Re: How long to wait to go to the ER?

[Guest guest]

My cardio tells me to go immediately. All my tests were perfectly normal.

Maybe because my heartrate goes very high, (220). He did put me on Atenelol

after

my last attack so I am praying that next time my rate will not go quite at

high. I really hate the thought of having to go right away. This board has

answered so many questions and made me feel so much less frightened. Thanks

everyone!!

kathy in Ct.

[Guest guest]

My cardio tells me to go immediately. All my tests were perfectly normal.

Maybe because my heartrate goes very high, (220). He did put me on Atenelol

after

my last attack so I am praying that next time my rate will not go quite at

high. I really hate the thought of having to go right away. This board has

answered so many questions and made me feel so much less frightened. Thanks

everyone!!

kathy in Ct.

[Guest guest]

My cardio tells me to go immediately. All my tests were perfectly normal.

Maybe because my heartrate goes very high, (220). He did put me on Atenelol

after

my last attack so I am praying that next time my rate will not go quite at

high. I really hate the thought of having to go right away. This board has

answered so many questions and made me feel so much less frightened. Thanks

everyone!!

kathy in Ct.

[Guest guest]

> I have heard conflicting opinions about how long is safe to wait

> until going to the ER? During an attack.

>

> I AM on coumadin and Toprol XL, but last night I had the longest

fib

> attack ever, it lasted 11 hours. My heart rate was slow and good,

but

> the irregular beat , although not painful or anything, kept me

awake

> most of the night. I guess some folks live with this complaint

daily,

> but others warm that you should go to the ER if it lasts over a 24

> hour period? Does anyone know the answer to this?

>

> My cardio is pretty unconcerned about the attacks, and says they

are

> not fatal as long as you are covered by coumadin. I also saw an EP

> who pretty much agreed. Any opinions?

>

> MandyofCA

I think I would agree with your cardio. Before I was on coumadin, my

cardio said I could wait 24-36 hours before going to an ER.

[Guest guest]

In a message dated 19/07/2004 06:48:59 GMT Standard Time,

joscelynblack@... writes:

>

> >My cardio tells me to go immediately. All my tests were perfectly >

> >normal.

> >Maybe because my heartrate goes very high, (220). He did put me on

> >Atenelol after ><

>

I didnt answer last time this was a thread , so here's what my cardiologist

told me.. not to wait longer than 30 minutes before going to hospital

(whatever the rate) when I was on meds, and Im now not on any meds for it. It

would

take me about 30 minutes to get to the hospital from where I live as I have to

cross a City Centre, so I guess that he took that into account!

Haze (UK)

[Guest guest]

> My cardio tells me to go immediately. All my tests were perfectly >

> normal.

> Maybe because my heartrate goes very high, (220). He did put me on

>Atenelol after > <

Exactly - my EP says anything over 180 go to ER. Seems this is a

fairly common threshhold (very fast beat) that doctors use to guide

patients.

My EP says 4 hours or fast heartbeat. I believe the reason he says " 4

hours " is that he'd like to avoid " afib begs afib " and not leave me

in afib if I can be converted out of it fairly quickly.

Joscelyn

[Guest guest]

--- Thanks to all the replys on this question.

If a person has fib attacks once a week, one couldn't go to the ER

every time. Mine seem to go away for months and then come back for a

few months at the rate of one or two a week. Stress and certain foods

seem to trigger this. The food I can control, but the internal stress

feeling, just from worry about the fib, can't seem to be controlled

as well. My understanding has been to make sure the rate is slow, and

if it is, and you are on coumadin, then it is OK to wait it out a

reasonable length of time. I will recheck with the cardio on this,

but he seems unconcerned. (as long as one is on coumadin) In fact, He

says that many people live in permanent fib, and lead a relativily

normal life.

MandyofCA

[Guest guest]

--- Thanks to all the replys on this question.

If a person has fib attacks once a week, one couldn't go to the ER

every time. Mine seem to go away for months and then come back for a

few months at the rate of one or two a week. Stress and certain foods

seem to trigger this. The food I can control, but the internal stress

feeling, just from worry about the fib, can't seem to be controlled

as well. My understanding has been to make sure the rate is slow, and

if it is, and you are on coumadin, then it is OK to wait it out a

reasonable length of time. I will recheck with the cardio on this,

but he seems unconcerned. (as long as one is on coumadin) In fact, He

says that many people live in permanent fib, and lead a relativily

normal life.

