Re: Urgent need for conversion - what am I missing?

March 19, 2004

In a message dated 3/19/04 11:15:45 AM Eastern Standard Time,

ColonelBlip@... writes:

Snip

My question - I read here where folks go into afib and might rush off

to the ER or have their cardio doc want to put them on something in

addition to an anti-coagulant immediately. Why? As I understand it

afib is not life threatening if one can avoid a stroke. What am I

missing. Currently my intention, assuming my symptoms don't change,

is to continue with warfarin (until and unless something better comes

on the scene) for the rest of my life and avoid surgery or

pharmaceutical treatment. But then, maybe there is something about

this condition that prompts such urgency that I am missing.

I really appreciate the existence of this group and I welcome your

comments.

******************

I think its a matter of personal preference weather to go to the ER or not.

My longest afib attack has been 9 hours. I have had afib since my early 20's

but just diagnosed at 47 almost 3 years ago. Since then I have gone into afib

around 10 times and had many medication changes. I have not gone to the ER

on all occasions but have on several. I go in the hopes of a faster conversion

with the meds. I have had a problem just recently with an embolism to my

eye. The tests all came back good and they can't say it was from the afib but

they said IM an afib patient and they are leaning that way. The theory is 48

hours before you produce a clot but that is not in stone so I tend to take more

precaution now.

a in Massachusetts 49 NSR Sotolol 85 x 2 Adult Aspirin

March 19, 2004

For me, as one who has long running NSR to the point I am off of

Coumadin, If I go into afib I need to be converted within a short time

(my doc says 18 hours, preferably), or I would have to go on Coumadin or

have a TEE before the cardioversion.

For this reason, if and when I do go into afib, I don't eat (in case I

will be having the anesthesia for cardioversion later), and plan to go

to the office or ER within that period if I don't revert on my own. This

happens once every 1.5 to 2 years.

Bobby

colblip wrote:

> My question - I read here where folks go into afib and might rush off

> to the ER or have their cardio doc want to put them on something in

> addition to an anti-coagulant immediately. Why? As I understand it

> afib is not life threatening if one can avoid a stroke. What am I

> missing. Currently my intention, assuming my symptoms don't change,

> is to continue with warfarin (until and unless something better comes

> on the scene) for the rest of my life and avoid surgery or

> pharmaceutical treatment. But then, maybe there is something about

> this condition that prompts such urgency that I am missing.

>

March 19, 2004

I have a new cardio and his thinking is go to ER if you are feeling

uncomfortable with the a-fib. This at least gives me something to

base my decision on whether to go or not.

Debbi, OU Alum in OKC

********************************************************************

> My question - I read here where folks go into afib and might rush

off

> to the ER or have their cardio doc want to put them on something in

> addition to an anti-coagulant immediately. Why?

March 19, 2004

Unfortunately, with afib, everyone can respond differently to

triggers and severity. I think some doctors err on the side of

(ultra) caution or perhaps expediency. Yes, afib is usually not life-

threatening, but until one is tested to rule out underlying issues

some doctors may " jump the gun " a bit. I see, after a few months

you're on warfarin therapy. I had afib episodes for two years before

my Dr. put me on coumadin therapy. Different stokes for different

folks (VERY bad pun, sorry)..

I also think that most people tend go to an ER when first confronted

with a major afib attack. I know I did. It can be a scary

experience. The urgency, in my case, really had more to do with

fear. Shortly after my first episode in 2001 I was fully cheked out

by my cardiologist. I was told to take a full aspirin a day and if I

had an episode to take a cardizem. That worked for a few years,

until I went into permanent (but rate-controlled) afib.

Even in chronic afib, my doctor gave my the option of staying in

rate-controlled afib (but he did begin coumadin therapy). I chose to

try an anti-arryhtmic, flecainide, which has returned me to nsr.

Personally, I think that if you sense your doctor is not listening

to you, or you get the feeling he's more concerned about his/her

golf game, or not explaining options to you, or rushing you into

treatment (assumimg it's not life-threatening)then it's probably a

good idea to look around for a better doctor.

