know many of you suffer worse than me

but

Today I’ve been in Af and it’s up at

110 /120bpm

I’ve taken 7.5mg of bisoporol Over the course of the day

My normal daily amount is 5mg

I take 200mg of Flec as well .

I feel ok as I’m resting but is this rate alarming as it hasn’t dropped with the Bisoporol and should I go to A&E or just wait etc ?

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mjm1971 profile image
mjm1971
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28 Replies
jeanjeannie50 profile image
jeanjeannie50

It needs to be your choice really.

If it goes any higher than 120 I would go to A&E. If you're not having any symptoms it may be an idea to sit it out at home. You'd probably sit for hours in A&E bored silly and by the time you're seen your heart will be back in normal rhythm. Do your best to stop thinking about it and don't keep checking. It took me years to learn that I had to do that, it really works, the mind plays such a big part in our AF attacks. That's why your heart would go back into normal rhythm in A&E - because you would feel safe. Try to get absorbed in a film if you can, not a stressful one. I've had AF for 17 years.

Have you seen the instructions I posted a while ago to get you back into normal rhythm? I've copied them from this forum over the years.

I'll repost them below. They have worked for several people recently.

Jean

I am a therapist in private practice for over 20yrs.One of my therapies is yoga based. Having quite an accurate knowledge of anatomy, neurology and physiology also having PAF I have found this technique helps me immensely when my heart is fluttering like crazy. Make yourself comfortable either on a bed or lying on the floor, position a pillow under you head, Raise your left arm in an extension position as if you are doing the backward crawl. Stretch as much as you can and imagine that it is stretching your heart muscle...I bend my arm and position my hand under my head palm upwards.. Stay in that position for as long as you can or until the fluttering subsides...At the same time I think of something pleasant. It does not matter what you think about as long as it is a pleasant thought for you. This stops my heart jumping about almost instantly....I also place my right hand over my heart area...Don't panic and just keep calm thinking pleasant thoughts....I do hope this helps you. Kind Regards. C

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As someone else who finds yoga breathing and some positions helpful, I would love to try (xxxx) suggestion, but lying down flat tends to make things worse for me. My most helpful position, taught me by a lovely yoga teacher, is based on a yoga forward bend. I sit up with my legs outstretched in front of me and a pillow under my knees, and then bend forward from the hips not the waist, with my arms relaxed but outstretched towards my ankles, and breath deeply and slowly. It's not so good on a full stomach and is more comfortable with your knees slightly apart, and I guess you have to be a bit flexible to find it comfortable, but it has proved to be a great help.

I agree with (xxxx) that staying calm and focusing on something pleasant is a must, and I've even fallen asleep like this as most of my episodes occur at night. All the best Liz

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Finally, like AV nodal re-entry, some people have recurrent rapid rhythms that are infrequent and easy to self-control by using various methods to increase neural slowing to the AV node (so-called, "vagal maneuvers"). Using these maneuvers, one can sometimes stop the arrhythmia. These maneuvers include:

Bearing down forcefully like you're having a bowel movement for 5-10 seconds, then slowly exhaling.in the neck while lying down for approximately 5 seconds

Placing very cold (soaked in ICE water) cloth on the face abruptly.

Coughing forcefully

Rubbing the carotid artery

_________________________________________________________________

There's a yoga breathing exercise that has worked for me before. Lie on your back, bend your knees up so they are above your hips and your lower legs are at 90 degrees. Take a breath in for a count of 4 then breathe out for a count of at least 8. As you breathe out, bring your knees into your chest so you curl into a ball. When you think you've got all the air out of your lungs, try and breathe out more! Breathe in again for 4 and release your legs out to the starting position. Repeat several times. It helps to reset the diaphragm and focus should be on a good long out-breath.

mjm1971 profile image
mjm1971 in reply tojeanjeannie50

Hi Jean

Thanks for that

I had an ablation 12 weeks ago and have been in AF more than ever since ( about 60% of the time ). But the last 7/10 days things have been different .

Eptopic beats and now today AF at a higher rate .

