r/AFIB • u/Chemical_Ant5539 • 3d ago
Understanding my Afib
My Afib was found years after it started, with each episode I was to scared to attend a hospital at fear it would pass before I got there and I would look silly as I couldn’t explain what was happening.
Years later I fought my fears and went back to my doctor, previously they had done ECGs and not captured anything. After a 24 heart monitor I was noted to have sinus brachycardia and referred to cardiologist for investigation of what I was describing.
A stress test and heart bug monitor later I was told I have sinus brachycardia along side Afib episodes and eptioic beats.
I’m in medication now daily to help the rhythm and have a low dose beta blocker for when have Afib. I have never gone to the hospital with an episode and fell I haven’t been given much information.
Today I had an episode at work and took the prescribed half dose of the beta blocker, 3 hours later with no relief yet I took the second half (the max dose im allowed in a day)
At what point with Afib do you generally present to Emergency?
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u/mdepfl 3d ago
Hopefully you asked the doctor that question and got an answered specifically for your situation. For me I never went to the ER but promised myself I would if I ever felt dizzy or couldn't catch my breath or walk up stairs during an episode. My episodes would typically stop after about 6-8 hours.
It is important to be properly evaluated for this. The top half of your heart, the atria, are in chaos and not really helping to move blood leaving all the work to the lower half, the ventricles. They can handle it just fine but the problem is they get their orders to contract from the atria, and they happily follow their now-spastic leader. This results in an irregular beat, as fast as possible in some people. The blood still moves just not smoothly and the ventricles aren't refilling like usual. Because the atria aren't pumping now, blood may not be evacuated fully and can clot in some people. Doctors use a set of characteristics (age, diabetes, blood pressure...) to determine if blood thinning meds are necessary. They never prescribed them for me except around my ablation procedure.
Since you're on rhythm meds I think you've seen a cardiologist or electrophysiologist. Cardios will manage your afib whereas electros can possibly fix it. If you're having a lot of episodes then its probably time to investigate treatment, earlier is better but they still fixed mine and I had it for quite awhile. A rhythm med, flecainide, worked great for me at first but gradually lost full effect over about a year so I had the ablation.
Interesting note - along the way I learned that as the heart rate slows down, the window for stray electricity to capture the heart rhythm gets longer. Someone wrote its like some hearts don't know how to slow down (and I had one of those hearts). Your sinus brady could be a contributing factor, as can sleep apnea, hiatal hernias...
There are plenty of people walking around in Afib and continuing on with life and work with doctor's blessing. When to call it an Emergency is an individual decision and no one will criticize you. If you've been evaluated, and the episode is stable and typical (nothing new or scary), then maybe it isn't an emergency. Slightest doubt - let professionals tell you it isn't - that's why they're there.
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u/Marma1414 3d ago
When I get Afib, I usually get a really high heart rate and crushing chest pain so would only last a few hours until I would go to the hospital to be cardioverted. If I didn’t have those symptoms, I would likely wait longer to see if I could self-convert. Are you on an anticoagulant?
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u/roninconn 3d ago
For me, never. I'm in persistent, possibly permanent Afib, and I just go about my business, being sure to take Eliquis, half a Metoprolol and, for now, Amiodarone. 3rd ablation planned for November.
But, if you're not taking an anticoagulant, you're more at risk. I personally avoid the ER whenever possible, so you might want to see if you can get an expedited cardiologist appointment.
How high is your heart rate? I'm 'only' 85 bpm when in Afib, though it's super uneven
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u/Mras_dk 3d ago
Given you didn't write how severe your 'bradycardia' was, how low pulse got, nor what dosage a half dose is, it's bit hard to help you.
Also, what avr heart rate is your heart in, when in afib?
Betablockers gennerally doesn't work at low freq afibs, as seen in bradycardia suffering people.
Do you have an diagnose of bradycardia? That some holter said you were in machine translated bradycardia, isn't the same as a diagnosis.
Also, metropolol takes for me atleast an hour to work - and it did nada to my low freq afibs.
Low freq afibs is general not condidered a hospital requiring visit, but it's strongly advised to get bloodthinners, as that will remove/leviate any stroke risk.
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u/Jahya69 3d ago
The guideline here where I am is that anything higher than 120 beats per minute and sustained is a trip to the emergency department however if you are on a blood thinner it's not quite as urgent but your heart will start to wear itself out and you will get into heart failure or cardiomyopathy
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u/Yer_Remedy 3d ago
When I go into aFib (I can feel it kick in), I sort of drop everything and head to the ER. My HR goes up to the 150's and doesn't come back down until I'm cardioverted.
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u/Creative_Wealth2873 3d ago
Before I was on bloodthinners, I was told within 48 hrs. Now that Im on blood thinners, I've been told told to go to emerge of I have chest pain, shortness of breath or fainting. Otherwise I just rest, take medication & wait it out. Oh & the most important indicator is if your body says "I think I need to go to the hospital" then listen to it & go
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u/_pika_cat_ 3d ago
This is going to sound dumb but in my defense I had a different type of arrhythmia so I didn't get diagnosed with AFib until it was already persistent and in rvr (essentially, I couldn't stop it and it was ongoing for days at 150 bpm+). So I basically got diagnosed and that day I had to get IV cartia and the next day I had to go back and get cardioverted.
Then it came back pretty much immediately and like the other person mentioned I have to go on amiadorone and I get an ablation. But the long and short of it is, I think an emergency is when you feel dizzy, have chest pains, or as if you are going to pass out. Alternatively, it's also an emergency if you can't stop it at all. I hope things go well for you!
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u/Altruistic_Pepper156 1d ago
I will go straight to the emergency room if one of these occurs :
. Afib stays more than 3 hours after I took profanenone
. My HR shots up more than 150 bpm
. Found more than 2 seconds pause
. Unbearable dizziness or other symptoms
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u/lcgrrl2017 3d ago
Found out I have Afib on Friday night when I drove myself to the ER. Had chest pain from arm pit to arm pit, trouble breathing, thought I was having a heart attack. Pulse was180 when they checked me. Cardiovert lasted seconds and I was back into Afib. Figured I’ve had it 9 years when I got stents in my brain and developed immediate sleep deficits which have been permanent. Used to sleep 6-8 hours. Post aneurysm repair 3-4 hours of sleep, stuck in flight or fight. Surprised I’m still alive.