> AFib

>

> Friday, March 19, 2004

> 9:53 AM

>

> Maybe I am missing something here or I am just fortunate. I have

afib

> (diagnosed about 8 months ago but I suspect I had it for longer,

just

> happened to catch it during an exam). I am on warfarin (10mg/day)

and

> have an INR about 2.1.

>

> I've been doing my own 'what triggers this stuff' diagnoses for a

> while and have identified the following as APPARENT triggers for

me:

>

> 1. Drinking/eating something very cold (especially when reclining)

>

> 2. Jogging (walking 3.5 mph for 30 minutes has no effect).

Sometimes

> jogging will cause me to convert to NSR as well.

>

> 3.Ginseng

>

> I've also dropped caffeine and even non-caffeinated coffee to see

if

> it has any effect on longer term NSR maintenance. Likewise I've

> dropped back on some other herbal type stuff just to keep from

> confusing the issue, although there was no indication these had

any

> effect.

>

> Typically when I go into afib it might last a day (longest has

been 5

> days). So far I auto-convert (i.e. it just happens). While afib is

a

> bit uncomfortable it is not debilitating in my case. So far it has

> not stopped me from doing anything, including jogging. However

when I

> jog with it I do have to stop and walk more frequently and can't

jog

> as long in a single stretch.

>

> My question - I read here where folks go into afib and might rush

off

> to the ER or have their cardio doc want to put them on something

in

> addition to an anti-coagulant immediately. Why? As I understand it

> afib is not life threatening if one can avoid a stroke. What am I

> missing. Currently my intention, assuming my symptoms don't

change,

> is to continue with warfarin (until and unless something better

comes

> on the scene) for the rest of my life and avoid surgery or

> pharmaceutical treatment. But then, maybe there is something about

> this condition that prompts such urgency that I am missing.

>

> I really appreciate the existence of this group and I welcome your

> comments.

March 19, 2004

Unfortunately, with afib, everyone can respond differently to

triggers and severity. I think some doctors err on the side of

(ultra) caution or perhaps expediency. Yes, afib is usually not life-

threatening, but until one is tested to rule out underlying issues

some doctors may " jump the gun " a bit. I see, after a few months

you're on warfarin therapy. I had afib episodes for two years before

my Dr. put me on coumadin therapy. Different stokes for different

folks (VERY bad pun, sorry)..

I also think that most people tend go to an ER when first confronted

with a major afib attack. I know I did. It can be a scary

experience. The urgency, in my case, really had more to do with

fear. Shortly after my first episode in 2001 I was fully cheked out

by my cardiologist. I was told to take a full aspirin a day and if I

had an episode to take a cardizem. That worked for a few years,

until I went into permanent (but rate-controlled) afib.

Even in chronic afib, my doctor gave my the option of staying in

rate-controlled afib (but he did begin coumadin therapy). I chose to

try an anti-arryhtmic, flecainide, which has returned me to nsr.

Personally, I think that if you sense your doctor is not listening

to you, or you get the feeling he's more concerned about his/her

golf game, or not explaining options to you, or rushing you into

treatment (assumimg it's not life-threatening)then it's probably a

good idea to look around for a better doctor.

> AFib

>

> Friday, March 19, 2004

> 9:53 AM

>

> Maybe I am missing something here or I am just fortunate. I have

afib

> (diagnosed about 8 months ago but I suspect I had it for longer,

just

> happened to catch it during an exam). I am on warfarin (10mg/day)

and

> have an INR about 2.1.

>

> I've been doing my own 'what triggers this stuff' diagnoses for a

> while and have identified the following as APPARENT triggers for

me:

>

> 1. Drinking/eating something very cold (especially when reclining)

>

> 2. Jogging (walking 3.5 mph for 30 minutes has no effect).

Sometimes

> jogging will cause me to convert to NSR as well.

