Am in fastish AF and have brought myself over to A&E (as advised by medics). I am hooked up to intravenous digoxin. HR highest 142. It should start to come down now I am on meds. I don't feel ill whilst in AF but am always advised to come to A&E.
However- it is my daughter's wedding day!! I am thinking ahead and am definitely not missing it but wanted advice from you lovely lot as to what is a safe HR to be discharging myself, if it comes to that. I know my health is paramount and wouldn't do anything to jeopardises that but I read on here all the time of folk just riding out episodes, which is what I had intended to do this time.
What would you do? Hospital staff are being amazing and doing all they can. I'm trying to stay calm.
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Sputnik56
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Gosh thats a big question. Please be advised by your medics. I assume they know its your daughters big day. Best wishes, I hope it all works out for you and your family today.
I don't feel it unless on exertion sweating and fatigued.
It is control you need. Under 100 H/R at rest.
But you are on Bisoprolol. But CCB Diltiazem controls Heart Rate 10 fold. Within 2 hours on 1/2 dose I dropped to 51. Much better than Bisoprolol which is better for my BP.
See if you csan try. Diltiazem but start low dose.
Not only in AF but a pretty high heart rate - Atrial Tachycardia.
You must take the advice of the doctors as they are caring for you.
Whilst we have experience on this forum we are not medically trained.
You are better to stay safe where you are as you run the risk of being unwell at the wedding and therefore you being the centre of attention which is not what your daughter deserves.
Awful timing for an episode of AF. Weddings are both a joyous and stressful occasion, sometimes in equal measure. You naturally want to witness the marriage of your daughter, it would be a very big day for any mother. You are now following medical advice and receiving treatment, I would stay wre you are and finish the treatment. If you discharge prematurely and your health took a turn for the worse it would ruin the day for everyone.
Not advice as such but I can Potter around quite comfortably at 130. There must be a reason why you are always advised to come to A&E - do you have another condition? I was given digoxin tablets for fast AF once, told they were supposed to work in 6 hours if at all. Heart slowed quite quickly and back in NSR after 7 hours. I hope that info helps.
I think, understandably, the hospital are being cautious. HR has come down to low 100s, popping up to 130ish now and again. They have given me all the beta blockers they are willing to give at this stage. I am literally sitting here on a heart monitor when I believe I could be at home. I have kardia gadget so can keep tabs on myself. I am on waiting list for ablation and it cannot come soon enough. This is such a nuisance isn't it. Thanks for your response x
When in afib, not unusual for hr to move up with activity. Not a medic, but you seem safe and stable and not sure there would be a major difference lying in a hospital bed or sitting in a chair at the wedding. Wheel chair would be ideal. If you feel up to it, ask to speak to head of department and explain the wedding situation.
I’m hoping your HR has come down a little more by now. I think only you will know if you feel able to get on with the day by how you feel. I could probably move around and do things too at a rate of about 130. Are you usually on digoxin? Why are you always told to go to A&E when in afib?
I’m glad A&E are being good to you though. Best see how you feel and what they suggest.
I hope you make the wedding 😊
only just seen this so hoping your situation has improved. I’m sure your medics are doing everything possibly to get your heart rate down. I wonder if using a rhythm drug such as Flecainide as a pill in the pocket has been suggested. Not suitable for everyone but might be worth asking the question but needs careful supervision so probably not appropriate on this occasion…..hope you make the wedding, but toast the bride and groom with something non-alcoholic!
Hi Sputnik I hope you make the wedding - please do let us know how it goes! Maybe assure the medics you'll just attend part of the service, miss the reception, see what they say. But you are there in spirit whatever, creating another tale to tell of the day, and there will be a space for you to offer a second celebration for daughter and son in law in the future if you can't make this one - or even if you can! Congrats to bride and groom.
Look, none of us are doctors and we don't know your case and we are not there. But in general, I see no reason why they can't at least lower your rate to the point where you can attend your daughter's wedding. Personally, I would make a very strong request to be released, assuming my heart rate was controlled and I felt ok after a trial of walking around the halls.
