When do I go to the Emergency Room?

I was diagnosed a week ago with Atrial Fibrillation (AF), following several months with loss of consciousness episodes caused by prolonged heart pauses. I received a pacemaker during one of these pauses in August. My doctor told me to call their pacemaker clinic when I think I am having AF. However, the clinic is only open 9-5 pm weekdays. Last night after their offices were closed I had AF off and on for about 6 hours. When I woke up this morning, I had another episode of AF. I called the nurse for the clinic and she told me to call 911, but earlier in the week the pacemaker clinic seemed unconcerned about other episodes I was having. Since I am having this a lot, I'm thinking I cannot run to the hospital every time it happens. If I had access to my pacemaker reports and knew the episodes were lasting a long time, I might go to the hospital, but since it ebbs and wanes, I don't know. The off-hours nurse doesn't have access to those records. How do I get access? Do those of us with pacemakers typically not have access to their own data?

5 Comments

AFib

by AgentX86 - 2018-10-13 21:06:21

First, what drugs are you taking?  Are you one an anticoagulant?  A beta blocker or calcium channel blocker? 

Second, What is your heart rate when you're in AFib? 

Understand that AFib, itself, isn't particularly dangerous, though it can be a real pain in the ass.  The danger from AFib comes from clots forming in the heart and then moving to the brain (stroke) and a high heart rate causing VFib (short term) or cardiomyopathy (long term).  As long as your heart rate is good (ask your doctor) and you're on an anticoagulant, I wouldn't consider an AFib episode an emergency at all.  I understand wanting to get to NSR but it's not an emergency.

You can get a copy of your health record (including PM settings and dumps) but likely not immediate raw information. 

 

Just like all test results these days......

by BOBTHOM - 2018-10-13 22:37:57

You need to ask for copies of your test results.  Same is true for data from your pacemaker.  In my case I actually have to go to their records office (or rely on snail mail).  It shouldn't be this hard, but it is.  Good luck!

Thank you. It sounds like I made the right decision in not going to the hospital.

by Tumbleweed - 2018-10-14 02:14:57

I just started Apixaban and Metoprolol today. At the time I made the decision not to go to the hospital early this morning, it was midnight, so I didn't have an option to go to an urgent care. I only measured my heartrate between episodes during the episodes, and it was 77 then, which is fine. In retrospect, I should try to measure it when I am having an episode. I just didn't realize that the issue with AFIB is increased heart-rate. I thought the issue was just that the irregular beat could lead to a stroke. So, it helps hearing from the people on this forum. I certainly don't want to go to the ER if I do not have to absolutely do so, I just had my doctor's nurse telling me to get off the phone and dial 911 and the BCBS nurse telling me the same thing, so even though the Pacemaker Clinic had acted like episodes of AFIB weren't a big deal, I didn't know. Thank you for filling me in. I'll decrease the worry index on my end, which sounds splendid.

AFib heart rate

by AgentX86 - 2018-10-14 12:53:15

You should note your heart rate both in NSR and in AFib, for different reasons. In AFib, your heart rate should be less than 100bpm. Short term excursions above that aren't dangerous as long as it's not too far above. Anything above, maybe, 150 is time for the ER. Your EP should be able to give better guidance.

Watch heart rates below 50, too. They're not emergencies, and really not related to AFib, but your EP still needs to know about it. The meds typically given for AFib will cause Bradycardia. He needs to know about it to get the balance right.

Unfortunately,  one of the side effects of AFib is the constant concern over heart rate. Some may think it OCD and perhaps it is but so be it. It comes with the territory.

when

by ROBO Pop - 2018-10-14 15:23:37

You might ask your doctor for some guidance on this, however, Go to the ER (hospital) when you are having any issue and are concerned, it's that simple.

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