>

> 3.Ginseng

>

> I've also dropped caffeine and even non-caffeinated coffee to see

if

> it has any effect on longer term NSR maintenance. Likewise I've

> dropped back on some other herbal type stuff just to keep from

> confusing the issue, although there was no indication these had

any

> effect.

>

> Typically when I go into afib it might last a day (longest has

been 5

> days). So far I auto-convert (i.e. it just happens). While afib is

a

> bit uncomfortable it is not debilitating in my case. So far it has

> not stopped me from doing anything, including jogging. However

when I

> jog with it I do have to stop and walk more frequently and can't

jog

> as long in a single stretch.

>

> My question - I read here where folks go into afib and might rush

off

> to the ER or have their cardio doc want to put them on something

in

> addition to an anti-coagulant immediately. Why? As I understand it

> afib is not life threatening if one can avoid a stroke. What am I

> missing. Currently my intention, assuming my symptoms don't

change,

> is to continue with warfarin (until and unless something better

comes

> on the scene) for the rest of my life and avoid surgery or

> pharmaceutical treatment. But then, maybe there is something about

> this condition that prompts such urgency that I am missing.

>

> I really appreciate the existence of this group and I welcome your

> comments.

March 19, 2004

My 2 cents: If you determine that you are in an irregular heart

rhythm, how do you know it's AFib? What if it's something that is

potentially more serious ... or even if it is AFib, what if the Afib

is an indicator of something else going on with your heart? Make your

own diagnosis? Not me. I choose the let the docs make the diagnosis.

Sometimes time is precious when dealing with the heart.

The other major reason to go right to the ER (from what I have read

and heard) is that the sooner that anti-arythmic drugs are tried for

it, the better the chances are of converting back to NSR.

Just my 2 cents.

Larry

> My question - I read here where folks go into afib and might rush

off

> to the ER or have their cardio doc want to put them on something in

> addition to an anti-coagulant immediately. Why? As I understand it

> afib is not life threatening if one can avoid a stroke. What am I

> missing. Currently my intention, assuming my symptoms don't change,

> is to continue with warfarin (until and unless something better

comes

> on the scene) for the rest of my life and avoid surgery or

> pharmaceutical treatment. But then, maybe there is something about

> this condition that prompts such urgency that I am missing.

>

> I really appreciate the existence of this group and I welcome your

> comments.

March 19, 2004

>

> My question - I read here where folks go into afib and might rush

>off to the ER or have their cardio doc want to put them on something

>in addition to an anti-coagulant immediately. Why?

........................................

Everybody's symptoms are different. Some people don't even know

they're in afib, others know but have very mild symptoms. But other

people, like myself, are extremely symptomatic. Once I felt myself

passing out and fought to stay conscious.

A couple of times I had chest pain and had to take nitroglycerin. At

all times I'm short of breath, dizzy and extremely uncomfortable. So

you see, for me, the decision to go to the ER, within 48 hours, is an

easy one. Before my first cardioversion I had to wait for a month to

get my coumidin levels within range. While waiting for the

conversion I had some work that had to get done and I had to sling

around 100# bags of shelled corn. Let me tell you, it's not easy

handling that when you're in NSR let alone while you're in afib.

That's why, for me, I take the drugs and am planning a PVI.

P <Michigan>

March 19, 2004

>

> My question - I read here where folks go into afib and might rush

>off to the ER or have their cardio doc want to put them on something

>in addition to an anti-coagulant immediately. Why?

........................................

Everybody's symptoms are different. Some people don't even know

they're in afib, others know but have very mild symptoms. But other

people, like myself, are extremely symptomatic. Once I felt myself

passing out and fought to stay conscious.

A couple of times I had chest pain and had to take nitroglycerin. At

all times I'm short of breath, dizzy and extremely uncomfortable. So

you see, for me, the decision to go to the ER, within 48 hours, is an

easy one. Before my first cardioversion I had to wait for a month to

get my coumidin levels within range. While waiting for the

conversion I had some work that had to get done and I had to sling

around 100# bags of shelled corn. Let me tell you, it's not easy

handling that when you're in NSR let alone while you're in afib.

