I had an AF in the middle of the night,took Bisoprolol and attempted to go back to sleep, still in AF in the early hours,tried to relax and take my mind off of it and thankfully by 7. 30am suddenly back to normal. My question is how long can you safely leave it before taking yourself off to A&E??
When do you go to A&: I had an AF in... - Atrial Fibrillati...
When do you go to A&
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valthomas15
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BobDVolunteer
AF is neither an accident nor emergency, it is a chronic condition and should be treated by your GP or cardiologist (EP). The exception is if you have any chest pain or fainting./dizzy spells in which case a call to 111 or A and E is the way forward to find out why.
Same reply as Bob but I would add that if your heart rate is towards and over 200 bpm and will not abate then a call to 111 or 999 .
Ps...if you are really in a state of panic over your heart then a call to 111 may well result in a visit from paramedics to reassure you or otherwise!
Interesting what you say, I've been told by my GP that if my heart goes above 100bpm and stays there for more than a hour, call an ambulance.
Lots of different answers, sadly leaving me none the wiser! Still it's good to pose the question!
I agree that it can be very confusing! Having had very many visits and admissions with AF and 22 'emergency' dc cardioversions over 28/29 years, I can say that I made my decisions on how I FELT at the time!
If you are feeling compromised with your fast heart rate and breathlessness then do give 111 a call at least. You will be taken seriously.
In the end you have to do what's right for you. There may be a reason why your GP has told you to do this.
None that I've been told about.
Never! Does your GP get this condition?
In think that the comment is basically down to the fact that they can't be bothered. Having referred me to a cardiologist, they see it as his job to treat me despite the fact that they don't talk to me either. At the end of the day, it's down to the Nothing Happens Soon post code lottery
Thank you Bob for your reply, your suggestion to either see or speak to your GP or Cardiologist is not so easy. Firstly obtaining an appointment these days is practically impossible and I have only ever seen the Cardiologist once at my initial diagnosis and never been called back! So my question how long to leave it would mean perhaps leaving it a little too long!!
Agree BobD that's exactly what I was told by my EP
Depends - I think at the start of your AF journey it’s natural to feel very anxious when AF starts and getting to know your particular alerts. Everyone has different sorts of parameters but the guide I was given by my GP in 2007 were:-
If your AF continues in fast AF ie: 150+ For more than 48 hours - others would say HR 120+.
Chest pain - ring 999
Cold and clammy
Syncope or near syncope (fainting)
Extreme breathlessness when resting or hard to breath
After about 3 trips to A&E and very long waits in the waiting room and no treatment other than on one occasion when I was hospitalised, I gave up going. Others seem to have more assistance from A&E but frankly, in these time, I wouldn’t even think of going as I’m much more comfortable at home and I can monitor myself appropriately - BP, O2Sats, ECG - which is all they will do at the hospital anyway.
BUT I was a patient at an outpatient clinic at the hospital and every A&E visit is logged and on your file so if you are prepared for the long waits etc it can help to get to see your specialist if you have a number of A&E logs on your file.
That’s just a personal opinion and others I know will have other views so basically it’s your call. I would suggest you go ask your GP, (if they know anything about AF) or your cardiologist to give you your guidelines as to when to attend.
Know that AF in itself, is not an emergency and if you attend Outpatient Clinic they may not treat you without consulting your consultant.
Have some strategies to help yourself at home. If you live alone, alert someone you know and ask them to check in on you or talk on the telephone - that alone can be very reassuring. Learn some breathing techniques - LSD breathing - long, slow, deep breaths help relieve anxiety and may reduce heart rate. Distraction helps. Develop a regular Mindful Meditation Practice you can go to when AF starts. I’m sure others will add their suggestions.
Best wishes and hope Normal Service Resumes very soon for you.
Thank you
PS - when you say ‘safely’ - if you are not on anticoagulants - I was told 24 hours. If you are anticoagulated there is less concern.
