Suggestions on referral to an EP...

Hello, I have requested an appointment with an EP my GP says this has to be done through the Cardiologist who has recently discharged me.However,he has referred me back to the Cardiologist. Can anyone advise me as to how to approach the Cardiologist with a view to being referred by him to an EP of my choice. Also the fact that I am on Asprin although my CHAD is 2 which my GP believes is not an entitlement for Warfarin. Many Thanks.C

[Beancounter Volunteer]

Hi Caromia

You have been diagnosed with A Fib I presume?

If so then everything I have read tells me your GP is just plain wrong, you should be on an anti-coagulant such as warfarin, with a CHADS of 2, and not on the aspirin, unless you have other heart based conditions for the aspirin.

However I am not medically qualified, and I am really surprised that the cardiologist did not refer you to the anti-coagulation clinic immediately.

The risks here are stroke as I understand it, not really the A Fib.

If you have been diagnosed and discharged and are unhappy about the reasons for the discharge, then I would ask your GP to refer you to another cardiologist at this stage and if he/she won't do this, then I honestly would look for another GP.

You have to have trust and a two way conversation with both the GP and the cardio, and right now it sounds like both are leaving you unsatisfied, and that has to change.

Have a look on the AFA website for more information, or maybe even ring them tomorrow, I am sure they will point you in the right direction.

Wishing you all the best

Ian

[Hidden in reply to Beancounter]

Hi ian,You are right I am loosing trust here now and feel my my condition is being played down for whatever reason. I am quite athletic and appear and look very fit which maybe sends out the wrong signals, never been on medication before and recently trekked through the wilderness of Canada were there "ain't" anymore wilderness.My GP of nearly 30 yrs said only this week when I expressed my concerns that I was fitter than most 50yr old but of course he is blinkered. Thank you for your advise. At this moment I am attempting to contact AFA...KInd regards.C

[TheStand]

caromia, I agree 100% with Ian. With a Chads score of >2 there is no choice. The Chads results sheet say you should be on an anticoagulant. This is not uncommon unfortunately, There is another on here with a chads score of 4 and was told to just take aspirin. I have spoken to so many that where told just to take aspirin and then had a stroke following an AF attack. As Ian said, call the AFA and speak to them. I'm sure that they will be able to point you in the right direction.

Tim

[Hidden in reply to TheStand]

Hi,Keep trying to get through by phone to AFA for at least an HR now will try again in a few mins.C Thank you for your continuing advise.C

[BobD Volunteer]

Hi there Caromia,. There is a list by area of EPs on the main AFA website so look one up and demand that your GP writes and refers you.as is your right.

No doubt you should be on anticoagulants but sadly this is all too common in UK which has one of the lowest number of at risk patients anticoagulated in Europe. Many GPs are plainly still in the dark ages. Aspirin is of no benefit in AF yet remains with the possibility to cause you harm (internal bleeding) .

BobD

[Hidden in reply to BobD]

Hi Bob,Thanks for your advise but my GP is still insisting that this is the procedure that has to be followed ie Cardiologist referral to EP.Also the medication is doing its job and I am at a low risk of having a Stroke..I don' have a problem with my GP of 26 yrs but I am sure he feels that I am over reacting here.Thanks again.C

[Hidden in reply to BobD]

Hi Tim, Thank you fro your reply.When I am with my GP and he explains why I am at a low risk it sounds plausible and I get sucked in.I have an appointment now in June with my original cardiologist and I will ask him does he think I should be referred to an EP.Thanks again for you help.C

[johncb]

I live in Australia and you certainly can get a referral from a GP to an EP. I had a cardiologist who didn't believe in ablations for AF, so I saw my GP and got the referral immediately, had the ablation almost 3 months ago and after some problems in the early stages of recovery (was warned of this by the EP) am now completely free of AF and have never felt better.

You should certainly be on an anticoagulant, I am on Pradaxa for another 2 weeks and had no problems at all with it. I don't like the sound of your Cardiologist, get to a EP as soon as you can and preferably one who has done 1,000 ablations or more. Good luck

[Hidden in reply to johncb]

Hello Johncb,Thank you for your advise I have an appointment with the cardiologist in June and will suggest to him that I see an EP.C

[BobD Volunteer]

As has already been said with a Chads score of 2 you are at stroke risk. Don't let your GP talk you out of that and remember that once given a score can't be removed so for instance if you score one for high blood pressure but take tablets to control it ,then that score stands and does not suddenly vanish into thin air.as some people might think. A more accurate risk assessment is the Chads2Vasc2 score system. so do look tghat up and check you rating.

Sadly many GPs are terrified of warfarin yet dismiss the very real risk of aspirin and since this has been proved to be of little value in stroke prevention for patients with AF you are taking something pointlessly which could harm you. Full info form fact sheets on AFA main website might help your GP into the 21st century.

BobD.

[Hidden]

Thank you Bob.C

I have sent another message with my scoring.