My night in the ER

Woke up yesterday morning with what felt like skipped beats. After a few hours of them every couple of minutes, I meditated for 30 minutes and they went away. But 30 minutes later I was in afib. But with the afib came stuff I am not used to, including some chest pain. So called my HMO and sent me to ER.

Went in about 3:30pm. Came out 3:00am. Ugh. Did not realize that they had to hold you for 12 hours in order to do two separate heart blood enzime tests. So in ER having my usual afib, with monitor and pulse reader on me. Also oxygen, as my blood oxygen was 93 when went in. My pulse topped out at 125 and stayed in the 90-115 range for the most part so there wasn't a lot of panic I guess. Doc came by to say "hey yeah, you're in afib" (it's amazing, you tell medical people you're in afib and they don't believe you). Anyhow, I asked for a saline solution since last time I was in ER with afib that helped bring me out - it did again this time. Then the skipped beats returned around 10pm. But since I was there for potential heart attack and afib, the doc on the night round didn't look into the skipped beats. Just said, "hm, probably a sinus arythmia."

By 2am doc had results of 2nd blood enzimes, both were fine, as were electrolites. So said I could go home. I really wanted to by that point. I don't do laying around well, especially since my phone was out of juice and I was by myself. So left ER this morning with pulse in the 80s (my normal is 60s), and skipped beats. Which are with me today as I write this after 6 hours of sleep. I am eating breakfast (yesterday I had no food except some crackers they gave me at the ER when I said I'd had no food). Will try to remain calm and peaceful and see if that helps.
Nancy

Nancy, ER visits are never good and sorry you had to go there. Journal of Afib (Natale's open forum style magazine) just had an article on the effects of AF on blood flow reserve. The reason why you had angina during AF. This seems to me a very important reason to get rhythm control It is the last article in the magazine. The link is below.

[www.jafib.com]

Hi Nancy,
Most of us cane sympathize for sure, no fun at all having to deal with all that and especially with new docs you have to partially 'train' before they realize you know your body very well.

Researchers link to the new Journal of AFIB that Dr. Natale hosts as editor is a excellent issue. I encourage you too to read that last article on AFOIBS effect on blood flow reserve.

And there are a few new articles dealing with Left Atrial Appendage) LAA research and clinical experience during ablation research taht are very important for those trying to decide when and if to get an ablation after having tried all teh supplemental and dietary protocols to control it wihtout success.

One study outlines their experience in doing a PVI ablation and at the same time while they are in there going ahead and installing a Watchman LAA Occulsion device to help prevent strokes and lessen the need for anti-coagulation going forward.

Another is a single case report of a 58 year old man in persistent AFIB whose first ablation failed due to the fact that much of his triggering was coming from the LAA that was not address properly in the first one. In this case, even after they did a deliberate LAA-isolation they were still able ti enduce a fast tachycardia/flutter within the LAA itself even though it was not apparent on surface ECG!

Only after isolating his LAA has he been quiet and arrhythmia free for the past 7 months which to these physicians in Europe highlight what DR. Natale has pioneered and others are discovering, that for a class of Afibbers particularly those with long duration episodes and also persistent Afib especially, there is a stronger likelihhood of LAA involvement requiring LAA isolation to properly address.

In this mans case it was the first reported evidence of a sustained tacharrhythmia with inside the LAA post electrical isolation which gives more weight to the argument of possibly needing life long anti-coagulation is such patients, or better yet, a Lariet-II device or maybe in some cases the newer version of the Watchman in order to prevent or minimize the chance of any clot formation in the LAA even with a properly mechanically functioning LAA.

finally a third article is an overview of LAA pathphysiology and clinical significance related to AFIB and ablations that makes some very good points.

The AFIB world is finally focusing in on this up until recently neglected area, not unlike what happened in the last 90s when the PVs were first discovered to be the major source of triggering energy. No doubt the ongoing difficulty in getting satifactoruy outcomes for persistent AFIB cases with ablation has spurred this interest in the LAA as an unaddressed source.

Perhaps the relative success rates of Mini-maze for persistent AFIB was a good tip off to the advantages of dealing with the LAA in such cases, since they physically remove the LAA during that procedure which isolates it both mechanically and electrically from the rest of the left atrium. Maybe that is a key factor that accounts for the higher overall success on one procedure for persistent afibbers with the more invasive mini-maze??

In any event, its a good issue with a number of other interesting articles.

Best of luck on quieting down the skipped beats.,

Shannon

Shannon