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Heart rate in afib and when to go to ER or A&E

kocoach profile image
32 Replies

Sitting down watching tv and I felt in my chest I was trying to go into afib, so I grabbed my trusty oximeter and put it on and watched HR go down from 80s to 70s to 60s to 50s to 40s to a reading of 37 HR. Freaked me out so I got another oximeter different manufacturer and put it on and it read 37. Well I thought I was a goner so I called the VA nurse hotline and told nurse what was going on so she said go to the VA hospital which I did. Told the triage nurse what happened and he said you'll never get a correct reading from oximeter's when in afib because heart is bouncing all around, he said you have to be hooked up with wires to get accurate reading like from EKG machine. They put me in a room did an ekg, blood tests hooked me up to monitors and after about fifteen minutes the Dr. came in and I told him what happened and he said I was indeed in afib, HR 120 and asked me if I wanted to be admitted overnight and I said is that all HR is, so I said NO I want to go home so he said ok as it looked as if my rate was starting to go down. He offered me diltiazem but I refused it because I didn't want HR to go down any lower when I convert back to NSR and he agreed. I just wanted to let some of the members on this site who have had questions about HR and when to go to ER in US or A&E in UK know that right from Drs. mouth and a couple of nurses, that with afib it's about how you feel more than what an oximeter or BP machine says. Hope this clarifies some questions about HR and when to be concerned. Have a Great Day.

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kocoach
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32 Replies
baba profile image
baba

Oximeters and BP machines are not accurate for heart rate when in Afib.

kocoach profile image
kocoach in reply tobaba

I can't seem to get that through my thick skull.

Palpman profile image
Palpman in reply tokocoach

Oximeters and BP machines use algorithms that can measure heart rate from the time taken between 2 or more beats and translates them into beats per minute.

Due to Afib causing variations in milliseconds between beats the devices give erratic readings.

Sometimes the ventricles beat when empty due to the inefficiency of the chaotic atrials and these beats are not picked up in the arteries by these devices.

kocoach profile image
kocoach in reply toPalpman

Thank You for that bit of clarification.

Dippy22 profile image
Dippy22 in reply tobaba

Yeah, it’s like when they’ve tried to take my wrist pulse with their fingers and manually count the “beats”. I just sit there trying not to laugh.

Or when they hook me up to a BP/pulse monitor and the obs look fairly normal. They look at me like I’m mad (all in my head?), but when they put me on an EKG machine, that “Oh sh*te” look comes over their faces. 😂

waveylines profile image
waveylines

That sounds scary.... Glad you got it checked out. I had nine months of running at 130 at rest and that made me feel poorly...... How are you now?

kocoach profile image
kocoach in reply towaveylines

I feel great same as when I was in the ER, I've sat out 150/170 HR many times but the 37 HR got my attention, although it only lasted for 30 seconds or so. I've had afib for 32 years and I can never get accustomed to it. I bet now the EP will mention a pacemaker but will refuse it, I've been trying to get off amiodarone for a while now but he says NO, which I'm positive is giving me all of these problems. Funny story, while in the ER when the two nurses were hooking me up to monitors the head nurse asked what I was in for and I told her HR dropped to 37 the other nurse said to her "mine goes down to 30 all the time I'll show you later on her apple watch, I think she said. Anyway things are back to normal now, still in afib HR 110-120 but I know it will convert to NSR before this evening. Thank You so much for your reply and concern. Have a Blessed Day!

ninks01 profile image
ninks01

i get really low readings on oximeter when having an AF episode....34 i think has been lowest....i try and work on the "how do i actually feel"before getting too panicky but its not always easy........AF is very trickyto deal with.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toninks01

Hi

We are made aware that in newly diagnosed AFers that 1 in 5 patients die of AF in the first year.

How you feel is most important.

cheri JOY. 74. (NZ)

Budken profile image
Budken in reply toJOY2THEWORLD49

I was told by my Cardiolgist here in Germany, that Afib is not a cause for concern. You will not die from it! It is all about how you feel.

kocoach profile image
kocoach in reply toBudken

Just what the ER Dr. explained to me.

Karendeena profile image
Karendeena in reply toBudken

That is exactly what I was told

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toBudken

Hi

Yes that is what we are told on this site but I read the truth if we don't get checked over in the math of being left with uncontrolled events.

