I have been in afib for 14 hours . Rate from 49 to 117 beats a minute. I am taking 50 mg of flecanide twice a day and 2,5 bisprolol.
Should I go to emergency room with those rates. I feel anxious. I usually get in rhythm in 2 hours but this one is lasting. Hi
They like to see your resting rate controlled at 110 bpm or under, so you're almost there.
Can you contact your doctor about taking an additional PIP (as needed) dose of Flecainide and/or Bisoprolol?
Of course, if you feel chest pain, shortness of breath, feel like fainting, or otherwise unsafe do not hesitate to go to the ER.
Jim
Thank you..
Also the way to measure your heart rate in afib is to count the beats for a full minute, or at least half a minute. Anything less and you may get a false value because of the irregularity.
Ideally, you would do this with a home EKG device like Kardia or Apple Watch , but you also may be able to compute the rate by finding the pulse at wrist or neck. Many home blood pressure devices and oximiters will give inaccurate readings if you are in afib.
Jim
Are those rates from a heart rate monitor instantaneously?
Instantaneous heart rate readings are not much use when in AF and you need to find the average by counting the beats as Jim said.
I replied to a similar question recently here : healthunlocked.com/afassoci...
117 is just under 2 beats in a second and 49 is just under 1 beat (0.8) when measured instantaneously and quite normal in my experience of AF episodes.
Best wishes
If you have any chest pain, dizzyness or short of breath then yes go. Otherwise relax at home and stay well hydrated. Your AF burden sounds very low and here in UK you would just be left under observation for a short while before being discharged. As one of our members once commented "If I called for an ambulance every time I had AF I would have one stationed outside my house permanently. "
Thanks for your information ..
maybe 200mg of flecanide ? My ep said I should take this when I have a af episode? But please speak to your ep First
Ask your cardiologist, assuming no other comorbidities, to sanction 200mg Flecainide per day. All I can say it worked in my case after 9 episodes of varying lengths in a month.
you being anxious won’t help the hr, in my opinion your heart rate isn’t high at all. I was in paroxysmal af for a few years and now in persistent with controlled resting hr. I was anxious to but now just get on with it, your body adapts to the change. Just settle and get it to under 110 at rest and you will be fine. Only my opinion
If you have an episode of AFib,the normal dose of fleacainide is 300mg in one go and a beta blocker like Metoprolol.
If it then continues for 8 hours after taking the big dose of flecainide,then go to Emergency at your nearest hospital.
I've done this twice & worked a treat,only alternative,was cardioversion, which I've gone through,3 times
If you get a breakthrough episode you should take 100mg as a pip which stops the episode in a few hours and you would not be exceeding the daily maximum of 300mg! I did that for a while but as breakthrough episodes continued to occur I have been on 100mg twice daily which has put an end to episodes ( just one around the time I must have been infected with covid with no other symptoms but a positive test, ended with an extra 100mg). No need for hospital visits.
Hello Vonnegut. Thank you for your advice for Duckey, just a reminder everyone experiences AF differently. The PIP is a treatment option but must be explained, discussed and agreed upon an individual basis via their own doctor as it may not be suitable for everyone.
Many thanks for your support.
TracyAdmin
The approach my cardiologist advises is to take an extra dose of 200 mg. That should stop your AF within 3 to 4 hours. Better still is to take the extra dose within half an hour after the breakthrough. Just be careful not to exceed 400 mg. in 24 hours
Thank you for your post, if you have tried to control the symptoms and taken all the necessary precautions you would normally take, but continuing to experience severe symptoms, such as feeling very breathless or having difficulty in catching your breath or presenting painful chest pain then you should seek medical advice. As you have described you would usually expect to revert back into NSR after 2 hours, on this occasion medical advice is recommended.
Kind regards
TracyAdmin
If it helps put your mind at rest at all my wife was regularly in AFib (often + Flutter too) at 150-170bpm for a few hours and we'd been told repeatedly by different doctors to attend ER (A&E here in the UK) if it continued at such high rates for >4 hours. We used to do this and her episodes got more frequent and longer but the emergency dept often didn't do much if anything - we'd spend majority of time in waiting rooms on many occasions and then go home when it self reverted to NSR. At times we did see a doctor they were often dismissive or just suggest she took additional diltiazem (which we realise isn't an ideal attitude), or they'd try digoxin with no effect.
Eventually a private specialist cardiologist (who was investigating and planning ablations) said it wouldn't really matter if the heart continued at that rate for a fortnight if there were not any significant symptoms (e.g. breathlessness). So, we stopped worrying so much and then recently only went to A&E after it had been at 150bpm 24x7 for 14 days. [As an side, then they switched back to bisoprolol again, which she was previously intolerant to due to it sending BP very low, and she now puts up with BP around 90/50 most of the day and gets by okay with a controlled heart rate & rhythm - fingers crossed]
So I guess if it isn't causing you too many problems then don't worry and it'll hopefully stop soon. As others said - if you get pains or problems then just go to ER immediately.
I would go and get checked out! I have gone before and it did work out for me , you feel a lot better getting professional help!
My opinion for what it’s worth is that your HR is not high enough to cause alarm. If you should have symptoms such as dizziness, shortness of breath or chest pain always regardless of in a fib or not go to the ER. Biggest piece of advice is IGNORE those telling you how to adjust your medication! Even if they are EPs they do not have your records in front of them! It is absolutely inappropriate to ever advise someone regarding medication unless you are their physician . That being said, call you Dr.
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