My daughter was married last year I was in AF all day, I actually felt better in AF as it was one less thing to worry about, we had a great day.
I have had paroxysmal AF since 2004, I went to A and E twice in the beginning to get it looked at and the right advice and medication but have never gone back to A and E, (AF is not considered an emergency in our hospital unless you have chest pain or fainting, then its a different ball game) A and E is far too stressful especially, these days and all they do is monitor you and kick you out with more medication.
I get AF which lasts from 1 day to 4 days, I have a yearly appt with my Arrythmia nurse and she is always there if I need advice. Everyone is an individual, what's good for one person is not for another you should agree a plan with your own doctor/EP who knows you health situation and is in the best position to give you advise on what action to take.
So happy to hear this! I'm in the US so get the daily forum feeds later because of time difference. Was wondering about your dire situation, so it's wonderful news that you got back into NSR and made it to the wedding!
Glad you made the wedding.Hope you had a lovely time.
I’ve been told I have to go to A&E when I get an AFib episode, as my heart rate goes very high. Last time was February and they did a Covid test and it was positive, which surprised me, as I’d never had it before and didn’t feel ill, just had little bit of a cough. The Doctors think this is what brought my AFiib on this time.
Well - it's raining here but I hope the sun shines for the wedding photographs and that you are on them smiling with pride and happiness!
There must be an underlying medical reason why you have been told to take yourself to A&E with your AF episodes, in which case, I would ask what that is and why you can't treat yourself at home using either (as I do) a rate-control drug (bisoprolol, 1.25 - 5mg), or, as many do, it seems, a rhythm drug such as flecainide.
The very last place I would want to be is A&E, given current NHS crisis, even though I have found my recent AF episodes (with a rate up to 155 and above) tiring and hard going. With bisoprolol, so far, my NSR has returned within 2-4 hours, mostly.
Hi Steve, thanks for the reply. I am on 7.5mg Bisoprolol daily and take Flecainide as PIP (which has very little effect other than to temporarily reduce HR - never stops it). I have paroxysmal AF since 2019. I don't ever feel faint or tight chested but HR reaches around 150bpm mark. My doc has always said anything on or around 135bpm mark is 'small fry' but when I am in A&E every consultant I ask says always to take myself to A&E to be monitored. I read all the time on this forum of folk staying at home and riding episodes out as long as they feel well, so to say I'm confused is an understatement. Am on wait list for ablation but think I'll give arrhythmia nurse a call this week to discuss further.
Sun shone for us yesterday. Made it to the wedding. All's well that ends well. Thanks for the support.
Well, yesterday here in Leicestershire, the weather was blissful if a touch cold - perfect for wedding.
As far as I know, AF, in and of itself, does no harm to the heart; rather, it is the tachycardia that can, over time weaken its pumping ability, i.e. affect the much more vital lower-left ventricle chamber. This means that treatment is often rate control primarily, usually with, say, bisoprolol, and then rhythm control but only if the atrial rhythm causes unacceptable symptoms, which in some people it most certainly does (fainting, dizziness, for example). It all seems to depend how far the ventricular output is affected by what is going on oop North, as it were.
Why you would need to be monitored, I don't know, but from reading posts from others, especially in the USA, it is a common thing, so probably just a quirk of different doctors rather than for any other reason.
Did you phone 111? Because I have discovered they automatically send you to A&E for anything heart related to be on the safe side (theirs, not yours 🫤). So unless you actually feel ill, don’t call 111 😀 unless, of course, you want to go to A&E, in which case you can just turn up……
I ride out all of my episodes. They are 'uncomfortable' fast and go on for an average of 30 hours. I was told to do this by my EP unless I felt particularly unwell with chest pain and dizziness. Not pleasant but less stressful than being in hospital hooked up to bleeping machines! Enjoy the wedding 💒
My afib episodes always start with a high heart rate 140- 150bpm according to my Kardia. I take an extra dose of Nebivolol and try to carry on as usual . I make whatever meals need to be made , wash up etc. Sometimes a bit of more vigourous housework has put me back into NSR. If they strike in the evening I relax , read or watch tv. I would consider going to A& E much more stressful than the afib and the first and only time I was taken to hospital (when diagnosed ) they kept me in for 4 days till INR was ok! Maybe you have special circumstances where you need to be monitored . At least you got out in time to get to the wedding but worrying about whether you would make it or not must have upped your stress levels a lot!
