You walk into emergency with 187 BPM, they say you have Afib, and pump you full of drugs to lower your heart rate.
It was my first. At what point do they perform carioreversion? I was in the hospital 2 days while they waited for return of sinus rhythm. Dont they do reversion in the emergency dept within hours???
I meant electrical reversion
Cardioversion to restore NSR needs you to be anticoagulation for a period prior , I believe. I've never been offered one ,even at my worst.
If you are back in nsr, they will want to see if medication helps.
It's a horrible feeling to know your heart is being crazy 🤪 but it can be controlled and is not fatal ( although special attention to reduce any stroke risk factors is necessary ,of need be)
You will find a lot of good solid advice on here.
Take care x
I’ve never been offered cardioversion either - for that they need an anaesthetist and a cardiologist and you need to be anticoagulated for I believe at least 2 weeks. Different hospitals in different countries will have different protocols and available resources so experiences may differ. I can only speak for UK.
AF is not normally considered an emergency here in the UK but high heart rate over an extended time is a concern. If it was your first experience of AF it can come as quite a shock. Suggest you read as much as you can, look at lifestyle factors and see if you can get an appointment with a cardiologist specialising in arrhythmias asap.
If you go to the AFA main US site you can pick up a lot of information so that you can ask questions.
Good luck.
All hospitals are different in how they cope with patients in a high AF rate. One member here has had countless cardioversions, she goes to A&E and is soon cardioverted back into normal sinus rhythm, can't remember the exact number but she has had something like 25. I was once cardioverted after being in hospital with high rate AF for a week, that was my first experience of one. Since then I've had quite a few more but always had to wait at least 4 weeks before being cardioverted. Then there came a time after having two within a year and still going back into AF I was told I wouldn't be offered anymore. I was devastated and have now been in constant AF since 2019.
Fortunately once my heart became used to being out of rhythm the rate dropped and now flits between 60-90bpm. Far better to cope with than paroxysmal attacks and heart rates going up to 200.
Before all this happened I had been given 3 ablations. They didn't work for me and my EP discharged me from his care saying I was one of the people that weren't helped by them.
Sorry my words can't help more.
I now watch what I eat and avoid any food containing artificial additives.
Hope you manage to get more help next time.
Jean
Hi there Jean, when you say your in AF permantly do you actually mean you have a constant irregular heartbeat?
What’s the difference please?
Yes, in general it constantly flips between 60 to 90 bpm at rest. Sometimes it will also drop briefly to 50's.
Jean
I suffer from AF. A friend of mine did not know that he had AF. He went for a heart check up and they did an ECG. He heart was in AF. He spent 2 days in hospital and was prescribed blood thinners. He has to wait 2 weeks before he has the Cardioversion.
I believe what you experienced appears to be normal practice.
Best of luck and hopefully you have gone back into Sinus Rhythm.
You need to be on blood thinners for 4 weeks before a cardioversion in case of stroke.
Only if you know exactly when you went into AF can they perform a cardio version on diagnosis because as others have said otherwise you need anticoagulants. It has to have started 48 hours or less before the cardio version otherwise.I was very lucky as I knew exactly when mine started so it was done the same day and lasted 4 weeks. Next time it reverted spontaneously while I waited for a second cardio version, which I never needed.
Any new illnesses comes as a shock, I hope all goes well for you.
sorry to hear that . I have had 3 episodes of AF with same rate as you and rapid ventricular response . The only time cardioversion was mentioned was on the cardiology ward the first time but I went back into sinus myself.
