- Hey, I'm Dr. Morales,
and in this video I'm gonna discuss AFib attacks
and what to do during an AFib attack.
If you have ever had AFib attacks,
and you might be having one right now
if you're watching this video
you might be wondering what can you do,
how can you improve these debilitating symptoms
that you may be having,
how do you know when is the right time
to go to the emergency room,
that's what I'm gonna discuss in this video
to help you when you ever get an AFib attack.
And make sure you stick around to the end
'cause I'm gonna talk about ways in which I can help you
with minimizing the amount of AFib attacks that you have,
no matter where you live.
So AFib attacks,
AFib attacks basically are debilitating symptoms
of atrial fibrillation,
usually they happen when people have
what's called paroxysmal atrial fibrillation,
where if it comes and it goes
and you're not an AFib all the time.
So a person may be having a nice natural, steady heart rate
in the 60s and 70s and from one moment to the next,
boom, that heart rate goes up, way up,
it goes anywhere from 120, 150,
sometimes even faster than that.
People usually describe that it feels like
their heart just exploded and it's off to the races,
people usually feel that
their heart is going extremely, extremely fast.
However, some people also have different symptoms as well,
some people may have chest pain
because their heart is just going so fast
they're actually not feeling the heart racing,
they're just feeling like a intense pain
and pressure in their heart, and you may be wondering,
"Is that a heart attack
or is that Afib causing this pain or pressure in my chest?"
Some people may feel just very dizzy or lightheaded,
just from the lack of blood flow
from the heart rate going so fast,
lack of blood flow to your brain
making you feel dizzy or lightheaded.
Some people may just have severe shortness of breath as well
just because the heart's going so fast,
kinda like when you're running
and you start feeling short of breath,
same thing's happening
except that you're not running at that time,
though the heart rate is going extremely fast
during an AFib attack.
The upper chamber of the heart or the atria
which where AFib comes from
and actually going extremely fast
usually over 600 beats per minute.
Fortunately the pulse comes from the ventricle
or the bottom chambers of the heart
which usually do not go that fast,
as fast as the atria goes,
but it can still go extremely, extremely rapid,
anywhere from 120 to 150,
sometimes even close to 200 beats per minute.
It can cause severe debilitating symptoms.
So if you're having an AFib attack
or you wanna know what to do
if you're having an AFib attack, here are my top tips
for anybody who is having an AFib attack at home
to try to improve your symptoms,
potentially stop an episode,
potentially avoid a trip to the emergency room
and also understanding when is the right time
to go to the emergency room.
So what are ways in which you can stop this episode of AFib?
Number one would be things that you can do at home
which would be,
one way you can do that is what's called vagal maneuvers.
Vagal maneuvers are ways in which you activate
your vagus nerve, which is a main nerve in your body
which could help slow your heart rate down
and sometimes even could even stop the episodes of AFib.
But it can certainly help to slow your heart rate down.
One of the most common one would be called
a valsalva maneuver.
Valsalva maneuvers are where you basically
take a deep breath, hold it in, and then push down,
kind of like where you're having a bowel movement,
so you're pushing down on all your muscles.
So just take a deep breath and then you push down in,
kind of like if you're having a bowel movement
and just pushing down
and that can help slow your heart down
and improve symptoms of AFib attacks.
Also other things that can slow your heart down
and improve symptoms would be
what's called a carotid massage.
The carotid is your artery that's right here
on the side of your neck.
If you feel where the pulse is the strongest,
right next to it there's a strong area of the vagus nerve
called the carotid body,
has a lot of nerve inputs right there.
So you would put a nice firm pressure on there
and massage it for about a minute,
that can help slow your heart rate down as well.
You can also do the other side as well,
just don't do 'em both at the same time.
Okay, so you can alternate from one side to the other.
Just have a nice steady pressure,
massage it in a gentle circle like that
and that help slow your heart rate down
and improve symptoms of an AFib attack.
Another thing that you can improve symptoms
of an AFib attack and slow your heart rate down
and potentially stop that AFib episode
is what's called a divers reflex.
A divers reflex is when you actually put your face
in usually very cold water,
you get a bucket of just ice cold water
and just submerge your face in it for several seconds.
That can actually activate your vagus nerve
and slow your heart rate down.
Another thing that can potentially help with an AFib attack
but I wouldn't recommend it if you're having severe symptoms
would be actually exercise.
I've had countless people tell me when they have Afib,
if they exercise, usually something cardiovascular
like either running, doing sprints
or going up and downstairs very rapidly,
that could help stop their AFib episodes.
But if you're already having severe symptoms
from an AFib attack,
exercise may not be the best option for you.
