I started an AF episode yesterday at 4pm and it's still ongoing 22 hours later. I have been to A & E several times in the last 2 months but last time the doctor told me not to go unless my hr was 180 or so. I just lie quietly usually and it's about 80 unless I move around when it's about 100. He said just to take an extra 1.25 bisoprolol which I have done but it's going on so long now and I'm not sure what to do 😔 The longest it's lasted before was 20 hours.
Hospital or not? : I started an AF... - Atrial Fibrillati...
Hospital or not?
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Spj57
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BobDVolunteer
AF is neither an accident nor emergency , it is a chronic condition and needs to be treated as such. many people have AF all the time and learn to live fairly normal lives. Your doctor is correct BUT if you have chest pain or have fainting spells then A and E is appropriate.
Thank you for your reply. I was sent to A&e twice by 111. I was just wondering if it should not last over a certain period without referral. I can't spend my life in bed but if I walk around my hr is too high. I am still waiting to see a cardiologist.
A heart rate of 100 for someone with AF is not too high. Just get about your day as normal, see how it goes. My heart rate is all over the place, I have permanent AF, but I just don't worry about it.
Thank you 🙂 it probably seems high to me as my normal resting hr is only about 50. I'll take heed of what you are saying!
The actual classification of a normal heart rate is up to 100bpm. That's for anyone. Some just have naturally higher or lower rates. For us with AF it fluctuates a lot. The best way to deal with it is to ignore it and think of something else.
Are you on medication?
hi Bob. Could you help me. I don’t post on here often and have forgotten how to post a message to everyone!
I'm not Bob, but all you need to do is click on the button labelled "Write" positioned on the top right side of any AF Association web page, as shown in the highlighted area in the image below.
Steve
Screenshot of Home Page
many thanks!
I'm no medic. You are not in a fast rhythm so unless you are experiencing chest pains or undue breathlessness or fainting then A^E would not be appropriate .
You may have to take extra Bisoprolol and the person to ask is your GP. Most people can titrate up to 10 mg daily.
I can't help commenting that the advice from the A&E doc not to present unless your heart rate was 180 ish sounds a bit cavalier but then, as I said, I'm no doc!!
I think some people are more symptomatic than others. When I was in AF I managed to lie down for a few hours until I went back into nsr. The thing is apart from lying down there is no way I would have been able to do anything else at all, even reading watching tv or having a meal, totally out of the question. It was lie down and wing it out. I think after two days of that, it is appropriate to visit a&e or the very least dial 111 for advice if you haven’t reverted back to nsr.
In my experience 111 always send you to A&E if you call about a heart problem. I have had AF at that rate for a week at a time and although it slows me down I find if I potter along with my mind on other things it gradually fades away. It is a complaint that thrives on attention 🙄 Think of your heart as a child throwing a tantrum - be kind but don’t indulge it!
please try 1000 mg of vitamin C time released one a day I think you may stop it forever like I have
Hi Pamuella What brand of vitamin C do you take and is it natural vitamin c
As already said, Afib is not an emergency unless there’s chest pain and then of course you must go to A&E. I have had Afib for 18 years and my episodes have been as short as 6 hours and on one occasion as long as 57 hours. I average between 16-23 hours. My HR fluctuates between 95-134. Usual resting HR 60ish. I have only been to A&E once due to chest pain and tightness. All was clear. Otherwise I ride it out. I am symptomatic and it does wipe me out but catch up on reading, T.V, craftwork etc. nothing that causes too much physical activity. That’s just me though and we are all different.
Sounds just like my episodes
Assuming no chest pains/fainting then when you get to 7 days then your condition has changed and you are in persistent AF. GP should refer you to cardiology at the hospital so they can review treatment plan.
In my wifes case she went into AF 24th March and is still in it. Not bad enough for A&E but QoL impacting. Pestered GP who has tried changing doseage and types of beta blocker and got referral to cardiology.