It took 2 years 3 months over no follow up after a stroke with AF Rapid and Persistent to be controlled.

Of course how you feel should alert you to get checked out with A&E.

Left with H/R 187 sweating, fatigued and couldn't exert as I became breathless on Metoprolol looking back was not acceptable and at the hospital admittance diagnosed with thyroid cancer ; Papillary.

No cardioversion, no ablation. No Echo, No 24-hr monitor.

Looking back I am horrified what I went through. But always my heart slowed down at night to 47.

Over time I have filled in many surveys over internet.

I see the fault as NO FOLLOWUP after a stroke hospital stay!

Now I see those having an ablation are 'stuck' with a slow heart.

Not many AFers I see get controlled by a CCB instead. My heart slowed 105 H/R per minute within 2 hours of first introduction to Diltiazem. before ablation.

cheers Joy. 74. (NZ)

healingharpist profile image
healingharpist in reply toJOY2THEWORLD49

That would be 20% of AF patients! totally misleading statistic. Best not to scare newly-diagnosed friends on this site by quoting any AF-related study out of context. I am a research dr and the studies are all over the place, depending on whether you have previous cardiovascular disease or any other disease, high blood pressure, diabetes, your emotional state, whether you're living in a nursing home you hate, or with friends/relatives you love, or on your own, whether you rest enough, exercise, frequently hunt lions in Africa, eat salmon but drink aspartame-sweetened diet Coke, are over 50, or 75, or 90, whether you live with a dog or a cat or a goldfish... our jobs, our hobbies, whether we go to church or synagogue or temple... every factor in our lives has influence on the outcome of a study. The size of the study also matters greatly, and many studies have unreliable results because there were too few participants. The DESIGN of the study, who is included and excluded, the study's endpoints, is vitally important. Check out cardiologist Dr. John Mandrola's website and blog for more on this. We should be very cautious about flinging around statistics out of context. I believe it is more accurate to say, as we have often heard on here, "You may die WITH atrial fib; you will not die OF atrial fib." Dr. D

Karendeena profile image
Karendeena in reply tohealingharpist

Well said and I love your analogies, made me laugh 😂

healingharpist profile image
healingharpist in reply toKarendeena

Ha ha, thanks, Karendeena. I admit I was having some fun, thinking of all the ways we live... & I almost added that death rate "also depends on your hobby of wandering in the woods and sampling the fungi you find there" :-). But I was also feeling exasperated at how awful it is for frightened, newly-diagnosed AF patients to hear wild stats thrown at them, without qualifying information. Your EP was correct!

Karendeena profile image
Karendeena in reply tohealingharpist

Love it love it, I'll remember I mustn't touch the fungi when I walk in the woods at the back of our lodge otherwise I might die, but would it be the afib that killed me? 🤔🙄😜

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply tohealingharpist

Hi

I would say 'CAUTION' to the wind.

I say no point in suffering. It points to being checked out.

I agree its how you feel.

But what irritates me that the saying "you will never die of ... AF" Because that is just not true.

We all need the truth to break down ourselves. Don't you agree.

As I said looking back the treatment was unacceptable.

Reading the 2nd discharge papers (as I was transferred to a minor hospital) reads - hospital appointment .. NO. GP appointment .... NO

Meds change .. YES (triage team Pradaxa 110mg x twice day to 150mg.

I arrived back at A&E 4 days later breathless.

And I was rung by the previous hospital "would I consent to a biopsy of my thyroid as we think you have Thyroid Cancer". I said yes. That action needed prompting when 2 months went by without that happening.

Even NZ lets down patients.

Making AFers unaware of the seriousness of their life is also a serious demeanor.

I'm all for "managing our own health". That is getting our aF controlled.

As one Heart Spealist stated if your heart beats 187 avge your poor heart is beating at least 87 beats a minute more than normal, x 60 mins x 24 hr day x 365 days to make one year! That was me.

We need to be REAL on this FORUM. And often AFers don't fnd out about this forum until some time is elapsed.

I was diagnosed Sept 2019 and I did not join until Dec 2021. I also joined Thyroid UK where you cant talk about your own meds, forward and levels. Not a helpful site to those asking for just that other folks experience.

