Here we go

[NJ47]

Saw my Cardiologist on Monday. Holter monitor in about 6 weeks for 24hrs then almost certain referral to an EP for an Oblation.

Today I had my Echocardiogram where I got an unwanted surprise. I was told that one of my atrium is larger than the other meaning that Cardioversions may not keep me in sinus rhythm for long. First one was late November last year followed by my second on 4th Jan, just 6 weeks later.

On Monday night, my heart went nuts again, thankfully not going over 90bpm and reverted back 3 hours later, but I really thought I was about to go into AF again. No problems since..... yet, (that's the worrying bit). At least there's an answer - Oblation.

Can I please ask, if you're offered two hospitals to have the procedure, can I insist on which hospital I want, (under NHS)? My choices are Stoke or Leicester. I've been treated at Glenfield, Leicester before, and the hospital has a superb reputation. Also, what about EP's? My Cardiologist will sort it for me, but if I find, or am recommended a particular EP, can I/should I request him or trust my Cardio's judgement?

Thanks all,

Nigel

[Mike11]

You can insist on any hospital in the UK you want as your GP controls the budget, but that doesn't mean you'll get the same waiting time at your preferred one.

[dedeottie in reply to Mike11]

I live in Wales and discovered its not as easy as it sounds to request an E.P./ ablation in England. You can do this if your surgery is deemed to be urgent and you have been waiting for 3 months but for non urgent procedures my experience is that they won't fund it. Any other experiences with this? In the end I decided to stay with the E.P. At my local hospital. I think the case may be different if the closest hospital is in England. Mine was only half an hour away.

[Mike11 in reply to dedeottie]

Sorry yes you are probably correct - Wales has a devolved Health service so different rules.

[jennydog]

If I were you I would choose the hospital which is the most convenient because you will have to go 5 or more times ie See EP, pre-op, ablation. 3 month check, 6 month check.

I thought I had the best EP but on the day of my ablation he had an emergency so a different one did it, and he was amazingly good.

Lots of us have dilated left atria. Mine is called " severly dilated." It's not good but if the dilation isn't too bad then I understand that it can shrink back.

24 hr monitor? It would be a total and complete waste of time for me. You need it on for a week to stand a decent chance of picking anything up.

Best wishes.

[NJ47 in reply to jennydog]

Thanks Jennydog. When my Cardiologist suggested another Holter monitor I originally thought he said I'd be monitored for six weeks but then the person who did my Echocardiogram said I'd be monitored for just 24 hours. I agree totally with you. Last time I had a 24 hour Holter, it picked up one small incident. I then went back into AF 2-3 days later.

I'll suggest to my Cardio about being monitored for a week so thanks for your comments.

[BobD Volunteer]

Hi Nigel and that sounds like good news all round really. Enlargement of the left atrium is a normal side affect of AF as the constant fibrillation causes the muscles to enlarge and get fibrous in those with untreated AF. . The good news is that an ABLATION if successful can allow this to return to normal after a while.

I won't comment on the choice of EP but agree that you must be prepared to make many visits to whichever hospital you choose. MY EP is in London and I live in North Devon so I have spent a considerable amount of time and money travelling back and forth over the years. Add in the fact that you will not be allowed to travel alone post ablation and public transport is not recommended at such times and you can have a logistical headache of biblical proportions. Trust me when I say that seven hours of travelling for a ten minute consultation does get tedious after a while. LOL Still if you want the best..........

Bob

[NJ47 in reply to BobD]

Thanks Bob. Re choice of hospital that's easy. Glenfield, Leicester. Would you leave it to my Cardiologist to request the right EP, (after all, he's more likely to know them), or should I do my own research and ask my Cardio to appoint him. How did you select yours, Bob?

Also, Jenny mentioned that another EP ended up doing her op as hers had an emergency. Once I've got confidence in a certain EP I wouldn't be happy with this. I definately want someone who is very experienced with a good success rate. Would you allow a 'stand in' to proceed or insist on your personal EP?

Thanks.

PS. I've already decided. I'm definately going ahead with an ablation

Nige

[BobD Volunteer in reply to NJ47]

My local main hospital did not do PVI ablation and the consultant there was a friend of the chap at Royal Brompton Hospital to whom he referred me. I was lucky as he is a good man but that was nearly 10 years ago when there were far fewer EPs in UK. As far as choosing now, the best thing is to try to find out the number of PVIs done and success rates plus number of serious outcomes. When I met my man he told me that the worst thing that could happen might be that I died, I asked him when he last killed somebody to which he looked very shocked and said never. I then asked him to put me on the list for the week after he did as I would know that he would be much more careful then. We have been good friends ever since! To be honest, since I have always had GA I wouldn't know who did my three and suspect that he teaches during them anyway. Else how would anybody learn?

Bob

[NJ47 in reply to BobD]

I love your humour, Bob. Yea, I'll choose one who killed someone yesterday. Should be fine then, lol.

Seriously though, this forum is priceless. Thanks to everyone who has responded. I'll keep you posted re developments. Since the blip on Monday, my hearts behaved pretty well. Must be the thought of am Ablation, lol. Wouldn't it be nice if that fixed it forever? In my dreams, lol, sadly

[PeterWh]

The Hospital / my EP is in Central London and I live in Hertfordshire. Last week when talking about an ablation one of the questions I asked about was it feasible to go back on the train (station right near the hospital) with someone or go by car. He said that it would be absolutely fine by train (it is a 30 min journey). For my cardio version I did go back by train. From seeing the comments is it realistic to go by train?

[BobD Volunteer in reply to PeterWh]

IF you are accompanied then you may go on public transport but NOT alone in case of bleeding in the entry wound. After one of my cardioversions they asked if my wife was picking me up and I told then she was waiting in the car park. What i didn't tell then was that was Tiverton station car park. and that I had a 2 1/2 hour train journey once I got a cab to Paddington! Not one of my more sensible ideas to be frank. I really felt pretty bad and it seemed like the longest 2 1/2 hours of my life.