As always sound advice from everyone. I can relate to your experience and I do have PIP. These being Flecainide and Metropolol. As time has gone on the PIP are taking longer to have effect. Maybe my tolerance levels. Recently I went for close to 48 hours give or take out of rhythm- HR 140 possibly tachycardia. Anyways my biggest concern is that due to my CHADSVASC (please correct me if wrong). score being 0, I am not currently on anti coagulants. Personal choice, maybe, still scares me a bit when it takes so long to go back into NSR. A and E at my local hospital are always very accommodating. When first diagnosed or not really knowing what was going on I spent a fair bit of time there. Wee bit more experienced now but still appreciate all knowledge and advice gained from forum. All the best re your concerns.
Thank you all for your advice 😊 it's still pretty new to me so I am comforted by your help x
My EP told me to go in if it lasted 24 hours. That said my HR has been about 175 bpm and difficult to get down . Sorry this is happening to you it really isn’t nice
Hi
Sounds like the spec. could try you on CCB Diltiazem. A BB did not do much with H/R but controlled my BP.
cheri JOY. 74. (NZ)
Hi there. I do hope you are feeling much better now. I have been in AF a number of times and am now experience some problems. I can’t remember how to send a post. Could you help me please? Thank you.
I go into AF with HR at 80-120 pretty well weekly, lasting 12 to 48hr. I just ignore it and get on with everything- including exercise, which pushes it higher if course.
I’ve never consulted medics owing to an attack as I consider AF a chronic condition and have no pain/fainting/etc. (of course I’m under the general care of a specialist and GP). if you’re generally ok in AF, don’t keep reviewing your heart rate and try to ignore it. Becomes easier as you get used to it.
I have vagally mediated AF and in the past I have stopped an episode by resting and listening carefully to a steady heartbeat on YouTube, walking at a consistent briskish pace and gulping a long fridge cold drink. No side effects, worth a try 🤔.
Hi I have persistent AF and my HR is always around 80 to 115. Ideally, I'm told, you want it 90 or below if its persistent. I'm working on that....with my cardiologist!As yours is paroxysmal it will go up and down but the figures you quote shouldn't make you feel that unwell. I only really feel it if it goes over 140 but everyone is different/ has different sensitivity and I'm not a medic. I would agree with others that it's not a case for A and E, unless you have chest pain or are faint etc, but the fact that you feel so unwell/ are so symptomatic with your AF suggests to me that a conversation with your GP would be helpful because whilst it's not dangerous at those levels it is obviously affecting your quality of life. Hope that's helpful. Take care 🌸
You've has lots of good responses here and I've been where you are. Different forms of gentle distraction do help. It's a lovely day, perhaps potter in the garden or sit in the shade. Drink plenty of water and don't starve yourself. It's a mistake I made! Eat sensibly and sit down quietly after the meal. I found something that combined protein and carbon really helped. I noticed that when in A and E once they allowed me a cuppa and a sandwich my AF would often convert. Rest and digest 😀
You've said the magic words- I can't lie down for the rest of my life - this is great! You've taken the first step. And if the longer episodes continue you may need to discuss different medication regimes with your GP or cardiologist.
Hope today is a good day for you.
I hope you are feeling better now but I wanted to reply because I know how bad it feels not to know what to do. When I first had paroxysmal AF my attacks only lasted a few hours but over the years the attacks have become longer. I have recently had an ablation but shortly before that I had an attack lasting 18 hours with a heart rate of 150 / minute - that was no joke I can tell you as I was unable to do anything but lie down without feeling faint and chest tightness. I was told by my cardiologist to shout for help if an attack lasted more than 24 hours (UK - Scotland) in case I needed a cardioversion. The symptoms I had were probably related mainly to heart rate and at 100 you may not feel as bad as me but the last thing you want is for AF to become permanent if you can avoid it. You might also want to ask about a change of treatment. I was on flecainide and diltiazem.
I have never had an episode that lasted long since I was first diagnosed because when I realise I am in AF and check with my Kardia, I take100 mg of Flecainide (prescribed by an EP I saw privately after taking 1.25 mg Bisoprolol daily brought my heart rate down too low) and the episode usually ends in a few hours. I now take it regularly night and morning and only have very rare episodes ( like when I had covid) when another Flecainide gets my heart back to normal in a few hours. Only advised to take 1.25 Bisoprolol if heart rate exceeds 140 twenty minutes later, which it hardly ever does now. We are all different and I do hope you find what works for you soon.