Latest is that one shouldn't on anti-coagulant if you have cancer. Did you know that?

cheri JOY. 74. (NZ)

Budken profile image
Budken in reply toJOY2THEWORLD49

OK, this is mean. However, where did you get your Medical diploma?

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply tohealingharpist

Hi

Having had a stroke with AF, if it wasn't the thyroid cancer that killed me in the 1st year of being first diagnosed with AF, I guess they would have put me down as died - STROKE.

In recalling prior as I had had no meds prior except B12 Solgar for B12 Deficiency. and tajking an antibiotic for Vaginal Bacterium (Awaiting removal of TVT Johnson & J Kit & damage) I did have excessive sweating and fatigue on exertion. And anxiety due to ACC and nearest DHB Hospital declining removal of latter.

I believe AF is the result of more than one issue. My Systollic level was in 140s. Earlier in April Dr tried Losartin but didnt move it and I was losing protein in my urine.

Straight-up I would like to be told the truth. When signing for my thyroidectomy I didn't bother to read small print. I was lucky in its discovery.

I'm one you researchers made RAI and Suppression a necessity after thyroidectomy for cancer. I was low grade, it was Papillary cancer and surgeon removed as well 12 right lymph nodes. I confess I have had 3 x yearly 'no cancer' scans.

I look carefully ar research information. My results always say needs more surveys or experimenting if necessary.

As an ex Nurse I can sign on to some important research.

Research are you a registered Doctor or a PHD qualified in your field and have you experienced AF?

cheri JOY. 74. (NZ)

Karendeena profile image
Karendeena in reply toJOY2THEWORLD49

Don't understand, never heard of people dying of afib, consequences yes, such as stroke or heart failure but never from actual afib or am I missing something. My EP (a top man in his field) told me afib is not life threatening

kocoach profile image
kocoach in reply toninks01

I agree, when in the ER they weren't too concerned that it dropped to 37. just with how I felt and yes, anxiety can really be a problem giving you feelings of lightheadedness. After 32 years still learning and trying to deal with afib.

bassets profile image
bassets

I went to A& E once and they said my heart was bouncing from the high100s to 30ish - can't remember the numbers but I can remember how it felt!

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Yes care should betaken in falling H/R. Did you feel light headed? breathless? Sick?

First time on Diltiazem 180mg my heart rate fell 105 H/R per minute! to 51 in 2 hrs.

Very light headed it was deemed too high. So happy on 120mg. AM and taking my Bisoprolol PM 2.5mg.

Night avge 47 H/R.

cheri jOY. 74. (NZ)

Qualipop profile image
Qualipop

Last week I had really bad arrhythmia; not A Fib but when I tried both oximeter which showed 42 then BP monitor showed 50 I got worried. I then tried BP several times and it simply couldn't give a reading. Yes I freaked out, rang 99 9 and was admitted for 4 days to get a diagnosis. When you have any sort of bad arrhythmia those machines just don't work.

Palpman profile image
Palpman

Shows 120 bpm but actual not nearly that.

Here is an example of my ECG yesterday. Actual hb not near as stated.
Palpman profile image
Palpman

My ECG above shows a heart rate of 120 but that is between the PVC and the normal pulse. The pulse rate between normal beats is 30.

I measured it at 30 bpm in my neck and wrist. This means that the BP machine and oximeter will read 30 as well.

BaileyC57 profile image
BaileyC57

MY HR has been that low too but my Doctor said too that you cannot get a correct reading when you are in AFIB!

kocoach profile image
kocoach in reply toBaileyC57

That's what mine said also, what matters is how you feel.

Sharonsue profile image
Sharonsue

Thank you for the info. I have been doing the same thing. Actually threw 1 oximeter away I was so frustrated. Blood pressure cuffs act the same way.

kocoach profile image
kocoach in reply toSharonsue

I have five blood pressure machines and 5 oximeters and they drive me crazy when I use them. The good Hospital grade equipment is very expensive.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toSharonsue

Hi Herthel

My big Cuff monitor always threw itself into ERR. ..... R. when I guess I had rapid persistent AF. But controlled with Microlife it doesn't bring up an ERR..R

cheri JOY. 74. (NZ)

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