Emergency appointment with Cardiologist

My husband had a Cardioversion on 28h November which brought him back into sinus rhythm. It lasted all of 12 days.

After that he was back to a heart rate of 130. So, basically he's been in AF since October with a break of less than a fortnight, with a heart rate of 130/140.

We had an emergency appointment with his cardiologist this morning who prescribed Amionadone, because he said his heart rate had to come down because it was damaging his heart. He will be given another Cardioversion in February. He talked about ablation in a very negative way, saying they only really work in younger people who have a slower heart rate when in AF (he's just turned 60). He didn't recommend it.

His attitude was that nothing much was going to help. He mentioned having a pacemaker, but shrugged his shoulders as he said it as if that probably wouldn't work either.

We said that the 10mg of Bisoprolol was making him dopey and unable even to drive - and he's a driving instructor - I'm having to do all the driving at the moment - but he said it was the best drug and even if it didn't reduce his heart rate would stop him going into cardiac arrest. Really, is that true??? He wouldn't change it.

He also wasn't even sure whether Amiodarone would do anything.

We appreciate being told it like it is, but some of what he said contradicts what I've read on this site. It's been depressing, to say the least.

Sorry it's me writing but husband can't cope with medical stuff. I would just like some opinions on this. Thanks guys.

15 Replies

  • I would say, he should ask his GP to see an EP rather than a cardiologist. It's a bit like, as Bob says, asking a plumber to tell you about your electrics - they can be the best plumber in the world but they know a limited amount about fuses. Of course there are other drugs, and other options - and certainly I've seen people post here who have had ablations much later in life than 60. It sounds to me like a lazy answer to his problems... He's entitled to see an EP and it would be in his best interests to press for that I'm sure.


  • What a load of rubbish! Politest thing I can say.

    I have been given Propafenone to keep my heart in rhythm and Diltiazem to keep the rate down. That worked.

    I was promised a consultation with an EP with a view to having an ablation if the meds no longer worked. I was 69.

    I really don't think your husbands cardiologist is trying very hard (I'm sure you can translate that.....)

    I'm very sorry you are having such an awful time - I really mean THAT

  • So true, it made me angry just reading this post and was trying to curb my instinct to be rude about the cardiologist. I am also on Propafenone all the time and Metoprolol as required for rate control. The Propafenone even converted me back to NSR when I started taking it (after one beta blocker got me stuck in a persistent flutter) before I had a cardioversion.

    Thank goodness there are second opinions to be had on this site so people don't have to suffer this high handed treatment without question.


  • I don't know if it is at all possible for you but if it is I would pay to see an EP privately as soon as you can.

  • Hi davesgirl

    As others have said you need to see an EP quickly, and ideally before the CV in Feb, because the chance of that sticking for any length of time is probably quite low.

    I always found Bisoprolol a "zombie drug" others get on OK with it, but even at 1/4 the dose your hubbie is on I was asleep every afternoon, and I'm no supermodel build believe me.

    However Bisoprolol is very popular as not only does it usually control a high heart rate but it has some rhythm control built in as well, but nothing like as powerful as Amiodarone.

    Ask your GP for an urgent referral to an EP, or as also stated if necessary go for a private appointment, others can tell you how much that is, I think around £300 but that's a guess.

    Also you could try ringing the AF helpline, it's exactly the sort of case where they can tell you the best next steps, not going to comment on the Cardio (but he sounds like at best 10 years out of date)

    Be well


  • It doesn't sound a very comprehensive review of options, it wouldn't make me very happy. I also think you need to see an EP. I was told that they don't like you to be in fast AF for sustained periods as it can damage the heart, so there might be the case of trying to manage that whilst waiting to see the EP. They have tried so many things with me, I can't believe that there is a single solution that you can like or lump it. I was put on and still use if I go into a fast AF episode of any length Metoprolol (tried Bisoprolol) so can't even believe there aren't other alternatives to try for rate control, let alone longer term solutions. Keep your cool and see if your GP will refer you directly to an EP.

    All the best.


  • Thankyou so much everyone, for your advice and quick replies. We are going to try to see an EP as soon as we possibly can. We may contact the AF helpline, too.

    As far as nutrition is concerned I've given him magnesium citrate from day one, plus high quality multi vitamins and minerals. Under the supervision of a complementary therapist he's been taking Crataegus as well. I'm all for taking the best of all worlds....basically, I think it all helps. We've even gone organic!

    The underlying cause has been massive stress stretching back years. The cardiologist said his heart has been strained which resulted in scarring.

    So, we'll see what we can do tomorrow, thanks again.

  • bigleg I have found having potassium high foods had helped my AF and when I looked at the link you gave above many of the foods for potassium are included- I think both potassium and magnesium are needed in diet in larger quantities

  • Davesgirl...how traumatic for you and your husband...even the mention of cardiac arrest must have been distressing. I agree with everyone above...your husband should have been referred to an EP. I am sure once he gets the right advice and treatment, his heart will settle down. I really feel for you reading all that. A GP once told me to "fight my corner a bit more assertively" with the cardiologists....i have learned to do that over the last 18 months as I used to be so stoic and scared of being perceived as a nuisance but now I just think this is my health and i have to be proactive. Good luck.

  • Thanks Vony. It wasn't until I read everyone's responses that it's really sunk in how badly we've been treated. Sad, isn't it.

  • Utter Bollocks! Sorry to use such profanity but this makes me really angry. I had my first (0f three) ablations when I was 60. Demand (don't ask) to see an electrophysiologist and if necessary pay for a first private consultation. This is just not right to be treated this way. It is 2014 for goodness sake not 1814 !!!!!!!! (Unless there are other cardiac conditions which would prevent an ablation of course.)

  • Nope.....his heart is actually very healthy, and he's never had any chest discomfort. He doesn't have any symptoms indicating AF other than breathlessness when it went up to 170.

    Thanks Bob, that's interesting to know about your experience. I've been reading a lot on this site over the last few weeks, and I knew that what he was saying wasn't right.

  • I had high HR in 160-180 range due to flutter (rt. atrium) in addition to A-fib(lt.atrium). I am 67 and in otherwise good health and active refereeing soccer and playing full court basketball. Opted for ablation and flutter is gone and after 2 weeks post ablation a-fib almost gone. My only problem is ongoing muscle pain in shoulders due to Xeralto (about 10% have this side effect). Really pleased with ablation results so far. Did 1 !/2 mile fast pace walk today with light jogging with no adverse effects. Cardioversion results usually don't last. I'd suggest a second opinion with a different cardiologist that is experienced with ablation. Research the drug he is on. Severe long term damage to organs possible with Amiodarone.

  • My GP, Although having someone in mind, went through the list of specialists carefully so as to ensure that I went to see a EP specialising in AF and who performed cardioversions and catheter oblations rather than a general cardiologist. Very pleased indeed with GP's selection.

  • Thankyou Peter. It's always interesting to hear how other GPs deal with this.

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