Hmm … I am new to paroxysmal AF as well, since February. My experience with advice from Cardiologists and EP’s seems different than what folks on here have received, perhaps because I’m in Canada. I’ve learned too, that everyone’s AF story is very different. As a 64 yr old with naturally low HR as well (45-50), I was told Beta Blockers (BB) were not a good treatment choice, as they lower HR too much and my lifestyle already healthy. Like you in AFib, I was symptomatic even HR 80’s to 100’s), unable to do anything but lay down. Certainly could not walk around, garden, read etc. I was told to go to Emerg if not in NSR by 12 hrs, when cardioversions are more effective. That the goal is to prevent heart remodelling into persistent AFib. To NOT accept AF as a chronic condition, until all avenues have been tried first. Ive since had over 50 AF episodes, had 6 cardioversions (some at HR 80’s), until EPs found appropriate medication for me that have controlled intensity of the AF (still every day or two). This has increased my QOL tremendously AND moved me up the ablation list from initially one year, to 2.5 months … May 31st. So if I were you, I’d go in … speed up the waiting list to see Cardiologist and EP, more appropriate medication, ablation option sooner, etc?
I don't wish to alarm anyone I suffered AF for about 18mths getting so bad I had to be shocked to get heart in normal rhythm sometimes the shocked work others it didn't I was never even slightly put out off it before receiving a shock and it's not nice I can assure you of that my cardiac team say I've caused further damage to my heart my leaving Af to long at times so down to my own stupidity and not taking AF seriously enough I now have heart failure cardiomyapa and a defliberating pacemaker I pace 24 hours a day and now pacemaker dependent but I have the best cardiac team ever I owe my life to them they never ever gave up on me okay I am on a lot off medication 💊 but I lead a almost normal life sometimes I actually forget I have a pacemaker on a recent battery check I was very happy to hear your good to go for at least 3 years my cardiac team are brilliant all off them including cardiac nurses whom I've actually made friends with over the years my message here is to everyone we are all different and our heart problems are also very different but please build up a relationship with your cardiac team you will gain so much from that because when a illness relates to the heart we naturally get a bit scared of the unknown but with the correct team and relationship with your team it becomes so easy to raise a concern or not understanding your heart disease its amazing what can be done in this era god bless you all stay positive focused and work alongside your cardiac teams there the ones whom know our hearts inside out and know every patient is different what works for me may not work for you but together you can find a solution to all cardiac problems and best way to treat it take care everyone
My normal resting heart rate is between 80 and 90. Has been for years. My GP and cardiologist are fine with it. I don't have AF but had a heart attack 5 years ago and 2 stents
My HR usually peaks at ~146bpm during an episode, whether lying in bed or up and about. I've found I can generally carry on with life during this (not necessarily with a smile, or a marathon!), and if need be pop an extra atenolol or two (cardiologist approved). Absent any chest pain, I don't think you'll die. I will assume that you are properly anticoagulated, of course!
Last week my AF went 47 hours but the heart rate was around 140 at times and lower! My doctor said you cannot die from this but it is not pleasant! I SHOULD start the new drug Multaq but hate new drugs never know how you are going to feel taken them! I am on metropolo a beta blocker and Eliquis a blood thinner!
Hi
I suggest you have a 24 hr monitor as metoprolol gave me 2 pauses x 2 secs at night showed up. I was breathless on exertion and sweating with fatigue.
I was changed to Bisoprolol which helped a little 186 to 156.
But CCB Calcium Channel Blocker saved me dripping 105 beats a minute . Prescribed by private heart specialist.
Then twinked. Diltiazem 120mg AM BB Bisopropol 2.5 PM
Now 62 - 69 Day H/R. 47 Night never changed. BP 121-123. /. 69-77
I'm happy but I've come from Stroke with AF and discovery of Thyroid Cancer all within 4 days post stroke.
It took 2 years 3 months and a private Heart Specialist to get CONTROLLED.
Of course an anti-coagulant PRADAZA now 110mg x twice. Undergone Thyroidectomy with 12 lymph nodes removed Feb 2020 and TVT Johnson & J Mesh removal March 2022 latter uder CONTROL otherwise they couldn't do it. I had 2 anaesthetists and 1 uro-gyn specialist and a dr.
