Re: When Would I Go To The Hospital?

June 28, 2004

Greetings.

Your scenario was very similar to mine. I believe that you should go, as

there is the potential of stroke, and all of your internal organs are being

taxed

by the afib. My doctor eventually let me convert myself using a 250 mg dose of

Tambocor. This was effective within about 45 minutes.

This response assumes that it takes hours before you self convert. After

2 ablations, I am med. free and afib free.

Best wishes,

June 28, 2004

,

I am one of those that goes to the ER immediately when an attack starts as I

also have a very high heart rate while in afib (230) also my BP went very

high, usually I have a low BP 100/80. I am now on atenelol and hoping when my

next attack occurs my hear rate would not be quite as high. You mentioned the

potential risk of stroke, is there a risk before 48 hrs or is there a risk

sooner

due to the high heart rate?

Congratulations on being afib free!

Kathy in CT.

(40 yo)

June 28, 2004

>>is there a risk before 48 hrs<<

My cardiologist told me to only wait 12 hours before going to the ER as,

according to him, that is when the risk of stroke increases. Guess it has

something to do with the amount of time it takes for a clot to form. Not

sure which answer is right but I wait 12 hours, if I am not converted by

then I go to the ER.

Barbara Kersten

Lothlorien Goldens

Lorien@...

http://www2.bccom.com/lorien/index.htm

Cassie, Jewel & Harry

Lori, Beren, Gilly, Junior & Arrie waiting at The Bridge

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

Consult a doctor on when to go but IMO if you ever feel faint or have

a heart rate that high, GO

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

Consult a doctor on when to go but IMO if you ever feel faint or have

a heart rate that high, GO

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

Consult a doctor on when to go but IMO if you ever feel faint or have

a heart rate that high, GO

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

Hi, Elise,

You need to talk to your doc to get guidelines about what to do, but

with a heart rate that high, I think you should either go to the ER

or to the doctor's office. I don't know about the stroke risk that

someone else mentioned for this case, but I would imagine you'd be

faint and miserable. Also, if it persists for long enough (days,

weeks, not sure) it will temporarily stretch the heart.

You should be on meds, like a beta blocker, perhaps, to keep your

heart rate down when you're in afib.

June 28, 2004

> > A month ago I had my first AFIB attack, where my heartbeat was

250

> > per minute. I had to call 911 as I felt faint and didn't know

what

> > it was.

> >

>

> Hi, Elise,

>

> You need to talk to your doc to get guidelines about what to do,

but

> with a heart rate that high, I think you should either go to the

ER

> or to the doctor's office. I don't know about the stroke risk

that

> someone else mentioned for this case, but I would imagine you'd be

> faint and miserable. Also, if it persists for long enough (days,

> weeks, not sure) it will temporarily stretch the heart.

>

> You should be on meds, like a beta blocker, perhaps, to keep your

> heart rate down when you're in afib.

This is Elise ... I am on Atenolol and Digoxin. I was told that if

I had another attack (likely to happen) the rate would go down, but

if my heart is thumping like crazy in my chest I have no idea how

fast it is going and at what rate or time reference I should go to

the hospital. I know that stroke can happen after 48 hours. But

what could happen in 1 hour or 24 hours?

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

I was told by a nurse practioner, and it seemed to make a lot of

sense, that if you are alone and about to pass out, it is time to go

to the ER. The problem is that with such a high pulse rate and/or

blood pressure, a patient is at high risk of other issues.

And I don't mean to be alarmist, but I have been told by an ER doctor

and read in at least two or three places to confirm that with an over

rapid AFLUTTER it can over time degenerate into a heart attack. Erp.

I don't know about a rapid (250+) AFIB, but it seems that such a high

rate has got to be inherently unhealthy and dangerous.

When folks talk about being in permanent AFIB and sent home, I think

their rates (speed) tends to be a LOT lower.

I have read that many ER/hosptials will not let a patient go home in

AFIB unless their rate is under 100. I have no confirmation of that

fact, other than I read it in a few articles.

So... my gut reaction is that if a rate is over 150 or so, it's time

to seriously consider ER. If only to get the rate down and re-look at

meds to get it down.

Just my take on it, I'm happy to hear other viewpoints and

information on this topic!

Joscelyn

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

I was told by a nurse practioner, and it seemed to make a lot of

sense, that if you are alone and about to pass out, it is time to go

to the ER. The problem is that with such a high pulse rate and/or

blood pressure, a patient is at high risk of other issues.

And I don't mean to be alarmist, but I have been told by an ER doctor

and read in at least two or three places to confirm that with an over

rapid AFLUTTER it can over time degenerate into a heart attack. Erp.

I don't know about a rapid (250+) AFIB, but it seems that such a high

rate has got to be inherently unhealthy and dangerous.

When folks talk about being in permanent AFIB and sent home, I think

their rates (speed) tends to be a LOT lower.

