A Shocking Visit to the ER

Last Tuesday afternoon, after experiencing atrial fibrilation (when the two upper chambers of the heart, the atria, beat irregularly and out of coordination with the two lower chambers, the ventricles) and rapid heart beat, my nurse, Ernie drove me to the ER at UCSD/Thornton Hospital in La Jolla. In the morning, I felt my heart beating faster than usual, but thought it might slow down, as it usually does. I was lifted out of bed and into my wheelchair. As I sat in my wheelchair at my computer, my heart continued to race. Instead of going down, my heart rate got faster. As soon as Ernie showed up for work at 2:00, there was no change in my heart rate, so I had him drive me to the ER right away.

Once at the hospital I drove my chair as fast as I could to the ER. There were already a few people waiting as I arrived, and was afraid I would have to wait a while to be seen. Not a comforting thought as my heart continued it's rapid and irregular beat. To my relief, it was a brief, yet anxious wait. Since I had a heart problem, they took me in ahead of everyone. After a brief visit with the triage nurse I was ushered to an examination room where I was transferred to a gurney and put on one of their vents.

My heart rate got up to 182. They did an EKG and they had to find a vein to start an IV. They also took a blood sample from a good vein in my foot. The blood work showed that I had low potassium levels. About an hour later, after much searching and poking, and the help of an ultrasound machine they found a vein in my arm. Through it, they injected a medicine to slow my heart. Almost right away my heart slowed down. It felt like my heart would stop. Unfortunately, it only slowed my heart rate temporarily. This meant they would have to use electroversion, or electric shock to convert my heart back to a normal heart rhythm. It was not a very pleasant thought, but I steeled myself for this necessary procedure. I had an image of being shocked by the paddles and my body jumping. The doctor put me at ease by telling me that I would be asleep during the procedure, so I wouldn't feel a thing. I guess I have seen too many medical dramas. Instead of paddles, they stuck large pads to my chest and then injected a drug into my IV which knocked me out. They shocked me and my heart returned to a normal rhythm. I was allowed to go home when they were satisfied that my heart was staying in rhythm. I was at the ER for five hours and avoided a stay in the hospital.

This was not my first experience with rapid heart beat and atrial fibrilation. Last month I was hospitalized for rapid heart beat and atrial fibrilation after having a trach change(see Hospital blog post) I thought it was due to the Tetracaine, used to numb the trach area. In that case, my heart converted back to a normal heart rhythm by itself. It was also found I had low potassium. I thought it was an anomalous occurrence, but when it happened again without Tetracaine, I realize that there is something going on with my heart. I hope when I see my cardiologist next month he can get to the bottom of this. It is not something I want to keep experiencing. Since the shock, my heart rate has remained stable, but I am crossing my fingers that I won't have a recurrence.