Metoprolol now has discovered with problems.
cheri JOY. 74. (NZ)
I took myself into A&E about ten days ago, but my HR was consistently up around 160-170 and it was going into its fourth day, which was beginning to concern me. My episodes had only been lasting 2-2.5 days before that, so this one was a bit of a beast.
I too had been told not to go in (unless chest pain, breathlessness, etc), but this time I was told I shouldn’t have left it so long. It’s all very confusing.
Are you on an anticoagulant? If not I would ask your Dr. to put you on one ASAP. I've been to the ER on many occasion with HR of 190/200 and was very surprised at their cavalier response that they've seen higher or has this happened before? After lying on a hospital bed for a few hours I'm told to go home and "ride it out" and I feel like I'm wasting their time. All said get on an anti coagulant as soon as you can. Hope this helps.
Hi
A great majority of us AFers are in rapid persistent H/R Af.
I have never gone to A&E as that is for emergencies like Stroke/Heart Attack or bleeding.
On Metoprolol my H/R was 186 avge Day with hypertension. Night 47.
For 2 year 3 months before I asked for a Heart Specialist I struggled with extreme sweating and fatigue.
I was changed to Bisoprolol but H/R came down to 156 avg Day. Night always 47.
then at 2 years 3 mths a Locum Dr referred me to private Heart Specialist who carefully listened to my history and put me on CCB Diltiazem 180 (1/2 dose).
Wonderful as within 2 hours H/R day dropped to 51.
With w/end help reduced Bisoprolol to 2.5 PM. Diltiazem 180mg Day but following Wed NZ Heart Foundation who knew my private H/Spec. arranged to have Diltiazem 120mg. AM.
Now controlled. H/R Day 61-69. BP also controlled.
It appears that with a Heart Specialist you need to come to some choices if you can. I say that because I cannot have an ablation.
Otherwise meds should be controlling your H/R AF even by having a PIP which I assume is the 1.25 - your doctor's direction.
But Drs will only put up your med rather than reassess your meds and now history.
May be a CCB would help you. But only a specialist will prescribe the change.
You say Dr.
I would suggest you see a public or private specialist a.s.a.p.
Unfortunately being anxious will make your events worse.
A friend of mine worked through his episodes he said "he rode it out". He had had AF for many years. On 5 different meds a day. Got seen by an Ablation specialist.
His was para.... the surgeon found that he had 2 different electrical rogue AF at the same time. Had those scarred. Now 1 year 6 months no more episodes.
Its how you feel at the time of episode. Just laying there for 22 hours is not right.
Do go and see a specialist instead of A & E.
cheri JOY. 74 (NZ)
what is a A&E ?
l would be in the hospital so fast it would make your heart spin! But that’s just me. My cardiologist told me to go … why wait … they give me an IV and it stops within twenty minutes. Don’t wait longer if you don’t have to.
Hi there, my episodes go on for 30 hours plus with a heart rate between 100 and 170. My EP tells me to sit it out and take an extra sotalol
I’ve recently had the same problem. I’ve a lot of stress, can do nothing about it. My younger autistic brother died by the hands of a Buckinghamshire hospital negligence last July. I went on a weeks course in March in a new car up 3 motorways 😳 tense. After few days A fib kicked off 😳 lasted 2/3 days and had to go home, husband and daughter collected me 🙄
On 2nd morning of the inquest, went back into A Fib 😥 lasted 4 days, so went to a different hospital than usual, long story. Guess what, went back into rhythm on its own 🙄
Consultant changed my medication but tbh it’s probably stress. So far 🤞🏻
it very much depends on how YOU are experiencing it, everyone is different. I read that if in AF for 4 days or so, a cardio version won’t work , so that’s why I went to hospital, I didn’t want ‘permanent AF’. I feel this does stress the heart and you. Also, see if you can get your dr or preferably a cardiologist to give you an idea as to how and what to increase medications too to help revert.
There are actions you can try, like cold showers, valsalver manoeuvre, breathing techniques etc - none work for me 😳
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