No special circumstances. If (not if, when) it strikes again I think I will do just that. Extra tickle of Bisoprolol and wait it out for a while. I was fixated on the heart monitor willing my old heart to slow down but it made me more anxious, and angry that I was about to miss the most important day in my daughter's life. Thanks for the response.
Monitoring your heart rate can make it worse. I don't bother using my Kardia unless I am unsure whether I am in afib - not usual as I can nearly always tell. Keeping checking it made me more anxious. No way would I go to hospital and risk them keeping me in again ( I live in France ) unless it was going on much longer than usual.
Exactly, the monitors make you worse! I remember when I was diagnosed the cardiologist came in to see me and ordered the nurses to take off all of the monitors saying "take them down, I'm not bothered about that!" I then asked him what it was and he replied "A bloody nucience"
Remain in emergency until you are released. You don’t want to be at such an important event while in afib. If you miss the wedding, you miss it. Your daughter wouldn’t want you there during an afib attack and that is a very fast heartbeat. Best, Jan
The only time I ever have gone to A&E was when I needed to get ‘properly’ diagnosed with Afib as it could never be captured before then ( up to that point and over 15 odd years, I’d probably had 10 Afib episodes at home over that time, unmedicated) and the whole experience I had in A&E, including the ‘care’, was thoroughly unpleasant, so I wouldn’t want to repeat it. I’ve been told to only go to A&E if I have pains, or feel bad, or if I’m in Afib for many hours (over 12 with no signs of improvement or reduction). Fortunately, my Afib burden is currently quite low, but on 1.25 mg Bisoprolol it last got up to 150s. A valsalva manoeuvre got me back into NSR the last time I had one, so you could try one of those next time ( you never know!)
I would tell them that it is your daughter's wedding day ... can I go?
On a drip makes things a little different.
I have rung my St John's alarm ... but
On 24-monitor I was 187 avge H/R DAY on Beta-Lok (Metropolol!) 2 pauses at night 2x 2secs.
Changed to Bisoprolol 156 avge H/R DAY. Always 47 avge at night no pauses.
Breathlessness stopped on Bisoprolol and on exertion was improved.
My Locum GP suggested referral to private heart specialist.
He introduced CCB Calcium Channel Blocker Diltizem but it was twinked to 120mg AM. With Bisoprolol 2.5 mg PM. BB blocks Adrineline.
Controlled 123/68-80. with avge 62-88 DAY avge.
The 2 meds control my BP, H/Rate and Rhythmn.
If at rest you are 140s at rest it is too high and should be controlled down under 100 with meds.
I was diagnosed with Rapid. Persistence H/R with AF after stroke Isschaemic-Embolic type. But 4 days later I was given a further diagnosis of Thyrod Papilary Cancer. Removed within 4 months in Feb 2020.
I guess you have to wait and see whether they will allow you to leave/discharge.
I agree with mjames1 that really is not a high HR when in afib. I've been to the ER with heart rate of around 190 and the Doctors weren't that concerned saying they had seen a lot higher. They did give me intravenious drips and in an hour or so HR rate came down to low 100's and I could go home and " ride it out," of which I do even if it spikes to 160 or higher. As long as I'm taking apixaban I feel relatively safe and without the stress and anxiety of being in the ER HR rate usually drops in maybe an hour or less. Praying it slows down for you to attend wedding. GOD Bless!
I also used to take Beta blockers, but in the ER, while having episodes of AFib, they always put me on Diltiazem and I would revert back. The Dr. finally replaced the Beta Blocker with the Calcium blocker, and my every 3 month episodes became rare episodes. I hope it all turns out, well.
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