AF episode

[Fight-the-good-fight]

Experienced another AF episode which lasted 15 hrs. HR was 141 BP through the roof. Felt absolutely awful the next day.

As my episodes are (in his words) “quite aggressive” Dr strongly advise that I attend A&E if my HR does not come down within 2 hours.

Dr writing to Cardiologist to expedite my appointment. Apparently, only the cardiologist can advise and prescribe any anti-arrhythmic medication, or discuss other options…

Current medication, is keeping my rate down, and BP normal when I am in NSR.

However during AF episode meds not having and impact…

[Jalia]

This is exactly what my surgery advises me to do. Indeed when I have not heeded this advice and left it considerably longer I have been given a ticking off by A&E medics. My episodes are very symptomatic and although just once or twice a year these days they almost inevitably require 'emergency' dc cardioversion.

Hope you don't have to wait too long for your cardio appointment.

[Fight-the-good-fight in reply to Jalia]

Thanks Jalia, unfortunately my episodes are approx once a month, the last one was only a fortnight!

[Fight-the-good-fight in reply to Jalia]

What’s it like to have dc cardio-version? It sounds invasive.

[Jalia in reply to Fight-the-good-fight]

You will not know very much about it as you will be heavily sedated/anaesthetised. Basically you will be wired up with pads etc on your chest and a very carefully controlled electric shock passed through your chest to hopefully convert the heart back to sinus rhythm. You will be very closely monitored all the time and probably be 'under' for about 10 minutes .

I've had a grand total of 24 over 30 years which admittedly is somewhat excessive . These have been performed variously in anteroom of theatre, catheter lab, A&E & ITU. When I've had mine there was normally a consultant present plus junior doctor , a couple of nurses and anaesthetist but this can vary.

[Fight-the-good-fight in reply to Jalia]

Wow! Have they never considered a pacemaker? Or is that not an option for your condition?

[Jalia in reply to Fight-the-good-fight]

It's never been impressed upon me to have one although EP has said he would put one in if I wanted to. I'm OK in between times so have resisted.

[Dollcollector in reply to Fight-the-good-fight]

A pacemaker doesn't stop a.f or tachycardia just stops the rate from going tool low ( bradycardia).

[Fight-the-good-fight in reply to Dollcollector]

Thank you, I wasn’t aware of that.

[Sunnyday2022]

We all get different advice! I have similar length AF episodes with my heart rate usually around 110-150 for the 11-15 hours or so but I have been told by my cardiologist not to bother with a&e unless I get chest pain dizziness etc.

I take Flecainide daily and increase the dose if I have an episode but it doesn’t always help.

[Fight-the-good-fight in reply to Sunnyday2022]

Hi Sunny Day, last time I attended A&E they gave me the same advice as your cardiologist. Only thing is, I do suffer from is lightheadedness; which I presume is a symptom of hypertension-hence I suppose my GP’s advice to attend…

[mhoam in reply to Fight-the-good-fight]

Much more likely to be hypotension when in AF. My BP went very low when in AF so became faint and dizzy. I did “hit the deck” a few times😡

Happily a cryo-ablation last year made a big improvement

[Fight-the-good-fight in reply to mhoam]

Hi Mhoam - I take my BP when I ever I have an episode. It is deffo hypertension. 190/110 then off the scale…

[Sunnyday2022 in reply to Fight-the-good-fight]

I have only once gone to a&e after an episode lasted 18 hours and I couldn’t take any more PIP meds.

Of course after sitting and waiting for quite some time I reverted to NSR as soon as I finally got in front of a doctor 🤦‍♀️😂

[Fight-the-good-fight in reply to Sunnyday2022]

Hi Sunnyday2022- typical isn’t it? Stay well..

[Jetcat in reply to Sunnyday2022]

My cardiologist told me the same at the start of my Afib journey too. I think that’s why i sit any episode out nowadays.

[Sunnyday2022 in reply to Jetcat]

Yes I do too. I would rather feel awful at home than in a&e!!

[Jetcat in reply to Sunnyday2022]

Luckily I dont feel too bad when having a Afib episode, For now anyway.????? But I noticed the hospital only monitors you while you’re in afib anyway so I may as well be at home and not taking a hospital bed up. If I got any pain etc then that would be a different story of course and I wouldn’t recommend anyone sitting it out at home if there were pain etc accompanying a Afib episode.

[LoveRowing]

my Drs wrote to cardiology for advice as I’m still on the waiting list. Cardiologist advised Drs to start Flecainide to control rhythm. I was having 12-20 hr episodes every couple of days, these have reduced to 2 hrs and slightly less frequently. It is likely to be at least 6 months til I get a cardiology appointment. I hope you get sorted soon. Other meds did nothing to stop or reduce episodes

[Fight-the-good-fight in reply to LoveRowing]

Thank you LoveRowling, glad Flecaincide has controlled your rhythm. Do you have to take it every day-and do you experience any side effects?

[LoveRowing in reply to Fight-the-good-fight]

I take a low dose twice a day, I’ve only recently started taking it, but not experienced any side effects that I am aware of. Started off taking as pill in pocket, that seemed to reduce symptoms but make it more regular

[Buffafly]

Good for your doctor!