Other option to stop an AFib attack
would actually be medications.
Medications including additional medications
of what you normally take at home.
These are just tips, always ask your doctor
to see if any of these strategies
are acceptable in your setting.
Commonly people with AFib either take beta blockers
such as metoprolol or carvedilol
or sometimes calcium channel blockers like Cardizem
and taking extra doses of of your medication
can actually slow your heart rate down
and may actually help stop an AFib episode as well.
Metoprolol and Cardizem, they do affect blood pressure,
so always keeping an eye on your blood pressure
if you're taking extra doses of your medications.
In addition, there are other medications,
particularly antirrhythmic medications
that can help stop an AFib episode
or stop a severe AFib attack.
One of the most commonly used for stopping an AFib attack
would be a medication called Flecainide.
Flecainide is an antirrhythmic medication
which is commonly used in a technique
that was frequently called a pill in the pocket technique.
A pill in the pocket means that you usually would take
a pretty high dosage of Flecainide,
usually around 150 to 200 milligrams of Flecainide
in one dosage, ingest the pill
and see if the AFib episode will stop in its own
with the aid of that medication.
And it certainly can be useful for some people.
Obviously because it's a pill, you have to digest it,
it has to get into your bloodstream,
so it might be 30 minutes to an hour
until you really see that effect
from the pill in the pocket technique.
But Flecainide is probably one of the only
antirrhythmic medication that you can take
which may actually stop an AFib attack
relatively quickly at home.
The rest of the medications are usually
more of a slower acting
or long-term rhythm control strategy.
Obviously these are strategies for you to take at home
or things that you can do even at home.
So at some stage you need to know when is the right time
to go to the emergency room.
And the number one suggestion or recommendation
for knowing when is the right time
to go to the emergency room is actually your symptoms.
It's not the heart rate, it's not whether your heart rate
has been going 120, 150, even 180,
it's not the number itself that matters the most
but how you feel that matters the most.
So it really doesn't matter how the number is
or how long it's been going fast for.
I've had some patients who have had heart rates
in the 130s or 140s for weeks at a time
and they've been perfectly stable for outpatient management.
So it's not the number but how you feel.
So if you're having severe shortness of breath, chest pain,
dizziness, severe symptoms of your heart racing
where you feel like you just can't take it anymore,
and none of these other things that I recommended
at the beginning of this video have worked for you,
that would probably be the sign to go to an emergency room.
An emergency room is where they can give you
intravenous medications,
the ones that will act fairly rapidly
to help control your symptoms.
Usually in the emergency room, they'll give you
intravenous medications that will slow your heart rate down.
The most commonly ones used would be
intravenous versions of metoprolol,
as well as another one called Diltiazem,
which can help slow your heart rate down pretty rapidly.
And so they're gonna be most rapid onset
or relief of symptoms.
There are other intravenous medications
that can be used as well,
but those would be the most commonly used.
But at some stage when your heart rate is very fast,
intravenous medications in emergency
is gonna give you the most rapid relief,
especially if these other at home strategies
did not work for you.
Now, long-term you don't wanna have AFib attacks,
you wanna have less AFib attacks over time.
Obviously when you're having an episode,
you gotta do what you have to do
to alleviate those symptoms, whether that's treating at home
or eventually going to the emergency room if needed.
But then long term AFib continues to keep happening
and a long-term treatment needs to be strategized
to try to minimize episodes or reduce the amount of episodes
that you're having, which can include medications
such as beta blockers or antirrhythmic medications.
This is where procedures
such as catheter ablation procedures
can be really helpful to minimize
how many of these AFib attacks are happening.
But then also lifestyle modifications really help as well.
So that include things such as losing weight,
minimizing artificial ingredients, minimizing added sugar,
reducing alcohol consumption, all these lifestyle things
can really reduce, in the bigger picture,
in the long-term sense to reduce how much episodes of Afib
or how many AFib attacks that you're having.
And that's why I created to Take Control Over AFib Program.
The Take Control Over AFib Program is the step by step guide
to apply all the lifestyle modifications that you need
to improve AFib naturally
and to reduce the amount of AFib attacks you're having.
So right underneath this video, you'll get to see a link
to the Take Control Over AFib website where I list in detail
what's included in the program.
So see for yourself,
see even something that could benefit for you.
You can also see testimonials
of people that have actually signed up for the program,
see what they have to say as well.
And see the Take Control Over AFib Program
can be right for you.
But when you have an AFib attack,
please take a look at all the tips
that I mentioned earlier in this video.
See if they can help you reduce your symptoms of AFib
and hopefully reduce the chance of needing
an emergency room visit.
Till next time, I wish you the best with your AFib.