Advice please

[Bramley01]

I had a cardioversion in June for AF, thus evening I have felt a thump in my chest and back I fast Af, I've taken the extra bisoprolol as advised but how long do I wait until seeking medical attention ?

Thanks in advance

[mjames1]

Assuming the bisoprolol controls you rate and you're not overly symptomatic, my ep would want to be informed if I didn't convert to normal rhythm in 3 days. If the bisoprolol does not control your rate, or if you are overly symptomatic, I would let them know right away. This is just general advice as I don't know your history. Also, I"m from the US.

JIm

[Bramley01 in reply to mjames1]

Thanks for your reply, now admitted to hospital waiting for consultant

[mjames1 in reply to Bramley01]

You did the right thing. Hopefully before you leave, they will give you a plan to take care of future afib episodes at home. If not, you should ask them for one.

My first home plan was to take rate lowering drugs on a certain schedule in order to get my heart rate down while I waited to covert. My current home plan is to take an anti-arrhythmic drug , Flecainide, as a pill in the pocket, which generally converts me in one to four hours.

Good luck, feel better and let us know what the consultant says.

Jim

[Bramley01 in reply to mjames1]

Hi JimSent home with extra dose of bisoprolol 3.75 twice a day and restarted on apixaban twice a day, and now referred to cardioversion clinic, but feeling much better now heart rate is down from 160 to about 90, just feeling exhausted.

[CDreamer]

AF is not normally an emergency, even if it may feel as though it is to you if your HR is controlled and you are taking anticoagulants, which if you have had a cardioversion earlier this year I assume you are.

You would normally contact your GP and ask for a referral back to secondary care outpatient Cardiologist or EP clinic, but you may have a long wait. You could ask your GP to write to secondary care and ask for guidance, that often works. If you have the number of an outpatient clinic then I would ring that number and if there is an Arrythmia Nurse Specialist then ask to speak to them.

Seek medical urgent medical attention ie: 999 if you have chest pain, your HR exceeds 120 for more than 24 hours, you have blackouts and/or feel very ill. Having watched the news tonight I wouldn’t want to be near a hospitals if you can possibly help it but it always depends on where you live?

NHS is under tremendous pressure at the moment so my advice would be, if you can afford it, seek a private appointment with an EP in your area. At least you would then be able to have a consultation for treatment options and if need be, you can ask the specialist to refer you back to the NHS for treatment. That normally is the most efficient method of getting to speak to someone qualified to give expert advice. Your GP will be restricted in what they can prescribe without specialist input.

[Bramley01 in reply to CDreamer]

Thanks for your reply, I'm symptomatic and hr 150, so came to the hospital, luckily admitted quickly, just waiting for Dr's ward round for plan

[JOY2THEWORLD49]

Hi

Bisoprolol didn't do much and CCB Diltiazem great for reducing heart rate within 2 hours.

Perhaps go to a&E and ask for some CCB. Calcium Channel Blocker.

180mg 1/2 dose was too high. Settled on 120mg Diltiazem AN Bisoprolol 2.5mg at night.

Cheers JOY. 74. (NZ)