I have read that many ER/hosptials will not let a patient go home in

AFIB unless their rate is under 100. I have no confirmation of that

fact, other than I read it in a few articles.

So... my gut reaction is that if a rate is over 150 or so, it's time

to seriously consider ER. If only to get the rate down and re-look at

meds to get it down.

Just my take on it, I'm happy to hear other viewpoints and

information on this topic!

Joscelyn

June 28, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

I was told by a nurse practioner, and it seemed to make a lot of

sense, that if you are alone and about to pass out, it is time to go

to the ER. The problem is that with such a high pulse rate and/or

blood pressure, a patient is at high risk of other issues.

And I don't mean to be alarmist, but I have been told by an ER doctor

and read in at least two or three places to confirm that with an over

rapid AFLUTTER it can over time degenerate into a heart attack. Erp.

I don't know about a rapid (250+) AFIB, but it seems that such a high

rate has got to be inherently unhealthy and dangerous.

When folks talk about being in permanent AFIB and sent home, I think

their rates (speed) tends to be a LOT lower.

I have read that many ER/hosptials will not let a patient go home in

AFIB unless their rate is under 100. I have no confirmation of that

fact, other than I read it in a few articles.

So... my gut reaction is that if a rate is over 150 or so, it's time

to seriously consider ER. If only to get the rate down and re-look at

meds to get it down.

Just my take on it, I'm happy to hear other viewpoints and

information on this topic!

Joscelyn

June 28, 2004

In a message dated 6/28/2004 7:55:07 AM Central Daylight Time,

elisestobbe@... writes:

A month ago I had my first AFIB attack, where my heartbeat was 250

per minute. I had to call 911 as I felt faint and didn't know what

it was.

What nobody has told me is " when do you go to the hospital " ? If I

had another attack like that, should I lie down and wait for it go

go away, go to the Emergency Room after a certain number of hours,

or what?

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

What did the ER Dr. recomend? A heart rate of 250 is entirely to high. I

would go to the ER if it was me. You might want to get a HR monitor so that you

can see how high it really is. You didn't give your age but if your HR exceeds

(220-your age) it is probably to high, you might give it another 20 bpm but

I wouldn't let it go any higher.

Guy

June 28, 2004

In a message dated 6/28/2004 9:55:11 AM Central Daylight Time,

lorien@... writes:

My cardiologist told me to only wait 12 hours before going to the ER as,

according to him, that is when the risk of stroke increases. Guess it has

something to do with the amount of time it takes for a clot to form. Not

sure which answer is right but I wait 12 hours, if I am not converted by

then I go to the ER.

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

This is because the blood pools in the atrium and may form a clot. I think

the issue here is the very high heart rate. I still recomend you talk with your

Dr. on how high you should let your HR get before going to the ER.

Guy

June 28, 2004

>I have read that many ER/hosptials will not let a patient go home in

AFIB unless their rate is under 100. I have no confirmation of that

fact, other than I read it in a few articles.

The ERs may be covering their butts legally. We seem to be coming

across a number of new items today that I think people should really

check out with their docs before they consider them things to act

on. I do remember my excellent cardio adjusting my med and sending

me home from her office when my heart rate had been 137 on the

initial ekg.

June 28, 2004

>I have read that many ER/hosptials will not let a patient go home in

AFIB unless their rate is under 100. I have no confirmation of that

fact, other than I read it in a few articles.

The ERs may be covering their butts legally. We seem to be coming

across a number of new items today that I think people should really

check out with their docs before they consider them things to act

on. I do remember my excellent cardio adjusting my med and sending

me home from her office when my heart rate had been 137 on the

initial ekg.

June 28, 2004

>I have read that many ER/hosptials will not let a patient go home in

AFIB unless their rate is under 100. I have no confirmation of that

fact, other than I read it in a few articles.

The ERs may be covering their butts legally. We seem to be coming

across a number of new items today that I think people should really

check out with their docs before they consider them things to act

on. I do remember my excellent cardio adjusting my med and sending

me home from her office when my heart rate had been 137 on the

initial ekg.

June 28, 2004

Trudy said:

<<When I asked him how this could be, because it seems illogical, he

said a healthy heart can handle this situation.>>

Thanks Trudy, for passing this along. Your situation is approximate to

mine. I'm almost 62 and the doc keeps saying asirin is all I need and

that AFib has zero effect on my life expectancy. As a one time math

major, I have to take " zero " literally and can't quite believe him. But

your information certainly helps.

- OU alum in MI

June 28, 2004

Trudy said:

<<When I asked him how this could be, because it seems illogical, he

said a healthy heart can handle this situation.>>

Thanks Trudy, for passing this along. Your situation is approximate to

mine. I'm almost 62 and the doc keeps saying asirin is all I need and

that AFib has zero effect on my life expectancy. As a one time math

major, I have to take " zero " literally and can't quite believe him. But

your information certainly helps.

