AF Association

Hospital visit today

I've just returned from my visit to the Cardiology Department at my local hospital.

At no time did I see a Cardiologist. A very lovely Nurse Practitioner took all my details and read my ECG print out and then trotted off to see the Consultant. She returned and offered me a cardioversion, but I would have to go on Warfarin and another drug which escapes me and have the cardioversion in 6 weeks. However, I have terrible IBS and so Warfarin is not an option for me.

The other suggestion was to offer me Diltiazem in support of the other drugs I'm taking. (10mg Bisop, Digoxin 125 mcg and Candesartan for my BP, plus IBS treatment). No anticoagulant was offered for this option, despite my mentioning that my father and his siblings had all had strokes, which killed most of them.

Am I right in believing that none of these drugs will actually alter the rhythm of my heart? I thought that was the whole idea.

I was taking Adizem for 7 years prior to this recent AF (my GP took me off it in favour of Digoxin) and I told her this, but she said it is not the same as Diltiazem. After a minor tantrum on my part, the Nurse went back to the Consultant who decided that I should stop taking the Digoxin and start taking Apixaban. The whole episode was surreal. I asked why I wasn't being offered a rhythm control drug such as Flecanide. Do they actually care that they're giving me drugs which make me absolutely exhausted and ill? The Nurse told me she couldn't really go back to the Consultant to ask. She assured me that at 61 I am at a low risk and will arrange for an echo and a 24 hour monitor.

I suppose at least I got my anticoags.

I'm sorry this is longwinded, but it took a huge amount of courage to go today and to not even see anyone who could make a decision, make me feel very insignificant. I left the hospital totally dejected.

Any uplifting comments would be gratefully received :(


19 Replies

I can see why too! Whilst I have a great deal of faith in these Arrhythmia nurse specialists it does seem strange that you haven't actually seen a doctor yet. As you say at least you are now properly anticoagulated but you now need to ensure that your GP will continue prescribing it so make an appointment to see him/her soon. I would write and ask to see the consultant and stress that you are not happy with the current situation or look elsewhere for a consultation Sometimes it may be necessary to make a private appointment first to actually get into the system and then revert to NHS. Many have done this.


I think I may have to do that. All that has happened is that I am on the same drugs as before. I pointed out that if my heart rate is 109 BPM, then clearly they aren't working and she agreed. So the solution is to give me back the drug I had been taking for the past 7 years!?

The Apixaban was an afterthought after I suggested I needed it.

I have health insurance through my employers. I might ring them tonight and see what they have to offer.

Thanks for your help :)


Hi, After reading your post if I were you I would not be happy at all,

surely you are entitled to see a cardiologist. I dont know how things

can differ so much in different parts of the country. I went from my

GP to cardiologist after three visits with proof I had af on ecg, how do

you differ. By the way I have IBS and instead of warfarin I take rivaroxaban

and also bisoprolol. Im sure the nurse was very nice I have been treated

really well by everyone Ive met but really having messages passed to

you is not right. Do hope you get sorted you need to for peace of mind

especially with your family history. Shirley.


Absolutely agree with the above comments. I would strongly recommend that you write, I was told by my GP that any verbal communication can be dismissed and/or forgotten, however, the situation changes when you put anything in writing, it cannot be ignored and they have an obligation to reply to your concerns.

May I humbly suggest you write something to the effect that 'you were expecting to see a Cardiologist for an assessment and with whom you could discuss a treatment plan'. etc, etc. End by saying you have a number of urgent concerns and would like to know when you will be seen by a cardiologist, preferably one qualified to offer specific advice on the treatment of AF.

It is very concerning to hear such appalling treatment. On my first visit to cardiology I had an hour long consultation, the cardiologist took a long time to explain things to me and suggest options. As it turned out I didn't like his options and went privately but that is another story!

If you are not happy please do continue to pursue this matter.

Very best wishes CD


I shall certainly use your template, thank you. I worked as a medical secretary and agree that verbal communication doesn't get a reaction very often. I need to be pro active don't I?


If you have health insurance, I'd use it if at all possible. I had insurance years ago when I started with AF, and the service level was very high and everything happened quickly. I only saw the main EP/Heart Rhythm Specialist.

Failing that, personally, I would contact the cardiologists secretary and tell him/her how worried you are etc. See if that gets some action.



agre with everyone so far- very good suggestions- sorry it is so frustrating for you


Thank you so much for your replies. I am going to write to the cardiologist concerned. I do believe, that on my first visit at least, I should have been seen by someone with whom I could discuss my treatment and someone who could actually offer me rhythm control medication.

This gets a little worse I'm afraid - when the (very nice) nurse told me that the cardiologist had suggested the Diltiazem and I pointed out that I had been taking Adizem for 7 years and that my GP had told me that I could not take them with Bisoprolol. She advised that Adizem and Diltiazem were not the same drug but Google says otherwise bless it.

On my way home tonight, I called into my chemist and gave him my prescription. He commented that the Diltiazem was half the strength of the Adizem I had been taking and asked me why they had been prescribed. He then noticed that one 125mg SR tablet per day had been prescribed, when in fact they are a twice daily tablet. He was concerned and declined to give me either tablet until he had spoken to the Cardiologist tomorrow.