My post here is MY opinion and experience only. You really have to react to how you are feeling. I've often read on here that people have waited before calling an ambulance or going to A&E but I have always gone in when it starts. I had paroxysmal AF with a really fast ventricular response. But everyone's experience of a fast AF episode is different. I get dizzy and breathless and I just can't cope. I talked to the A&E consultant about this because I felt so guilty about taking up their time and a trolley/cubicle and his advice was.."If you feel like you're not coping and need support you should come in and we can support you. That's our job. You don't know how the episode will progress or how your heart will cope so you should really come in and be looked after and noone here would criticise you for being here. We'll do all the blood tests to see whats going on and we will take measures to cardiovert you. "He may have just been being nice but it was reassuring to hear.
To say that your heart rate should be this or that is misleading I feel. My heart rate on the hospital monitor varied from around 120-200+ and it was totally unbearable. The length of the episode has varied -from it reverting to NSR when the ambulance arrived to spending 12+ hours in A&E with the doctors giving various drugs to try and revert it. I can't take beta blockers and other drugs like the calcium channel blockers didn't work nor digoxin. I narrowly avoided the electrical cardioversion. I was already on 300mg flecainide daily but had the luxury of being told to take a 50mg dose as pill in the pocket at the start of an episode...it never worked.
I ended up in A&E 6 times over last Xmas. It was only by the doctors getting this information that they could identify what was happening ie prognosis and future treatment. But you have to be guided by the professionals. We are all different. Human biology and physiology is so diverse that having a single policy for reaction to AF is inappropriate. IMO you must react to how you yourself feel or by the advice given by your doctor.
Thank you so much, very helpful advice.
What an excellent reply that was. The feeling of not knowing whether to go into hospital is, for me, be one of the worst to have. It's simply an awful thing to endure.
That said, I was told that whilst AF can make you feel as if you might die, that feeling is an anxiety or panic response, and that the condition itself, if there are no other heart morbidities, is always self-limiting. Luckily, I haven't had it as badly as you had since 2019 and I wouldn't want to go through that again. I was on my own, and it was a miniature version of hell, so you have my sympathies.
Steve
I'm totally with you here and your experiences with A&E are so similar to mine.
I've had so many visits to A&E over the years I have lost count but have always been seen promptly , usually within minutes of arriving ,particularly when I was circa 200 bpm. In the early days I ended up in the cardiac ward and then latterly acute admissions..
I've always been told that I did the right thing in coming in and never been made to feel a nuisance. Maybe I'm lucky in having a great hospital close at hand and a first class A&E department. The consultant there is very familiar with my history which helps!
At the end of the day it is, as you say, how YOU feel which dictates whether a visit to AE is appropriate. You will learn from experience.
I can often get myself out of AF by using exercise but on 3 occasions over the past 12 years I could not, so each time I got myself taken to A+E. They saw me virtually straight away and each time I was given a cardioversion. The last 2 were done in ressus and I was out in 3 hours.I too feel guilty taking up their time so asked the cardiologist who said "if it happens again, come in".
It is a difficult one. I have PAF with RVR - my pulse will often be way up there pushing towards 200. The first two times this happened, I was taken to A&E, where it did respond to treatment (bisoprolol and magnesium). Since then, I have had several episodes and I have chosen to sit them out at home and self-medicate. It does worry me, as the advice appears to be that you should always go to A&E when AF is accompanied by a very fast heart rate, but going off to A&E every time it happens fills me with anxiety too. Touch wood, I have not felt breathless or had chest pains when these episodes have occurred and I would definitely go if that happened, or if I didn't revert to NSR. However, I'm now wondering if I'm doing the right thing 🤔
You have to do what's right for you. I think the issue is how long do you wait before reaching out for support. I've tried many things from taking my PIP flecainide to deep breathing to taking extra Verapamil to listening to meditation on YouTube to having a bath because that was everything in my arsenal! Tbh the interventions in A&E didn't always work either but I felt I needed their support and it was always freely and happily given. I seem to revert back to NSR after about 12-15 hours but after a cocktail of drugs! After the last time the cardiologist said you can't live like this. So I've just had a Pace and Ablate procedure. No more RVR again!!
How long did it take to recover from Pace and Ablate? My EP wants me to have it but I am a carer for my husband and can’t really take time off. Son lives in US but could come home for awhile. And how do you feel now?