[Jetcat]

I hope you get sorted out soon. My cardiologist prescribed me propafonone for the six months wait for my first ablation. It did calm things down a lot to be honest.👍

All the best mate.

Ron

[Bikica1234 in reply to Jetcat]

Hey Jetcat, what dose of propafenone are you taking?

[Jetcat in reply to Bikica1234]

Iff my memory serves me correctly it was 160 mg. That was 5 years ago.

[Ppiman]

I used to have episodes of up to a few hours from 85-140bpm and my doctor’s advice was to take an extra dose of bisoprolol. This did the trick, even though I can’t exactly say it was at all comfortable, with anxiety being the main issue. 15 hours is a long time, so I can appreciate how you feel. I would, myself, try hard not go to A&E unless the discomfort or fear became overwhelming as our local hospital seems always far too busy.

Recently my episodes (few and far between at present thankfully) have been worse at 150-180+ yet still bisoprolol was sufficient and I managed to press on not doing much but coping until things settled (a few hours at most).

All else being well, a beta blocker is a far safer option I was told so I’m hoping I can stick with that. I can’t take flecainide or sotalol so I keep my fingers crossed.

Steve

[Bikica1234 in reply to Ppiman]

Hey Ppiman,what dose of bisoprolol are you taking? Why should you not use Flecainide and Sotalol? Have you ever tried Propafenone?

[Ppiman in reply to Bikica1234]

I used to take 1.25mg only as needed but since March eveni has more AF, it’s been daily. I can increase the dose to 5mg if needed, I’ve been told, but I fear doing that as my heart rate is already quite low even on the lower dose.

Steve

[Ppiman in reply to Bikica1234]

I only take 1.25mg, and only daily since March when my AF became a bit more frequent (before that I took it occasionally, as needed). I have been told I can increase the dosage to 5mg if needed, but (fingers crossed) the lower dose seems to have stopped the AF, although not the many daily ectopics.

I have never tried anything else since my ablation, which was for atrial flutter. The only drugs that worked back then (2019) were bisoprolol with digoxin. I gather that beta-blockers or similar (i.e. "rate control") drugs are much the safer option compared with rhythm control drugs since I have some issues with heart timings that they can disturb (I have left branch bundle block).

Steve

[Fight-the-good-fight]

Hi Steve, unfortunately I could not tolerate Bisoprolol. I feel much better on Nebivolol. In NSR I take 1.25mg

At the beginning of my last episode I took an additional BB-then another 12 hours later - 3.75mg in total.

I eventually fell asleep for a couple of hours - I woke up in NSR and my HR was 58.

Maybe I should have taken an additional 2.50 mg at the onset?

I was reluctant to take without GP’s advice, as prescription says “take additional tablet for palpitations”

Hopefully, my cardiologist appointment will be brought forward.

Getting my head around AF is proving difficult. GP’s have different opinions as do A&E.

We will see what cardiologist advises.

Thanks for your support.

[Oldiemoldy]

I just had an AFib incident yesterday for first time in months. 8 hours and HR around 145. Went back to NSR finally - but tiring.

[Fight-the-good-fight in reply to Oldiemoldy]

Yes, it’s very debilitating-I am reluctant to carry out my normal chores for fear of triggering an episode.

[MaryCa]

You need an EP to do an ablation. That was me. Like running four marathons and wiped out for next three days and along comes the next episode. I had an ablation in Dec. Nsr since.

[Fight-the-good-fight in reply to MaryCa]

So pleased to hear you have not experienced and further AF episodes MaryCa. It must be great to feel normal again. Hope it continues.

[MaryCa in reply to Fight-the-good-fight]

Thank you

[Jackiesmith7777]

The heart is so bloody unpredictable , my husband is in permanent AF or persistent but sure which . He is being considered for a second ablation after the one in 2017 failed , we don’t know when as my husband can’t feel anything even when his heart is 160 plus . He recently had a stroke because of this . He is currently on bisoprolol 10mg a day which mostly keeps it in 80s 90s sometimes goes over 100 resting . We re waiting for an appointment at arrhythmia clinic . We also attend heart failure clinic once a month . Because his communication is limited because of the stroke and his vision he can’t go on his own as yet . He is also on thinners and cholesterol tabs as well as one for stomach and kidneys . He is 65. Hope yours settles soon .

[Fight-the-good-fight in reply to Jackiesmith7777]

Hi Jackiesmith7777, I am very sorry to hear about your husband’s situation. It must be very stressful for both of you.

Makes my situation pale into comparison.

I hope you get the help you so need very soon.

Take care, and thank you for taking the time to respond .

[JOY2THEWORLD49]

HI

The only impact was on CCB Dltiazem. 180mg 1/2 dose brought me down 105bpm!

BBs were hopeless with 187 bpm Metoprolol and 156 bpm Bisoprolol!

CCB Calcium Channel Blocker. Blocks calcium from entering heart muscles.

I balanced out at 120mg Diltiazem AM

Bisoprolol for BP 2.5mg PM.

I came down to 124/69. 88-93 until a year later now 110-124. / 69. 60s pulse

and always 47 avge no matter what drug at night. Always have cold shoulders at night.

I hope this helps.

cheri JOY. 74. (NZ)