MandyofCA

[Guest guest]

--- Thanks to all the replys on this question.

If a person has fib attacks once a week, one couldn't go to the ER

every time. Mine seem to go away for months and then come back for a

few months at the rate of one or two a week. Stress and certain foods

seem to trigger this. The food I can control, but the internal stress

feeling, just from worry about the fib, can't seem to be controlled

as well. My understanding has been to make sure the rate is slow, and

if it is, and you are on coumadin, then it is OK to wait it out a

reasonable length of time. I will recheck with the cardio on this,

but he seems unconcerned. (as long as one is on coumadin) In fact, He

says that many people live in permanent fib, and lead a relativily

normal life.

MandyofCA

[Guest guest]

In a message dated 7/18/2004 4:45:43 PM Pacific Daylight Time,

mandyofca@... writes:

>

> My cardio is pretty unconcerned about the attacks, and says they are

> not fatal as long as you are covered by coumadin. I also saw an EP

> who pretty much agreed. Any opinions?

>

>

Mandy,

I have had afib for over 20 years and have yet to go to an emergency room for

afib. However, in the early years when I was terrified and didn't know what

was happening, I had my brother to talk me through it and offer support when I

called him in a state of hysteria. He was able to calm me and comfort me

because he had been suffering the same symptoms since he was a teenager and had

survived. He is now in permanent afib, but I am still paroxysmal. The fact

that he had survived what I thought would produce imminent death calmed me and

made it possible to avoid the emergency room. Neither one of us knew at the

time that the source of our similar symptoms was afib, but we did conclude that

it obviously wouldn't kill us, or my brother would have been dead long ago. I

decided that I would probably be better off in the peace and quiet of my own

home than in the frenetic atmosphere of the emergency room That turned out

to be a good decision for me, but it may not be a good decision for everyone.

I often converted to sinus while talking to my brother. Ironically, on one

occasion when I went to the emergency room because of an injured eye, I

converted spontaneously from afib to sinus while waiting for about four hours to

see

the doctor. Maybe there is something to be said for the frenetic activity of

the emergency room after all. :-)

By the way, an eleven hour episode seems like nothing to me since I have had

six, seven, eight, and ten day episodes. If I have an eleven hour episode,

I'm rejoicing. It's all relative, I guess, and I find that my perspective on

afib and length of episodes has changed drastically over the years. In the

beginning a two hour episode made me hysterical, but now I would barely even pay

any attention to it. If your doctor believes that it is not necessary for you

to go to the emergency room, you could probably feel comfortable following his

advice. If the problem is just afib, the emergency doctors can only convert

you chemically or electrically anyway, and usually such a conversion is

temporary. Since I avoided all of that and have arrived at a stage in which my

afib

is now very rare, I wonder if I would have arrived at this point of relative

freedom from afib if I had gone the route of electrical cardioversion, which I

speculate may have some permanent effect on the heart in its aggressive,

invasive nature? I have not regretted avoidance of the emergency room.

in sinus in Seattle

[Guest guest]

> I didnt answer last time this was a thread , so here's what my

cardiologist

> told me.. not to wait longer than 30 minutes before going to

hospital

> (whatever the rate) when I was on meds, and Im now not on any meds

for it. It would

> take me about 30 minutes to get to the hospital from where I live

as I have to

> cross a City Centre, so I guess that he took that into account!

>

Haze, am I remembering correctly that you have other heart

conditions, though?

[Guest guest]

> I didnt answer last time this was a thread , so here's what my

cardiologist

> told me.. not to wait longer than 30 minutes before going to

hospital

> (whatever the rate) when I was on meds, and Im now not on any meds

for it. It would

> take me about 30 minutes to get to the hospital from where I live

as I have to

> cross a City Centre, so I guess that he took that into account!

>

Haze, am I remembering correctly that you have other heart

conditions, though?

[Guest guest]

> I didnt answer last time this was a thread , so here's what my

cardiologist

> told me.. not to wait longer than 30 minutes before going to

hospital

> (whatever the rate) when I was on meds, and Im now not on any meds

for it. It would

> take me about 30 minutes to get to the hospital from where I live

as I have to

> cross a City Centre, so I guess that he took that into account!

>

Haze, am I remembering correctly that you have other heart

conditions, though?