The second twice although anticoagulated for ages it was never mentioned but I was in a&e each time 24 hours. I think the a&e doctors wouldn’t cardiovert you unless it was an emergency , that seems to be the case at my hospital, they wouldn’t do it they would try and get you a bed on a cardiology ward ( which are as rare as hens teeth) and the cardiologists would do it
I was admittedl four times at the start of my Journey. They just gave me a tablet and waited for me to return to sinus , then discharged me. I was fine for quite a few years but this last month it’s been all over the place .The Dr upped my meds , still not great. The worse thing is waiting for the next flutter and bump in your heart. I’ve tried to get in touch with the Af nurse for a month, without success. I’m now thinking of going private just to be able to talk to someone. I try not to panic but it does make me really anxious. Best wishes to you Keep safe.
Being anxious doesn’t help, I did a post on her a few weeks back 8:episodes in 16 days generally after lunch. Then so far a week and nothing,,,no idea why. I have a dr appt this week to advise them but honestly all they will do is refer me if that…I will get an appt in a year..by phone….and will say if you feel fine it is what it is,..I am in flecanide , . Only if you have other problems,,,breathing,,tightness et etc should you worry then that’s a 999. Otherwise join the chosen ones and stop worrying…millions of us across the world have it. If still anxious check out the York cardiologist on YouTube,very reassuring. It’s not a life sentence and it won’t kill you…unless as someone said you have a stroke and aren’t following that advice
I was only in A&E for about 2 hours when they were going to cardiovert me but I was already on anticoagulants having had a pulmonary embolism 4 weeks earlier. Everything was there ready when my heart reverted on its own. Half an hour later I was sent home. It was all quite surreal.
I had been out for the day, got home, felt peculiar, took my pulse and B/P which were both high. Phoned 111 and was told to get to A&E immediately. At A&E had obs taken and ECG then wheeled to Resus.
Sat for a while being monitored, told they were going to shock me, heart went back then sent home. Whole thing took about 4 hours!
Staff were great but I wasn’t given any information except that I should come back if it happened again.
Saw diagnosis on my NHS app notes.
I have since had echocardiogram and seen cardiologist but the best information I have had has been here.
So far only had one episode of raised pulse but no accompanying dizziness so I stayed home and it passed after about an hour.
Wil remain on anticoagulants forever but no other treatment at present.
I have had P/A/F now for over 20 years, several visits and stays in hospital but only once have I been offered a cardioversion and that was a week after an ablation. I travelled a good hour to get to the hospital, gowned up and all was ready and I reverted back into sinus on my own, typical of my irritable heart! I think it was the thought of them stopping my heart and then starting again, my heart said NO lol
I’ve had to wait 9 months for cardio version which I’m due to have tomorrow .
Don't worry about this procedure. You will feel amazing after it is done and you are back to sinus rhythm
Thank you. I’m so ready for it! Because if this forum I have no worries about it. 😄
There is a video link out there somewhere where the renowned Professor Richard Schilling explains certain aspects of Afib episodes & symptoms. I specifically remember him saying that of itself an elevated heart rate during an Afib episode is not necessarily a dangerous symptom nor heart damaging, I suppose this is provided the episode and HR is resolved within a reasonable timeframe.
I remember him referencing marathon runners etc. who may have elevated HR for many hours without issues or damaging the heart. Nonetheless, where apparent, rate control appears to be the first thing addressed at A&E.
Yes, I’ve read some of his stuff, whatever he says is good in my book
Call me naive, but having worked with doctors for many years, I tend to trust them, as trained and experienced experts, to treat me safely and most especially so in an emergency. If there's any risk of thrombosis inside the atria, caused by AF, then a CV has the potential to be dangerous.
Steve
Welcome to the forum. It is devastating when you are first diagnosed and shocking. Like yourself, no one explained this condition properly to me in the hospital when l was first diagnosed, but they still know what they are doing. If it wasn’t for this forum l would still be thinking my life was over. Read, read and more reading for your reassurance. You will get lots of support on here from caring people.
My experience is anticoagulant for 6 weeks before cardioversion unless you’re already on anticoagulant.
This to eliminate any chance of stroke from clot whilst undergoing cv.
