For completeness, the I'm in AFIB, so what else is new episodes are 2-3 time per week.

This is an interesting topic. I believe many things drive how we all deal with Afib. This is most likely wrong thinking on my part, but there are times an ER visit may have been in order in my life (based on my Afib symptoms and just not feeling quite right at the time), however, my strong desire not to have a hospital bill always won out. After having two ablations within a 1 year period for which I had to pay out of pocket $5,200 for each, I would have to be in dire straits to want to go to the ER. However, chest pain, unrelenting high HR or stroke symptoms would definitely send me to the ER regardless of cost. Fortunately for me, my HR has never stayed over 130 for more than a few hours in my Afib career, so it paid off for me to wait it out. Now it seems the longer I have Afib, the less symptoms of chest pain I have. When I first started experiencing Afib, I would have chest pain. Even shortly after my second ablation, I still experienced chest pain when HR was high. Now, my HR can be in the 120s and 130s and I dont feel it. The only reason I know when my HR is high is I feel alittle light headed at times and feel a fluttery feeling in my chest but not pain. I agree with you that we all deal with Afib based on our particular station in life (social, economic and emotional influences). Sometimes I believe fear drive how we deal with it too. Sometimes people are afraid that something is wrong and will deny symptoms while some people are afraid something is wrong and act based on symptoms (avoidance/denial vs acceptance/proactive approach). Acceptance or non acceptance of one's own mortality I believe also plays a significant role in how we all deal with Afib. A person's general overall health is also a consideration. Some people with Afib also have additional health problems to consider while some are completely healthy other than having Afib . Those factors likely drive the opinion of severity of episodes in addition to all the other factors you mentioned.

I feel nothing, am longstanding persistent, am on Pradaxa and Bystolic (betablocker) that I take with my vitamins. So I am lucky that I feel nothing. I am always in it, so I don't worry about going in afib. I exercise as I want.

However... because I feel nothing, I always have in the back of my mind that I could have something else serious wrong with me that I can't feel either.

petey

Okay Paul, Im in for the game.
How can we compare a-fib events? I figure it this way; youve got subjective and objective factors. You pretty much covered the subjective factors and ruled them out. I think if James Bond had a-fib hed hold out a lot better than me; that man can take a beating. I hate pain.
Which leave the objective factors: speed, frequency and length. Things you can measure. How fast was your heart beating, how many times a year do you experience a-fib and how long does each one last. Ill bet a mathematician could come up with a nifty little equation. I can hear it now; My a-fib-O-Factor is 1.34, whats yours? lol. Unfortunately beta blockers can and do slow down the heart rate, so speed is out (but you could always add a beta blocker/tachy correction to the equation like Quick and INR). Then theres frequency factor but wait, theres rhythm control drugs which alter that, so thats out of the equation, too. That leaves the length of the episodes, which alone say absolutely nothing about the severity and can also be manipulated by the pip drugs.
Its a stalemate.

Interesting question.

I understand the premise but not sure what the end result is/or answer can be.

I think we all deal with this condition with the coping mechanisms that we've grown accustomed to or have newly learned or we go to the ER.

A trip to the hospital is not a bad thing if you are highly symptomatic and you think that you're going to die.

Unfortunately for many that do not have proper health insurance, they may not take that trip or think twice.

But if it does get bad enough it's not going to matter whether you have two or three cats or one or two children, you may have to seek medical attention or dial 911, even if you can't afford it.

Everyone seems to have a different story with this gig, but one thing is a common factor, noone can seem to be rid of it. At least completely.

If you're blessed to be financially secure and have a great health plan, even though you're still 'gonna suffer with this gig - you are way, way far better off than many others out there. IMO.

Well Surfrat, I think a got an answer today. Maybe, was trying to convince myself that my AFIB wasn't so bad. After all so many people here were getting ablations and going to the ER and on a lot more drugs than me. Well, the EP today convinced me that my AFIB is tearing my heart apart, I just tolerate the effects better than many. I still need and ablation.

Hey Paul,
Don't know the details of how your heart is being torn apart but after 40 years of AFIB there's is only one EP in the world who I would trust.
I would but a ticket and fly out to the Lone Star State.

McHale

Paul, it sounds like things are moving along for you! And it looks like the person who can gauge the severity of a-fib is someone who has seen and can compare 100s of hearts beating in a-fib.
Take care,
atp

I get confused about when it is time to go to the hospital. My cardiologist said the basic rule of thumb is if I am in afib for 24 hours I should go to the ER. I know there are people out there who are in afib all the time so this makes no sense.

