admitted to A& E with PAF

[09Bumblebee]

anyone else find that their PAF is set off after lots of exercise? Had a busy energetic week on holiday followed by a 34 mile e-bike ride then developed AF nothing worked tried everyone’s suggestions and Bisoperol so into A& E at 20.30 hoping to be cardioverted and sent home but no luck! Dr didn’t really seem to know what to do with me B/P very low so lots of IV fluids to bump it up which did work. Dr took my pulse manually said it was 80 however my Kardia which I thankfully took with me showed pulse 158 and AF luckily he did believe it. Finally referred to medic at 2am whom I saw me at 4am prescribed x4 tabs of oral digoxin which thankfully worked and phew back into sinus rhythm pulse 70. Finally saw cardiologist at 10.00 repeat ECG then home 15 hours after admission. Such a long awful night. So next time I definitely won’t go in to A& E at night time if I had seen medic or cardiologist soon after admission I could have been easily and quickly treated and sent home not taking up a hospital ‘chair’ at great cost to NHS. All good now just hope there isn’t a next time! Bit long sorry but it was quite traumatic.

[sassy59]

Sounds very traumatic and hope you’re doing well now. Take care

[09Bumblebee in reply to sassy59]

cheers sassy.

[Speed]

Hi Bumble. I believe although I have a family history of AF, my AFlut was probably brought on / accelerated as a result of a high level of exercise over several years whilst training for an Ironman triathlon. Symptoms didn’t appear for another 2,5 years though that was after a long intervening stressful period. Post my 1st ablation, episodes would always be preceded (by approx 12 hrs) by either significant exercise or a significant (though infrequent) drinking session, though they would not always follow. The common trait and known potential trigger could be dehydration - something I’m now very focused on managing. Post my 2nd Ablation (Nov ‘22), AFlut seams to have been resolved but I’ve now got PAF, managed with Flecainide, both as a daily 2x 50mg and PIP as and when (I have agreed with EP not to take Beta Blockers also due to the debilitating impact on any exercising). Episodes getting less but exercise seems to be the trigger to such an extent that several times it actually commenced during exercise. This had never been the case previously with AFlut / pre 2nd Ablation. Comforting, the last few drinking sessions (emphasise infrequent and undertaken accepting an episode likely) have not resulted in any symptoms. I also drink a glass or 2 of wine with most evening meals which has never resulted in going into AFlut / AF.

So that’s an overview - pretty sure exercise is a trigger but previously (AFlut) that could have been the indirect cause - dehydration being the direct cause? Now with PAF, and with at times symptoms starting during early part (5/10 mins) of exercise, I think I can rule out dehydration as sole cause.

Bit long but hope that helps - off to do 10 mile run this morning. Happy to divulge further if of interest / help.

[09Bumblebee in reply to Speed]

thanks Speed. Now on daily bisoperol 1.25 hopefully this will correct any future episodes. Have a good run!

[Speed in reply to 09Bumblebee]

Just be aware that being a beta blocker, it will slow your HR such that you will just not be able to exercise at the levels you were previously able. I found it extremely frustrating and demoralising.

Run was a tough one thanks - not used to that distance and the long haul climbs at this race (Rugby 10).

[09Bumblebee in reply to Speed]

I have noticed that beta blocker drops pulse to 52 (bradycardia) however this only last for a short while before going back to normal pulse rate of 62 av. apart from that I seem to be ok with no other side effects. Just hope it prevents me having another PAF

[secondtry]

Good advice. I am always aware of the cumulative AF effect of risky choices eg if stress levels are due to rise, I implement, before they do, additional relaxing measures.

[MarkS]

Personally I wouldn't go anywhere near A&E. During hundreds of AF sessions which typically lasted a day or so, I went to A&E once when I had a TIA. AF is a chronic, not an acute condition and A&E aren't really going to help.

You are better off looking at what is the underlying cause - too much exercise? Possibly though 34 miles on an E-bike is not excessive in my book. Did you get it after the exercise when you were winding down, then that might be vagal AF which required different treatment. Look at other lifestyle factors as well - holiday heart?

[09Bumblebee in reply to MarkS]

no 34 miles on e bike normal but had had a very busy active week previously so might have been accumulative.

[MalcolmCClark]

Hi

Sounds familiar to my experience in A&E. I start off with my heart going out if sinus rhythm and then my heart rate goes up. I get back into sinus with treatment but they struggle to get my heart rate down so yes hours in hospital. These days no bed or trolley just called into a treatment room given medication or hooked up to drip then sent back to a very uncomfortable waiting room. 17 or 18 hours at a time. Unable to sleep or eat and drink. So now im reluctant to goto A&E anymore. I am scared though that one day i will just wait it out at home but really should be in hospital and something serious happens.

I am waiting on ablation so fingers crossed it will help.

Good luck.

[Teresa156]

Hi 09Bumblebee,

Your trip to A&E sounds an awful experience and no wonder you don’t want to go there again. I can sympathise as I had a similar experience at my local A&E, I only went there in order to get it captured on their ECG machines, so a medic woukd be able to diagnose me properly. Like you experienced, it took hours and it was uncomfortable, frustrating and tiring. I feel your pain.

However, I think they’re probably still the place I’d go to ( and grudgingly) if I was ever unable to get back into NSR after a long episode, so you might have to consider that, if it ever happens, but hopefully not. I’d have to really consider it carefully first before I left home though…and I’d take plenty of water to drink as they seem to be rationing that as well at my last visit 😳

Teresa

[Jajarunner]

It could be dehydration with lack of electrolytes. I use High Five capsules called Zero to keep hydrated. You can also put a teaspoon if salt and sugar in water to make your own. Good luck xx