I can only tell you my experience. I'm 64. I was zapped on Tuesday. Wednesday I felt tired. Thursday and Friday just took it easy and today, Saturday, I feel normal. But...the procedure was very straightforward, I had NO bleeding in the groin although it's seeped a teeny bit but not infected. I have granddaughter (14 months) duties on Monday and Tuesday this week and I think I'll be ok but my sister is helping me on Monday just for confidence. Tuesday I'm on my own! Looking after her is like a gym weights workout 🤣 but she's easily entertained at home just now.
Another lady on here has taken a bit longer to feel normal. I keep forgetting I've had it done and then it pops into my head and it's a sort of shock! But time will give me confidence I'm sure.
I'm not sure I can advise you really. Can you access short term caring help? Either through the council but private? Good luck x
What made me ask the question was that when I had my first AF resulting in Cardioversion the consultant told me that it has to be done within 72 hours, hence my concern!
Trouble is 1) you need to have been on anticoagulants for at least 2-4 weeks. 2) There needs to be an experienced cardiologist in A&E along with an anaesthetist who are available to perform the procedure - that’s never happened to me. 3) It would depend upon whether or not you were considered an emergency and how many people would be ahead of you. Last time I went to A&E there were so many people considered much more ill and I was asked to leave my bed and go sit in waiting room - where I sat for 9 hours but did self convert during that time - then they wouldn’t let me go!
I relate this as this is was my reality. I wish I could say that was just one hospital, unfortunately this happened at several hospitals.
It is well known that the sooner you convert to NSR the better, and the longer you leave it the less chance of success but know that cardioversion is often temporary solution.
Best wishes
I would say if it’s only a few hours to wait it out. My GP, once hearing that I was in af for 36 hours but had come out of it told me I should have gone to A and E. No matter what the rate it was too long. So I think that length of time is more important.
I'm told to go straight in each time as my HR is always over 120 minimum and never settles without cardioversion 😭
My wife has had Afib for years without even knowing it. Never been to a GP or A&E. She is fine with 60 to 120 HB and no symptoms.
My AFlutter was bad and I went to A&E about 4 times to have it reverted and to get on the list for ablation.
Hi valthomas15, when I take an 'episode' boy do I know it! Heart goes like the clappers anywhere between 80 and 170 BPM and it jumps all over the place, usually lasting anything up to 48 hours which leaves me exhausted. My EP tells me that unless I have pains in my chest, breathless or feel particularly unwell to just 'sit it out' as all they will do in hospital is monitor you most likely until you revert to NSR. I want to keep out of A & E as much as possible. Hooking me up to a load of bleeping machines just makes me more stressed which in turn makes afib worse!
I agree, nobody wants to go to hospital and with my last few episodes I have 'rode it out', thankfully reverting back to NSR with the help of Bisoprolol. I just wondered if it continues for too long would you feel safer in A & E and I was told don't leave it too long!
I completely trust my EP, he is well known in his field here at Glenfield, Leicester. I can't say it doesn't scare me and after an episode I am always waiting for the next. Problem is who is controlling what. I think I have heard group members say "You control your afib, don't let it control you"! Interestingly enough when I was first diagnosed (in A & E) the cardiologist walked up to my bedside and sat down, telling the nurse (in his words) take those machines down, I'm not worried about that! I then asked him (naive as I was then) what this condition was, to which he replied "A bloody nusience"😂
One thing is for sure, it's good to speak to others about it!
I never go to A&E, I have episode of PAF every 8 days lasting 15+ hours and have no desire to spend a large part of my life in an ambulance sitting outside A&E where people have died waiting to be seen . There were 16 ambulances waiting yesterday outside my local hospital ,
I can monitor myself at home. I would only go to A&E if I had chest pain, I would rather take a chance in my calm quite home with a loo and food/drink available than spend anxious hours in an ambulance or on a trolley in a corridor with no comforts available.
I’m in the U.S. My a-fib rate was generally high, 150-ish. My dr. told me to go to ER if it lasted more that’s 12 hours. I had my 2nd ablation in March 2022 and seem to be rid of it. 🙏🏼 🤞
🤞🤞
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