I’ve had 3 cv’s over 3 year period. Since I was on anticoagulant for life since first cv (I was approaching 65th birthday) any delay for cv’s 2 & 3 were simply due to NHS waiting times in my area. N Ireland.
When I was first diagnosed with Afib it was after being prescribed an anti-biotic that did not agree with me and caused continuous vomiting culminating with vomiting little flecks of blood. I phoned my GP, went straight there, my BPM was 140 and the ECG showed Afib. She immediately sent me off to a Cardio. By the time I got to him I was in NSR, but he kept me for two nights in the cardio ward. When I left he just prescribed me Biso and no anti-coag. and told me to watch my pulse,because I was symptomless and to go to my GP for an ECG if it went over 100. A few months later it went up, ECG showd Afib and he instructed GP to prescribe Warfarin and he would see me in a week. At that appointment he said I was in A fib, and asked if I would like a cardioversion. and I said 'Yes'. I was admitted to the cardio word and had the simple procedure that afternoon, Fortunately, my son had driven me to my appointment as the parking at the small hospital was awful, so I had a lift home. I have been on an anti-coagulant since - he had wanted to be sure it was not just a one off before prescribing. This was in South Africa.
When I was taken to A&E with very fast heart rate I was told it Afib, I was put on anticoagulants and referred to Cardiology. I was booked for a Cardioversion but not for two months as anticoagulant had to be in my system a while before the procedure. Unfortunately the procedure only lasted two months and I’m now in permanent AF, I wear a medical alert bracelet saying I’m on Apixaban and in AF as I worried a nurse who tried to take my pulse until I told her I was permanently in AF.
My first time I was cardioverted on.second day but mainly coz I had a visiting Hungarian cardiologist who overruled everyone else. Subsequent episodes at same hospital I was in hospital 10 days, discharged still in afib, but drugged, only to be readmitted after I collapsed for another seven days THEN they did the cardioversion! Next time, same thing, more drug combos and kept in for seven days, discharged in afib and told I'd be cardioverted when COVID was over (this was march 2020). Private consultation got me an NHS cardioversion five weeks later ( had to wait for anticoagulants to get.in.my system.
Since then I always go the big teaching hospital an hour away, tell them my history and that the drugs never work. They listen and perform cardioversion within three to 16 hours depending how busy the A&E is!!! Now had nine more at that hospital!!
At the local hospital a cardioversion is a big deal, operating theatre to s of staff. At the big hospital they zap you with between 2-5 people in a resus bay (or even on the ward once in an emergency).
no they won’t do a cardioversion unless you have been on anticoagulants for a few weeks.
If it is a real emergency then they will have to do a special scan which looks for blood clots in and around your heart before any cardioversion can be performed
They always try medication first
All the best.
where I live in Canada, if you are already on AFIB meds, and present with 12 hrs of high HR, they try chemical conversion for 2 hrs, and if it’s doesn’t work, they call the electro-conversion team, and they convert you back into NSR. This exactly happened to me last month. The first time it happened 3 years ago, the chemicals worked…after 6 hrs…I’d rather be “zapped” right way, but that’s not their protocol.
I’ve been to A&E several times with my AFib, as I always got high heart rate and blood pressure. They have never given me a cardioversion, just drugs. Hopefully won’t need to again, as long as this ablation keeps the awful AFib away.🤞🤞
I was told I had to be on anticoagulants for 4 weeks before cardioversion if I didn't spontaneously go back into normal rhtym, and was kept in hospital until my heart rate was under 100bpm - I spent about 12 hours there.
I then had to wait for months for a cardioversion because the hospital was short of cardiologists. But 9 months later I had a cardioversion, which lasted me 3 years 8 months, before another episode. Some people seemed to waited a much shorter time though.
People have different triggers for episodes. Like leanjeannie50 I avoid artificial additives - before both AF episodes I had lapsed and eaten things containing them.
Hope you don't have too long a wait.
Symptoms of AFib
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Afib?
Travel while in Afib
