Paroxsysmal Atrial Fibrillation

[JoKelly]

Now that my condition has been definitely identified as PAF, I find my surgery doctor is very vague as to procedure during an attack (which can last up to three days).  The first time he said it was SVT but still just sent me home in that condition.  Following a stay in hospital having gone to the hospital ER of my own volition, they kept me for four days and changed my medication to Bisoprolol and Warfarin.  I reverted to sinus spontaneously after about three days and that was over a month ago - so far so good!  I am awaiting a Holter monitor to see how often I get spells of AF.  My question is - what ought I to do when I am aware of the rhythm having changed to AF?  Should I just wait for it to go away (sometimes it makes me feel faint) or is the procedure to report to the ER room.  I hesitate to go to my local GP as he doesn't seem to know the answer.  I would very much like to come off the Warfarin!

[JoKelly]

Thanks so much for the advice.  I guess the decision to go just depends on the heart rate which is usually about 133 and/or faintness or chest discomfort - or, as you say, just feeling scared.  I suppose also the length of the attack.  I think the monitor may discover I also get very transient night episodes, as these are enough to temporarily wake me.  I have decided that anything over 12 hours will be enough for me to seek help and this is just a personal decision.  Thank you again for replying.

[CFS56]

Cindy gives  you some good advice.  Definitely go if you feel faint, short of breath or have any chest pain.  If you are really scared...go.  My EP told me if my heart rate gets really high as long as I feel ok otherwise to lie down and try to relax.  If it doesn't go down in 45 minutes or so or if I start feeling weird..go to the ER.

[cindy707]

Well one main thing popped out at me here ...you said your GP.....this isn't something for your GP to deal w. but a heart doctor.....i had a pretty severe case of atrial fib that was i guess classified as paroxamol because it just means every so often basically and i chose to have an ablation done four years ago and that pretty much took care of it.  I am on no blood thinners, etc and would not like to be either at any point because of all of the issues that arise with them.  As far as the earmarks go for a visit to the E.R,....i think it is a personal decision that you will end up making on that one...i think if it gets to the point where you are sensing something really bad is coming...go....if you feel like you are going to faint....go.........if you are at the point where you are really scared go.......a good heart doc that you have a great relationship should be able to nip this one in the bud as they say...that is why they specialize in the heart only.........good luck...............

[Jerry_NJ]

I would have two main concerns:
1) stroke risk mitigation
2) heart rate control

If you are no longer on warfarin or any anticoagulant, I'd suggest taking an aspirin a day to help reduce the risk of a clot/stroke.

If you ventricle heart rate, the one you feel, is lower than 130 (just a rough number, my doctor did not consider an AFib or Flutter driven HR of 130 was a reason to go to ER) try to wait it out.  If it stays at 130 or higher (or even a little lower, but over 100) then you should discuss some medication to reduce the HR, such as a beta blocker.  

Hope this is of some use, if I missed your point/need post a follow up.  Perhaps others will pitch in with more help/experience.