I go in about once a week now and let it go for about 2-3 hours before doing a cardio workout to get back to NSR. I hope this keeps working. Been doing this for past 2 years. I do not measure my HR. My main concern right now is the duration of the event.

Not sure if this is relevant to this topic.

Great question.

I have always wondered about this especially since treatments such as ablation are often based on symptoms.

Many of the symptoms as others have pointed out are subjective and can be influenced by psychological and economic factors. I have often wondered what the correlation was between reported symptoms and heart rhythm.

You hear some people say that they always know when they are in afib. When I took my first 24 hr holter after being diagnosed with afib the episodes that I reported as afib were not afib and the holter detected afib episodes were not felt by me. I thought this was because I might be asymptomatic but the following study shows it also exists for symptomatic patients.

http://www.ncbi.nlm.nih.gov/pubmed/17532409

I think the best way to get a handle on symptoms is similar to what ATP suggests except you would probably need implantable cardiac monitors for the measurements. Now if these monitors could also utilize nanotechnology to deliver drugs (including anticoagulants that targeted the left atrial appendage cells) when in afib that would be really cool.

There have been attempts to develop models for atrial fibrillation symptoms. As an example check out http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2560532/

opsyn

I'm sorry to hear what you Dr. told you. It sounds pretty off-the-wall as a professional comment. IMO. I sincerely hope things settle down for you as well as everyone here. I don't want to beat the issue of $$$$ into the ground. But out-of-pocket costs for med.s etc. or Dr. appt.s is astronomical. Especially over extended periods of time. A visit to an EP can range from $325.00 to $500 or more. This is just for a visit. Obviously we all know what med.s and testing can cost. A stress test out-of-pocket can range from $1,200 to $2,000 subject to who and where is doing it. Not trying topreach to the choir here just sayin' 'cos if you're well covered without having to pay alot on your own. You are indeed fortunate.

Interesting question -
For me accurate objective factors, speed, frequency and length can be measured. Aside from Warfarin I'm not on any medication Period! Diagnosed in one visit to ER in July 2010 I was given diltiazem and metoprolol and converted to NSR while waiting to be admitted. Fortunately no room was available at the time.
I was sent home and referred to a cardiologist. We discussed anti-arrythmic meds and anticoagulants. I agreed to Warfarin.
I've been diagnosed with asymptomatic bradycardia. During an AF episode my HR is between 60-90. I'm aware of an irregular HB, some tiredness and dehydration but otherwise asymptomatic. No lightheadedness since I stopped taking BP pills.
Approaching 80,reading the Obits and experiencing the loss of many family members and friends I've accepted my own mortality.
I am blessed to be financially secure with good health insurance and good health.
To Life and NSR,
Annette

I'm on the PIP (Pill in Pocket) and the pill I use is Propafenol - 300mg. I found a medical article that summarized a study saying up to 900mg is ok and there is no long term adverse effects.

I always feel weak, dizzy and my chest is pounding hard and irregular when in afib - I always feel it. With me the difference is usually a medium pounding, or really hard and out of breath, so I sit in a recliner until the pill takes effect. If it hasn't worked after 2 hrs, I take another 300 mg of Propafenol (which is also called Rythmol). It seems that when I react to MSG I have the worst episodes. If I was triggered by stress, it is a medium type afib and the mild ones are if I've had wheat gluten and slight stress such as medium sleep deprivation. With the pill alone it can take from 3 hours to 6 hours to get back to normal.

Now for some interesting discoveries. I've been listening to Dr. Stephen Sinatra and Dr. Mercola on Youtube about boosting ones celluar energy. Sinatra (a cardiologist who's done many operations) says that he's found the combination Ubiquinol, L-Carnitine & Ribos boost celluar ATP which is critical to heart functions. Somewhere else I read that low protein can also have adverse effects on celluar energy and heart function.

The last 2 times I had afib I stopped in in 15 minutes.

What I did different was (in addition to the 300mg Rythmol) to take, in a glass of water "Garden of Life" Raw protein powder, 3 caps of Ginko Biloba, 2 caps of Ubiquinol, 2 caps of L-Carnitine, 2 scoops of Ribos and 2 Vit B complex. I opened all caps and mixed the powders with the protein powder and downed it.

According to Dr. Sinatra, a lot of heart conditions he saw could be traced to low ATP in the body, which will show up in heart problems first as the heart is the biggest user of cellular energy.

So now, I take the Sinatra "Trifactor" every morning with the Krill oil that Mercola recommends for Omega 3 as that is also a factor in cellular and overall body health. I find I have more energy, arthritis symptoms have lessened and if some unknown source of MSG hits me again (last time it was pizza sauce) I'll be doing the above to get back to sinus rhythm ASAP.