That's why, for me, I take the drugs and am planning a PVI.

P <Michigan>

March 19, 2004

>

> My question - I read here where folks go into afib and might rush

>off to the ER or have their cardio doc want to put them on something

>in addition to an anti-coagulant immediately. Why?

........................................

Everybody's symptoms are different. Some people don't even know

they're in afib, others know but have very mild symptoms. But other

people, like myself, are extremely symptomatic. Once I felt myself

passing out and fought to stay conscious.

A couple of times I had chest pain and had to take nitroglycerin. At

all times I'm short of breath, dizzy and extremely uncomfortable. So

you see, for me, the decision to go to the ER, within 48 hours, is an

easy one. Before my first cardioversion I had to wait for a month to

get my coumidin levels within range. While waiting for the

conversion I had some work that had to get done and I had to sling

around 100# bags of shelled corn. Let me tell you, it's not easy

handling that when you're in NSR let alone while you're in afib.

That's why, for me, I take the drugs and am planning a PVI.

P <Michigan>

March 19, 2004

My husband was in the ER three times last year due to A Fib. The

first time it was because there was a blockage in an artery and when

they put the stent in he converted to sinus rhythm. The second time

it turned out he was very anemic and it caused him to go into A Fib.

After two pints of blood his heart converted again to sinus. The

third time they did a cardioversion. This was last June and he has

had some A Fib which will last a couple of hours and have converted

on it's own but just this week it happened again and didn't stop. We

went to the ER and they converted him. I don't take a chance with

him because you never know if there is something that must be checked

out.

I should mention that I have had A Fib for 4 years and take

amiodarone and have a pacemaker. I still get small runs which

convert on their own and have only been to the ER once when I was

being diagnosed. The only cardioversion I have had was in the EP lab

when they put in the pacemaker. It is different for everyone but

better to go in and make sure there is no underlying problem.

JanMarie

> AFib

>

> Friday, March 19, 2004

> 9:53 AM

>

> Maybe I am missing something here or I am just fortunate. I have

afib

> (diagnosed about 8 months ago but I suspect I had it for longer,

just

> happened to catch it during an exam). I am on warfarin (10mg/day)

and

> have an INR about 2.1.

>

> I've been doing my own 'what triggers this stuff' diagnoses for a

> while and have identified the following as APPARENT triggers for me:

>

> 1. Drinking/eating something very cold (especially when reclining)

>

> 2. Jogging (walking 3.5 mph for 30 minutes has no effect).

Sometimes

> jogging will cause me to convert to NSR as well.

>

> 3.Ginseng

>

> I've also dropped caffeine and even non-caffeinated coffee to see

if

> it has any effect on longer term NSR maintenance. Likewise I've

> dropped back on some other herbal type stuff just to keep from

> confusing the issue, although there was no indication these had any

> effect.

>

> Typically when I go into afib it might last a day (longest has been

5

> days). So far I auto-convert (i.e. it just happens). While afib is

a

> bit uncomfortable it is not debilitating in my case. So far it has

> not stopped me from doing anything, including jogging. However when

I

> jog with it I do have to stop and walk more frequently and can't

jog

> as long in a single stretch.

>

> My question - I read here where folks go into afib and might rush

off

> to the ER or have their cardio doc want to put them on something in

> addition to an anti-coagulant immediately. Why? As I understand it

> afib is not life threatening if one can avoid a stroke. What am I

> missing. Currently my intention, assuming my symptoms don't change,

> is to continue with warfarin (until and unless something better

comes

> on the scene) for the rest of my life and avoid surgery or

> pharmaceutical treatment. But then, maybe there is something about

> this condition that prompts such urgency that I am missing.

>

> I really appreciate the existence of this group and I welcome your

> comments.

March 19, 2004