From the Cleveland Clinic:

Bruce D. Lindsay, MD: Patients are advised to go to the emergency room immediately if they have severe symptoms. For those who have less severe symptoms, a trip to the emergency room can be delayed to see if the atrial fibrillation converts spontaneously. If it persists for more than 48 hours, the risk of stroke increases in patients who are not appropriately anticoagulated. This is not as great a concern for patients who are treated with warfarin.

kat4: A previous questioner mentioned going to the ER after 48 hours in a-fib. I had thought the deadline was 24 hours?

Bruce D. Lindsay, MD: The recommendation is 24-48 hours, but it is not that specific. In some cases I would be willing to wait 72 hours. I would be more concerned about patients who do not tolerate atrial fibrillation, who have a rapid rate, or those who are at increased risk for stroke. Risk factors for stroke include coronary artery disease, valvular disease, heart failure, hypertension, age > 65, diabetes, and a prior history of stroke. Most patients with these risk factors take warfarin, so the risk of stroke would not be great if the dose is in the therapeutic range.


petey

I think you are fine to stay home as long as heart rate is below 100.
How long ago did you take the PIP? What med? It could take awhile for it to really kick in.
I convert the fastest if I stay very quiet, reduce any stimulation like computer, tv, talking to others, etc. If I stay very quiet, soothing music, try to either sleep or just focus on my breathing and meditate I convert the fastest.
I'm glad you got a PIP to take....hope it will keep you out of ER.

My doctor says under 100 is fine. My issue now is I used to have a "bounding" pulse maybe that is not the correct term but my pulse was very easy to detect. The pulse was like Boom, boom, boom, boom! Now it is weak and I hardly feel it. I am on Cardizem and am sure this is why it is so weak I wish I could go back to indearal because it lowered my pulse lower then the cardizem and I felt the pulse was stronger (maybe a strong pulse is not a good thing?) This and a kinda anger is starting to infliltrate my thinking.

Glen

Wow, thanks everyone for being there for me. This always happens at night so I can't wake my neighbor up. It's so scary when you're alone and this happens.

I took 25mg of metropropal when my heart rate started shooting up. It took less than five minutes for it to start coming down, but my bp stayed high at 143/104.

Now my heart rate is down to 64, but my BP is still on the high side, and my heart is still skipping beats.

How do I know if I'm in afib or if I'm having PVCs and or PACs? I just don't know if I can go on my merry way, or if I need to get converted and when.

I just hope that when the metropropal wears off my heart rate doesn't shoot up again in the middle of the night!

Hi Island, I took Metoprolol for 16 mos. as PIP. I get my afib average 2AM...pulse 140 average. Within 15 min. my pulse is dropping to ave. 100.

The effects of the beta blocker lets me go back to sleep as long as I don't stress. Beta Blockers slow all of me down hugely.

So, I stay in afib for the next 12 hrs. average. My pulse goes to 80's for the day. I have Bradycardia, so this is high for me.

I function, but barely. I have a 'not quite right' feeling that I keep until I convert.

I was told Not to go to ER. Once when I was in afib for almost a week, after episode caused by epinephrine, the doc told me to go to ER to be converted if I did not convert by the 7th day. I converted right after I talked to him.

He said, as long as I have anticoagulant in me, I will be fine, uncomfortable, but fine. So far, this has been true.

Doc. also told me blood pressure is not related to afib. If my BP goes up, it is anxiety.

Keep Faith that this bumpy spell will pass and Confidence that you will handle and manage it~ You Will, yes You Will~

Hi Island....
Just thinking of you. Hope you converted on your own during the night. I would give it 24 hours as long as you are doing ok otherwise. If they need to cardiovert its best to do it within 24-48 hours.
Praying all is well.

I -just- converted. Pulse way down to low 50 s and BP 122/75. I feel like I just ran a marathon.

Again, thanks for your thoughts and support. I wish I could even begin to express to you how much you helped.

And what would I have done without the PIP? I would have had yet another ambulance ride.

I think these are coming on by stress. It's been 8 months since my mom passed away.. I had to move into her house to take care of her dog, I now have a one hour commute each way to work, the dog wakes me up every morning at 6:30 am to go out, so I'm getting 5 to 6 hours of sleep a night.. I'm handling the estate, the lawyers, etc alone with no support. And of course, I'm distraught over losing my mom. It's been the worst time in my life.

And now after 15 months, I get two whopper afib episodes within two weeks. of course, thats adding to my worries.

I feel like I'm falling apart at the seams.

Stress is the enemy for sure. I'm happy it worked. YAY for those pills!
I know how exhausted you feel...you heart basically did run a marathon. Can you call in sick tomorrow? Just to have a day to regroup? I have done that in the past and stopped feeling guilty about it.

Island,

Hooray-your converted!!
I agree stress is a big factor. Did you ever think of going to grief meetings? I took my mom to one after my dad died. I think it helped. Just getting the emotions out. My mom has dementia, so I don't know how much she got out of it, but I think some did sink in.
Hope these don't come frequently.

Hi Island, So Glad you converted!!

When I took Metoprolol I was weary and lethargic. When using it for PIP I was lethargic for most of the day, until if wore off.

Actually, I spoke too soon. My heart is skipping around again, although my pulse hasn't started to shoot up.

Oh Fudge!!!
I hate a fib! You don't happen to have any ativan or xanax do you?
I also usually take an ativan with an episode because of the horrible anxiety. If I start feeling alot of skipped beats an ativan will usually help calm it down before a fib starts.

I hope things worked out for you IslandLuvr.

Great post by Petey early on in this thread.

Someone here mentioned the following: "I think you are fine to stay home as long as heart rate is below 100."

It has been my experience, that when you're in AF at or below 100 is where you "wish" you were! When you're in AF it's way higher than that unless you're on some wicked severe stabilization medications! I've spent way too many hours in the ER getting pumped with tons of stuff with the doctors and nurses trying to keep it at the 100 mark.

Let us know Island what happened,.......

Hi Surfrat,

I think I'm trying to understand the difference between afib and PACs/PVCs. I started the day with skipping heart beats.. then at 8:30 at night, all of a sudden, it was light a freight train roaring by-- my pulse shot up and up and up... I took my bp and pulse, and as mentioned.. at the time I took it, my pulse was at 140 and rising.

So, I quickly took a Metaropol pill. Within in minutes, my heart rate started coming down, although my bp remained high.

The next day, I was getting those awful skipping heart beats and I felt rotten. My pulse was not overly high-- just around 90 to 100. So.. was that afib too? Or was that just skipped beats? They were happening around every 4 beats, I'd get a skip.

Today, I'm at work, and feeling normal again. Petey is right.. I'm getting overly worried about this. I'm a journalist, so I tend to do a lot of investigating, and what I'm finding in studies is really frightening me, because I'm not even 60 yet and have this.

One way to tell the difference between Afib and PACs & PVCs is to get a portable ecg, like the Omron. It costs less than $300.
You may want to ask your cardiologist if he thinks it's a good idea, and whether he would be willing to examine selected recordings if you have trouble interpreting them.