The 40 ton truck that is AF!

[Jollies]

Went to see my GP on Thursday and feel like I have been hit by a truck. I am still spread eagled on the front clinging on for dear life! Didn't really have much chance to ask questions as I was shocked. The results of a recent ECG show a rate of between 100 - 175, so the slozem has not been working. I have had a failed cardioversion too. I suspect that because my condition was undiagnosed for so long I have now got heart failure. My ef (?) is 30% as opposed to 60 65%. I keep on forgetting what it's called but the left hand valve is enlarged ? Luckily I have a hospital appointment on Thursday. For now I am on digoxin, ramipril and spironolactone. My inr is 2.7 and I have a blood test booked for 10 days time. What questions should I be asking my cardiologist ( or the underling who works for him) I am seeing an EP for the first time in December. Thanks x

[jennydog]

Has the Cardiologist refered you to the EP? Could the EP's secretary be contacted to bring the appointment forward? The first time I saw my EP he asked my Cardiologist to fit me with a 7 day loop recorder to see what was happening as he thought that I was having more attacks than I recognised. Ask the Cardiologist if there have been sufficient test results and recordings for the EP to have a complete and clear picture of your problem. This should all save time and help the EP to reach a decision about your treatment promptly. Good luck.

[Beancounter Volunteer]

Hi Jollies

Not sure what the GP told you that was so difficult to take?, was it the results of the ECG or the heart rate?

You've obviously seen a cardiologist before, and you know you have AF so let me try at least to unwind some of the things you have said.

I'm not medically trained in any way just so you know.

You recent ECG shows a HR or 100 - 175?, that's unusual for it to vary so much during a relatively short timescale like an ECG, did they follow that up with a heart rate monitor?.

Failed cardioversion is very common, many of us have had that and you need to be more specific here, did it fail completely, or did you go back into NSR even for a few minutes or seconds?. It makes a difference I understand to the likleyhood of reversion to NSR using an ablation or similar.

You think because your AF was undiagnosed for so long you now have heart failure, well that's probably unlikely, AF does not usually cause heart failure, people live with AF for a very long time indeed, however bad it feels when you have it.

My ef (Ejection fraction?) is 30% as opposed to 60 to 65% Well that's not good and as you say will need to be treated, but it's not usually a symptom of AF.

The left hand Atria? is enlarged, that's the very common symtom of AF the atria dilates and becomes flabby due to the abnormal beat, the good news is that the size is a good measure ofhow long you have been in AF (and it only gets so big and then stops usually) and also on how likely an ablation is to work. If it's too big they look at surgical ablation rather than catheter I understand. And it goes back down when you go into NSR eventually.

Your INR is fine at 2.7 and where it should be anywhere between 2.5 and 3 is good and that's a result of your warfarin.

OK what would I ask my Cardio next week, well firstly I would want to know about the underlying structure of my heart, has he/she done an echocardiogram, and/or an angiogram to check what is happening?

I would then ask about the ejection fraction, sounds low ask him/her what can be done about it and what the prognosis is. I would also ask if I can get to see the EP earlier, your Cardio would be the best person to do this.

Lastly we ALL know what you are going through, the diagnosis is exactly like being hit by a truck and that truck carries you along a long way before you manage to crawl off the front and come to terms with AF. But you will and then you will learn to live with it, knowledge is key read everything you can especially the AFA website, and of course ask us anything you like, that is what this forum is all about.

Be well

Ian

[Jollies in reply to Beancounter]

Thank you Ian. Have been diagnosed with Af for 11 months. Have not actually met my cardiologist yet as he wanted me to have these tests first. I asked my GP to refer me to an EP or that wouldn't even be on the table yet. I badgered my GP to do it and will let the cardiologist know about the EP appointment on Thursday . I suppose the thing that shocked me was the ef of 30%. Been managing my warfarin ok for the past 10 months, although there was no one at our surgery to do it the other day so had to get it done at Sainsburys (disappointed that I didn't get nectar points) x

[Hidden in reply to Jollies]

Sainsbury's do blood tests? Crikey. Live Well For Less in action eh?

Lis

[Barb1 in reply to Jollies]

Sainsbury's??? I am intrigued....

[Jollies in reply to Beancounter]

Sorry, also never been fitted with a heart rate monitor. The cardioversion failed totally. Would not go into nsr at all, got zapped 3 times x

[GivEmkeL in reply to Beancounter]

Well said, Ian!

[barnes12 in reply to Beancounter]

Ian what does ejection fraction mean karen

[Beancounter Volunteer in reply to barnes12]

It is the percentage of blood which leaves your heart when it pumps (from the ventricles) they fill up and then pump and some is always left behind, 70% is considered very good.

Ian

[barnes12 in reply to Beancounter]

Thanks ian

[rosyG]

sorry to hear you are feeling bad -Ian has answered everything and I hope you get on well with the coming appointments

[Jollies]

Hi Barb and Lis. I live in a village just out of Cambridge. Our large Sainsburys which is about 2 miles from Addenbrookes hospital does blood tests Monday - Friday from 7 30 to 10 30 and then 430 until 7 30 pm. A phlebotomist comes from the hospital to do them. Most handy, just wish I could collect nectar points as I want to cash in my nectar points for an easy jet flight! X