[Guest guest]

In a message dated 7/19/2004 4:08:16 PM Pacific Daylight Time,

Pagequeen1@... writes:

>

But one should not be cardioverted at all unless one has been on Coumadin for

three weeks prior to the cardioversion, according to my cardiologist. To

have a cardioversion without three prior weeks on Coumadin is to open up the

possibility of a clot causing a stroke.

in sinus in Seattle

[Guest guest]

The CCF has the 48 hour rule if you aren't on coumadin.... you need

to be cardioverted within the 48-hour time-frame.

I recently had an echo to determine if they could see any evidence of

the clot which showed on my CT scan a week after I had the 39 hour

event that required cardioversion.

I was told by both the doctor - yes - doctor - who did the echo that

a clot in the left atrial appendage would not show up on an echo, and

Dr. Natale that the best diagnostic tool for that is either the TEE

or the spiral CT scan....because the clot isn't always evident on an

echo.

The greatest risk for clot formation is in the area of the Left

Atrial Appendage..... that is a little flap or finger of tissue in

the left atrium and blood is not always cleared completely from that

area (stagnation) - thus the risk of clot formation.

My spiral CT scan was re-read recently, and it was confirmed again

that at that time, the contrast in the area was interpreted as a

clot....in the area of the LAA.

So.... as I posted previously....with all my natural blood thinning

supplements including aspirin (but I wasn't taking nattokinase), I

still formed a clot before 48 hours. I'm just grateful that it stayed

in place....and is hopefully lysed by now either from the coumadin I

started a week after the CT scan or the nattokinase after that.

I can a TEE or a CT scan if I so choose.

The point of this post is that - in AF...where the clot forms is in

the LAA and it is not detectable from an echocardiogram..... so be

aware that is not adequate diagnostic technique.

Jackie

This is from Han's Lone Afib board...............My doctor tells me

if the heart rate goes over 100 to head to the ER.

Debbi, OU Alum in OKC

[Guest guest]

The CCF has the 48 hour rule if you aren't on coumadin.... you need

to be cardioverted within the 48-hour time-frame.

I recently had an echo to determine if they could see any evidence of

the clot which showed on my CT scan a week after I had the 39 hour

event that required cardioversion.

I was told by both the doctor - yes - doctor - who did the echo that

a clot in the left atrial appendage would not show up on an echo, and

Dr. Natale that the best diagnostic tool for that is either the TEE

or the spiral CT scan....because the clot isn't always evident on an

echo.

The greatest risk for clot formation is in the area of the Left

Atrial Appendage..... that is a little flap or finger of tissue in

the left atrium and blood is not always cleared completely from that

area (stagnation) - thus the risk of clot formation.

My spiral CT scan was re-read recently, and it was confirmed again

that at that time, the contrast in the area was interpreted as a

clot....in the area of the LAA.

So.... as I posted previously....with all my natural blood thinning

supplements including aspirin (but I wasn't taking nattokinase), I

still formed a clot before 48 hours. I'm just grateful that it stayed

in place....and is hopefully lysed by now either from the coumadin I

started a week after the CT scan or the nattokinase after that.

I can a TEE or a CT scan if I so choose.

The point of this post is that - in AF...where the clot forms is in

the LAA and it is not detectable from an echocardiogram..... so be

aware that is not adequate diagnostic technique.

Jackie

This is from Han's Lone Afib board...............My doctor tells me

if the heart rate goes over 100 to head to the ER.

Debbi, OU Alum in OKC

[Guest guest]

The CCF has the 48 hour rule if you aren't on coumadin.... you need

to be cardioverted within the 48-hour time-frame.

I recently had an echo to determine if they could see any evidence of

the clot which showed on my CT scan a week after I had the 39 hour

event that required cardioversion.

I was told by both the doctor - yes - doctor - who did the echo that

a clot in the left atrial appendage would not show up on an echo, and

Dr. Natale that the best diagnostic tool for that is either the TEE

or the spiral CT scan....because the clot isn't always evident on an

echo.

The greatest risk for clot formation is in the area of the Left

Atrial Appendage..... that is a little flap or finger of tissue in

the left atrium and blood is not always cleared completely from that

area (stagnation) - thus the risk of clot formation.

My spiral CT scan was re-read recently, and it was confirmed again

that at that time, the contrast in the area was interpreted as a

clot....in the area of the LAA.