I’ve got my follow up call on Tuesday so will find out what plan B is

Thanks again

Singwell profile image
Singwell in reply tomjm1971

If it persists and even though its a weekend (WHY does this always happen to us!!) I'd be inclined to go as you're post ablation. Ideally you want to terminate the episode if you can. I'm saying thus on advice from my arrhythmia nurse re my own ablation 12 weeks ago - the goal is to knock AF on the head if you can during the blanking period. As a suggestion- is it possible to take extra Flecainide to see if that does the trick? You can take up to 300mg within 24 hours unless elderly or a low BMI. Have you ever discussed this strategy with your EP? I'm thinking you might need more antiarrhythmic rather than more rate control

mjm1971 profile image
mjm1971 in reply toSingwell

Hi Singwell

I’ve been in and out of AF for probably 50 to 60% of the time since my ablation .

Longest run has been 6 days before reverting back .

I’ve given up on the ablation having worked this time

Was just wondering if these recent changes were anything to worry about or just normal after an ablation

Cheers

Singwell profile image
Singwell in reply tomjm1971

My first didn't work so I know how you feel. Although in my case it was long runs for 3 weeks with rates up to 136 and up to 18 hours a day. But after then it got easier- episodes got shorter and often self terminated - never happened before! Gradually I settled back into my old pattern of AF every couple of months but mostly less intense and symptomatic then before. So things still might improve for you. On the other hand, it'll be worth putting an idea of a top up on the table when you have your 3 month review.

jeanjeannie50 profile image
jeanjeannie50 in reply tomjm1971

My heart raced twice after my third ablation, one was the day after but that righted itself after another 24hrs (had to stay in hospital). Next time was about 6 weeks later. I rang my AF nurse, she spoke to my EP and I was back at the hospital fairly quickly to have a cardioversion.

I would ring your AF nurse on Monday and she can pass your message on to your EP that you're in AF. Perhaps then when you get his call on Tuesday he'll have given it thought and say come in and be cardioverted.

Let us know how you get on please.

Jean

captainKFF profile image
captainKFF in reply tomjm1971

Hi mjm , when you say worse than before ablation, how worse?

mjm1971 profile image
mjm1971 in reply tocaptainKFF

Hi Captain

Well I’m in AF 60% of the time now where as before it would only be 20/30% of the time .

In terms of symptoms when I’m AF they are the same

captainKFF profile image
captainKFF in reply tomjm1971

Try to stay optimistic about the success of your last ablation, I heard from doctors and patients that sometimes it could take up to a year or more for things to settle down.

Prettywoman15 profile image
Prettywoman15 in reply tojeanjeannie50

Thank you for these suggestions

LordGabriel profile image
LordGabriel

There's a yoga breathing exercise that has worked for me before. Lie on your back, bend your knees up so they are above your hips and your lower legs are at 90 degrees. Take a breath in for a count of 4 then breathe out for a count of at least 8. As you breathe out, bring your knees into your chest so you curl into a ball. When you think you've got all the air out of your lungs, try and breathe out more! Breathe in again for 4 and release your legs out to the starting position. Repeat several times. It helps to reset the diaphragm and focus should be on a good long out-breath.

That one worked for me recently!!

CDreamer profile image
CDreamer

Your choice, personally I found A&E far more stressful than supportive & was never treated so always felt more comfortable at home. If yoga breathing doesn’t help - distraction helps, as does hydration, electrolytes and sleep.

If you start to feel unwell or have chest pain then ring 999, if unsure 111. If you are on anticoagulants you should be ok and A&E are unlikely to do more than monitor if you are medicated.

Best wishes and hope it resolves soon.

Ppiman profile image
Ppiman

Mine can go to 135 and I wouldn't do more than lie down with an extra bisoprolol, but it never stays like that (so far). If you feel okay, it won't harm you (I was told), so long as it falls eventually.

I do feel for you though. It's just an awful feeling wondering whether to go to hospital or not. I'm sure there are worse feelings that many poor souls go through but, for me, it's one of the worst.

Steve

Singwell profile image
Singwell in reply toPpiman

Well said. Only the individual can know how bad it feels for them. I loathe being in AF!

Ppiman profile image
Ppiman in reply toSingwell

My elderly friend with permanent AF doesn't even know he has it, weirdly, but his rate is in the normal range; my son's colleague has PAF and copes really well, too.

When I had AF badly after my atrial flutter ablation with a rate of 150+ it floored me completely as well as scaring the pants off me. I spent an awful morning wondering whether to phone the hospital but did in the end. When I got there the nurses seemed shocked at the ECG but not the consultant, and 5mg bisoprolol soon had me back to normal. Anxiety is such a major part of it.

