In this article, we are going to talk about what to do when you have an episode of Afib. When should you call your doctor, when should you stay home and when should you call 911?

 

It can be frightening to have an episode of Afib, and as a cardiologist, I’ve dealt with this question hundreds of times. I understand that you don’t want to take an unnecessary chance and stay home, but it’s also frustrating to go to the ER and be sent home like it is no big deal.

 

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Here is what I tell my patients about what to do during an episode of Afib.

I do need to emphasize that this is for information purposes only and is NOT medical advice. Medical advice can only come from your doctor or another healthcare professional with which you have established a relationship. For your safety realize, there is no way that I can know what you should do without knowing you as a patient.

If you don’t feel well, call 9–1–1.

If you don’t feel well for any reason, but particularly if you have shortness of breath, chest pain or pressure, lightheadedness, passing out, unusual sweating or nausea or signs and symptoms of a stroke, call 911 right away.

If you feel fine, but your heart rate is fast (for example, over 130 beats per minute)

You should call your doctor or go to the closest ER. Calling 911 is always the safest option. If you choose not to call 911, DO NOT DRIVE YOURSELF. Have someone drive you.

If you are not on a blood thinner medication (and don’t have a Watchman device)

Call your doctor or go to the ER. This is particularly true if you don’t have symptoms and aren’t sure when you went into Afib. More than 24–48 hours of Afib when you are not on a blood thinner may increase your risk for stroke.

If you feel fine…

And your heart rate is not too fast, and you’re on a blood thinner medication, it MAY be reasonable to wait 24 hours to see if you convert back into regular (or sinus) rhythm. I would still recommend to call your doctor, let them know, and seek their advice.

 

If you have any doubts, call 911

Always err on the side of caution. Feeling like you wasted your time going to the ER is always better than staying home when you should have sought urgent medical attention.

 

In summary

Having an episode of Afib can be frightening. Although most episodes of Afib are not life-threatening, some episodes can be. Ask your doctor about what you should do if you have an episode of Afib.

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