So.... as I posted previously....with all my natural blood thinning

supplements including aspirin (but I wasn't taking nattokinase), I

still formed a clot before 48 hours. I'm just grateful that it stayed

in place....and is hopefully lysed by now either from the coumadin I

started a week after the CT scan or the nattokinase after that.

I can a TEE or a CT scan if I so choose.

The point of this post is that - in AF...where the clot forms is in

the LAA and it is not detectable from an echocardiogram..... so be

aware that is not adequate diagnostic technique.

Jackie

This is from Han's Lone Afib board...............My doctor tells me

if the heart rate goes over 100 to head to the ER.

Debbi, OU Alum in OKC

[Guest guest]

> The CCF has the 48 hour rule if you aren't on coumadin.... you need

> to be cardioverted within the 48-hour time-frame.

What's the CCF?

> This is from Han's Lone Afib board...............My doctor tells me

> if the heart rate goes over 100 to head to the ER.

100 seems pretty low to me. A random person can get to 100 just

exerting themselves in sinus. I remember being at 130 something in

my doc's office in afib, and they sent me home.

[Guest guest]

> The CCF has the 48 hour rule if you aren't on coumadin.... you need

> to be cardioverted within the 48-hour time-frame.

What's the CCF?

> This is from Han's Lone Afib board...............My doctor tells me

> if the heart rate goes over 100 to head to the ER.

100 seems pretty low to me. A random person can get to 100 just

exerting themselves in sinus. I remember being at 130 something in

my doc's office in afib, and they sent me home.

[Guest guest]

> But one should not be cardioverted at all unless one has been on

Coumadin for

> three weeks prior to the cardioversion, according to my

cardiologist. To

> have a cardioversion without three prior weeks on Coumadin is to

open up the

> possibility of a clot causing a stroke.

> in sinus in Seattle

>

I thought the ultrasound that looks for clots in the heart would

allow a cardioversion at just about any time if no clots were found?

I agree with a previous poster that this is not a regular echo, but I

have forgotten its name.

[Guest guest]

> But one should not be cardioverted at all unless one has been on

Coumadin for

> three weeks prior to the cardioversion, according to my

cardiologist. To

> have a cardioversion without three prior weeks on Coumadin is to

open up the

> possibility of a clot causing a stroke.

> in sinus in Seattle

>

I thought the ultrasound that looks for clots in the heart would

allow a cardioversion at just about any time if no clots were found?

I agree with a previous poster that this is not a regular echo, but I

have forgotten its name.

[Guest guest]

> But one should not be cardioverted at all unless one has been on

Coumadin for

> three weeks prior to the cardioversion, according to my

cardiologist. To

> have a cardioversion without three prior weeks on Coumadin is to

open up the

> possibility of a clot causing a stroke.

> in sinus in Seattle

>

I thought the ultrasound that looks for clots in the heart would

allow a cardioversion at just about any time if no clots were found?

I agree with a previous poster that this is not a regular echo, but I

have forgotten its name.

[Guest guest]

>By the way, an eleven hour episode seems like nothing to me since I have

>had six, seven, eight, and ten day episodes. If I have an eleven hour

>episode, I'm rejoicing. It's all relative, I guess, and I find that my

>perspective on afib and length of episodes has changed drastically over the

>years. In the beginning a two hour episode made me hysterical, but now I

>would barely even pay any attention to it.

I am confused! I have the impression that, since ³afib begets afib,² it is

not advisable to stay in afib--if cardioversion or some other means of

converting is available--for more than 24 to 36 hours. Is it accurate to

say that staying in afib can make the condition worse or take a paroxysmal

condition to chronic?

--

Kathleen Stept (Dofetilide 250mcg bid, Diltiazem 120 mg, Coumadin 5mg,

Magnesium Oxide 400mg bid), , MS

[Guest guest]

Kathleen wrote:

<<Is it accurate to say that staying in afib can make the condition

worse or take a paroxysmal condition to chronic?>>

Yes it is. But the time frame is more a matter of weeks than hours or days.

- OU alum in MI

[Guest guest]

Kathleen wrote:

<<Is it accurate to say that staying in afib can make the condition

worse or take a paroxysmal condition to chronic?>>

Yes it is. But the time frame is more a matter of weeks than hours or days.

- OU alum in MI