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Afib decisions ("Afib Cure" book vs typical cardiologist)
Heart Rhythm Conditions | Last Active: May 7 7:41pm | Replies (10)Comment receiving replies
Windyshores, I was put on metoprolol and a statin right from the moment I met my cardiologist for the first time. The first time I felt I needed help, and went to the ER, they gave me a bolus of 25 mg of metoprolol, but it didn't convert me. They then tried to cardiovert, but that failed as well. I went home with a reduce rate, but still in AF. I converted some time later that day (I had gone to the ER at around 1900 hrs and was released around 0300). About a year later, after my index ablation, I was in and out of the ER several times, and I usually reverted to NSR after several hours on a gurney. Those times, they only gave me extra metoprolol once, and on that occasion they were about to release me having failed a cardioversion, but I reverted moments before they kicked me out.
My BP was always normal, or very close. Nothing they felt they needed to mention. I only felt short of breath the second time I paroxysmally went in into AF, about six weeks after the first time. I had to double over and told the triage nurse I wasn't doing well. She hurried me into the ER. All other occasions, at home or at the ER, it was only the chest thumping and the anxiety that ganged up on me and had me worried. Weird, but that is my story. Just the one time short of breath in perhaps 10 episodes that lasted more than a few minutes.
And despite what Our Friend might insist is the case, I don't fault you for a pico-second for not being able to abide how it makes you feel, and for hying yourself to the closest ER. Done it meself, an I would hasten to do it again. And like you, I did ask twice, separate occasions, if I was doing the right thing. I was told unequivocally that I absolutely did the right thing by going to the ER. An arrythmia is serious business.
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I always feel calm. It's weird. Maybe it is a physical effect.
But I am not on any meds (cnanot tolerate them with low bp) and there is nothing I can do at home to bring the rate down from 190+. I need a diltiazem drip with IV hydration to keep the bp up. It just seems somehow that my situation isn't typical and I get responses that don't fit.
Anyway interesting that they let you go home in afib. I wonder, if my rate were to come down, if they would let me go home. When I self-convert, the rate goes down and stays down.
They always do two troponins, which keeps me there longer. Ugh. And once when it went on for 7 hours they did an echo.
I will say that last summer I had an episode that lasted until the ER door: it stopped in the ambulance (after a bolus of diltiazem with IV). The next two times, 6 weeks later, were very short and I brought the rate down and stopped the afib with Gas X. Those are the only two times I hadn't called 911.
On April 15 during my next episode, I tried to stay home. I did Gas X, one diltiazem (took my bp the whole time and did Kardia too), and walked around, played around with breathing, with bearing down, with cold water- and then drove myself thinking maybe it would stop before the ER but it didn't. So in ER all night.
The local ambulance crew know me well (from living in the same small town) and get really mad at me when I drive myself to the police station because I hate having the ambulance come to my street. They didn't know I drove myself all the way to the hospital. Ambulances cost!
But I could get the bolus of diltiazem and IV quicker in an ambulance and if my bp had been lower with my home cuff I would have called. For some reason it went high that time.
Thanks for sharing. I am meeting with the primary care NP who knows me really well tomorrow to discuss. I have not gotten the promised referral to an EP from the high calibre cariologist I saw last week, or a new Rx for diltiazem (though I have only taken it 3 times in 10 years I still want it). More importantly, my questions were not answered.
- is short term anticoagulation based on length of episode possible and appropriate
- can I have a protocol with beta blockers or diltiazem to help me take steroids (lupus, asthma) or albuterol without triggering afib
-should I avoid certain meds due to borderline QTc interval (or is that long during afib only)
-how to handle periods of stress (I feel I have gotten a lot of triggers identified and handled but stress is tough to avoid; I do walk, tai chi, art, Reiki but may need meds at times when I get the feeling that afib may occur)
By the way I was "electrocuted" (my record actually says that) in 2014, s serious shock during which I lost muscle control and landed in ER. I suspect that did something to my heart. I was also on cancer meds that eliminate estrogen for 5 years. My afbi started after both those possible factors.
Ten episodes since 2015. Triggers dehydration, eating/gas, lifting (diaphragm shift), sudden alarm (once), stress (housing search, three episodes). Like George I do electrolytes.