Steve

Singwell profile image
Singwell in reply toPpiman

Absolutely. And like many here I've learned to manage better because of the forum itself.

Auriculaire profile image
Auriculaire in reply toPpiman

Usually my hr goes up to 145/150 at the start of my afib episodes but it does not flop about so I am only aware of how fast it is by consulting the Kardia. I take a big dose of Nebivolol and try to forget about it. If I check later it comes down but not by that much - maybe to 125 bpm. I can sleep brokenly and have always gone back to NSR after about 12 hours. Last time I didn't even bother with the Kardia. If it is during the day I can cook and washup etc and twice doing some housework has put me back in NSR. Going to the Urgences would be a drag and they might keep me in which would be an even bigger drag. Not to mention possibly catching covid hanging around there.

captainKFF profile image
captainKFF in reply toAuriculaire

Hi, how frequently do you have episodes? Mine are every couple of months

Auriculaire profile image
Auriculaire in reply tocaptainKFF

For the kast 2 years I have had 7 episodes. So far this year 4. Before 2020 they were very infrequent. I'm blaming the pandemic !!

The advice that I have received from GPs and cardiologists is that if there is a new pattern or the heart rate is over 100 bpm for more than 20 minutes, then it's necessary to go to A and E.

mav7 profile image
mav7 in reply to

The advice that I have received from GPs and cardiologists is that if there is a new pattern or the heart rate is over 100 bpm for more than 20 minutes, then it's necessary to go to A and E.

Same advice I received.

(using bold print to emphasize)

jeanjeannie50 profile image
jeanjeannie50

How are you this morning?

mjm1971 profile image
mjm1971 in reply tojeanjeannie50

Hi Jean

Woke up in AF 80/90bpm . Went for a walk and it went to 135bpm , came home and it took 30 mins for it to drop back to 80/90 bpm but still in AF .

I dont mind those rates though as that’s normal for me in AF and I can function ok

Still odd why it’s changing though

My review on Tuesday will no doubt have some answers

Thanks for asking though much appreciated

Buffafly profile image
Buffafly

A recent post reported heart settling down while cooking dinner! Basically it’s distraction - find something absorbing but not stressful to concentrate on. And make a firm decision like ‘if rate goes over x I’m going to A&E’ ‘if episode lasts longer than x hours’. The only advantage of going is that they will do a 12 lead ecg and hopefully monitor you so there should be a report of your heart doing varied things (or maybe not!). A holter monitor or similar for a decent length of time seems more valuable as a record. I was disappointed that I didn’t notice AF when wearing one but my monitor reported frequent episodes so they can be very useful. Best wishes ❤️‍🩹

Karendeena profile image
Karendeena

Hi mjm1971 I have episodes that take my heart rate up to 170bpm and this fluctuates very scary and makes me very anxious. My EP told me that unless I have chest pains, breathless or feel particularly unwell to sit it out again home. My episodes last around 36 hours which is awful but it usually slows down in the latter few hours before converting. The worst is trying to sleep

captainKFF profile image
captainKFF in reply toKarendeena

Hi that sounds similar to mine, how frequent are yours?

LaceyLady profile image
LaceyLady

I try to concentrate on my breathing.

Breathing Exercise for P/AF

Find a comfortable chair, place feet on the ground, close your eyes, breathe normally.

Start by scrunching your toes, and let go.

Tense your calves, let go

Tense your bottom, let go

Tense your arms, let go

Then your hands and fingers, let go.

By doing this you can see and feel what tension and relaxation feels like.

Next, breathe in through your nose to expand your belly for the count of

6, hold the breath, breathe out of your mouth like you’re blowing through a straw for the count of 8.

Keep doing the breathing for as long as you wish to help relaxation.

You need to concentrate on the process which can stop you from thinking about

Your P/AF

©️Angela Rawlins

Fullofheart profile image
Fullofheart

Hi if you've recently had an ablation then usual procedure (at least this is what I was advised following my 2) would be to get an ecg done at gp or a and e, the results of which can be sent to your surgeon and cardiologist. Also, they may be able to get it back in sinus rhthym for you. I had an unplanned cardioversion following second ablation and a change of meds as heart rate rocketed.

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