- OU alum in MI

June 29, 2004

In a message dated 6/29/2004 6:41:39 PM Pacific Daylight Time,

trudyjh@... writes:

> Sorry, I just googled all over the place and turned up something that

> supported what my cardio said. No idea where it was. He was adamant

> (sp?) that it just applied to appropriate age/no risk factors/lone

> afib people, however.

>

> Trudy,

> Doctors, like anyone else, can change their minds about the necessity of

> Coumadin and the likelihood of strokes with younger patients of supposedly low

> risk. My own primary care doctor was adamantly opposed to prescribing

> Coumadin for me because I was not in the high risk age group. Then two of her

> younger patients had strokes, and she was suddenly just as adamant that I

needed

> to take Coumadin. My brother had a similar experience. His doctor was also

> opposed to prescribing Coumadin and felt that my brother was unlikely to have

> a stroke, mostly because he had never had a stroke in many years of afib.

> Then my brother's doctor, for some reason, suddenly became quite insistent

that

> my brother should take Coumadin. Doctors are always learning, as the rest

> of us are doing; and frequently change opinions when new experiences or

> information shows them that their opinion is not consistent with most current

> information.

> This is why we may encounter so many different opinions from different

> doctors. In the case of stroke, I would rather not be the patient that

educates

> my doctor as to the reality of stroke threat with afib. :-)

> in sinus in Seattle

June 29, 2004

> I asked my new cardiologist that, and he said for me (age 60, no

risk

> factors, no underlying heart disease, lone afib) my risk of stroke

is

> identical to that of a person without afib, and so he would not

put

> me on coumadin at my age unless something changed, regardless of

how

> long I went into afib.

>

> I was very surprised, but grubbed around on the web and he is

> correct. When I asked him how this could be, because it seems

> illogical, he said a healthy heart can handle this situation.

>

> Things may be different for you, so I would ask your doc about

what

> to do.

This puzzles me. I frankly don't understand it. No matter what your

age, if you are in Afib, your risk of stroke is increased. Where did

you find something on the internet that supports that you are not?

Larry E.

June 29, 2004

> I asked my new cardiologist that, and he said for me (age 60, no

risk

> factors, no underlying heart disease, lone afib) my risk of stroke

is

> identical to that of a person without afib, and so he would not

put

> me on coumadin at my age unless something changed, regardless of

how

> long I went into afib.

>

> I was very surprised, but grubbed around on the web and he is

> correct. When I asked him how this could be, because it seems

> illogical, he said a healthy heart can handle this situation.

>

> Things may be different for you, so I would ask your doc about

what

> to do.

This puzzles me. I frankly don't understand it. No matter what your

age, if you are in Afib, your risk of stroke is increased. Where did

you find something on the internet that supports that you are not?

Larry E.

June 29, 2004

> I asked my new cardiologist that, and he said for me (age 60, no

risk

> factors, no underlying heart disease, lone afib) my risk of stroke

is

> identical to that of a person without afib, and so he would not

put

> me on coumadin at my age unless something changed, regardless of

how

> long I went into afib.

>

> I was very surprised, but grubbed around on the web and he is

> correct. When I asked him how this could be, because it seems

> illogical, he said a healthy heart can handle this situation.

>

> Things may be different for you, so I would ask your doc about

what

> to do.

This puzzles me. I frankly don't understand it. No matter what your

age, if you are in Afib, your risk of stroke is increased. Where did

you find something on the internet that supports that you are not?

Larry E.

June 29, 2004

> A month ago I had my first AFIB attack, where my heartbeat was 250

> per minute. I had to call 911 as I felt faint and didn't know

what

> it was.

>

> What nobody has told me is " when do you go to the hospital " ? If I

> had another attack like that, should I lie down and wait for it go

> go away, go to the Emergency Room after a certain number of hours,

> or what?

Elise,

This is a very difficult question to answer, as it depends upon the

individual. Some who are in paroxysmal Afib feel that they are so

used to the fact that it will come and go that they just greet a new

episode with a yawn :-), and move on conduting their business.

I have had 3 episodes in my life of lone Afib, so for me it's

different. When one has an irregular heartbeat, it can be Afib, or

it can be something more serious. To assume that it is Afib, IMHO,

is taking a risk.

I posed this same question to my cardiologist recently. His comment

to me is that it depends upon how high your heart rate is (one of my

episodes was around 130bpm, while one of the others was 250bpm ...

obviously much higher). Here's what we agreed on. His phone number

will always be answered by an answering service, there will always

be someone on call 24 hours a day, and they will call right back. If

I feel another episode coming on, I will take my pulse , and dial

the number. When the on-call cardio calls back, I will describe my

pulse (regular, irregular, whatever), any other symptoms, and my

heart rate ... and then let the on-call cardio make the decision on

whether I go to the ER or not (unless I'm feeling so bad that I feel

compelled to go without asking).

Larry E.

June 29, 2004