Essentially, apart from the Bisoprolol, I am on the same medication when I wasn't in AF but at a lesser dose. How on earth does that make sense? The only thing that hasn't changed is the Candasartan I take for my blood pressure.

If it wasn't happening to me, I wouldn't believe it.


Hi Jaybedee

Nothing I can add to the excellent advice you have received and with which I agree wholeheartedly.

There are some really interesting theories and this has been discussed even at national Conference I believe, that women who go for specialist appointments tend to make themselves up, and to some extent dress up, and that by doing this in some way it actually takes away from the seriousness of their condition, and that they are treated more (what's the word flippantly?) by the specialist staff?

I would be interested to know if this was the case here as it may be one of the indicators as to why you got such poor treatment

As a man (Yes and maybe a slob) I wear clean jeans for an appointment, and of course none of the makeup (saved for weekends indoors) but does that then come across as more assertive?

Of course we have a right to expect exactly the same treatment no matter what we wear, or whether or not we are assertive, but is that the reality of the situation? Does our sex and our attitude really make a difference when we go and see a specialist?

Forgive me for sidetracking, but I thought this an interesting thread possibly, as certainly women are now suffering more heart disease etc, but often get very different treatment.

If you wish I could open a thread about this.



You are right there Ian. we did discuss this but only after a Daily Mail article about it some two or three years ago,. The theory is that because ladies usually wear makeup and try to look their best at all times etc they often mask how they feel and appear well to the doctors they go to see. I guess that make up can work both ways as I found when appearing in the film I did about AF and looking absolutely near deaths door but I doubt many ladies would want to go to the GP wearing very pale grey foundation, hair matted down with "sweat" and with fake sweat sprayed all over their face. lol There is no doubt that appearances count. I always try to appear smart in public , NEVER wear jeans (Jeremy Clarkson does, nuff said) and often get told how well I look even when feeling less than perfect



Yes please - a new thread on clothes to wear for appointments would be very interesting


Well its true that we do judge by appearance when we shouldnt really.

Im not very assertive and lack confidence in many situations, but Im

old enough to remember when doctors were almost like royalty and

we were not expected to ask questions or comment on our treatment.

Thank goodness all thats changed but as far as Im concerned old

habits die hard. Having said that Ive been dealt with courtesy by

everyone Ive come into contact with, even when in the iab for what

turned out to be an aborted attempt my EP said we will now introduce you

to the staff caring for you today and they all repeated their name and

job, I was astounded. I did wonder if this was normal practice. Sorry gone

off subject a bit but judging by some of the comments I have been quite

lucky. Shirley.


Oh yes I can remember that time too and the fear still lingers :)


Hmm well I have to be honest. I was going straight to work after my appointment at the hospital. So was wearing pretty much my usual look I think. I work in a legal office so my dress was appropriate, black trousers and white blouse, black shoes, etc. (my son says I look like a waitress). However, nerves do take the better of me and I can come across as a bit snooty when scared rigid . :)

The Nurse Practitioner/Arrhythmia Nurse was young enough to be my daughter. However, I can say that most of the people in the waiting room did look very elderly, so I guess I was possibly the youngest there.

I see where you're coming from with regard to the make up and for the first time in a long time, I did actually wear some. I never go anywhere without mascara, but on this occasion I did put a bit of makeup on, it really is like a mask to hide behind. However I stomped the 2 miles to work and there was very little left upon my arrival at my desk!

I new thread on this subject would be fun



go armed with all your questions written down, if possible be as knowledgeable as possible about the areas you wish to discuss . Dont be daunted they are all people the same as us. Be as assertive as you can or ask someone to accompany you. I would demand in a polite way to speak to the cardiologist as nurse practioners as brilliant but their role is limited within their chosen fields.


go armed with all your questions written down, if possible be as knowledgeable as possible about the areas you wish to discuss . Dont be daunted they are all people the same as us. Be as assertive as you can or ask someone to accompany you. I would demand in a polite way to speak to the cardiologist as nurse practioners as brilliant but their role is limited within their chosen fields.


I did have my questions (taken from the AFA site and recommended by Vicki). I also jotted down all the things I had felt for the last week, such as breathlessness, tiredness, flu like symptoms, terrible fatigue etc. to try and give a comprehensive picture of 'me'. She barely glanced at it ! I proceeded to ask, rather tentatively, a few questions. She answered some.

I asked about rhythm control on a few occasions and she did ask if I had tried the 'pill in the pocket' and I said I hadn't but I would like to try flecanide as a remedy for the arrhythmia. But the consultant seemed to think it is better for me to revert to the drugs I was taking before this 'episode'. - Had she taken the time to talk to me, she would have been advised that I had already taken the drugs and they no longer worked, which is why I was at the cardiology unit again. The whole thing is so frustrating!

I am about to compose my letter to the hospital, whilst I'm in the mood to 'have a go'.



good luck


I'm quite offended by the suggestion that if you're male, you don't make an effort to be clean and tidy when you meet your EP.

When I go to see him I even take my wellies off before I go into his room, or at the very least scrape them off first.



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