Annual reviews

I while back people were asking if others had regular reviews with their doctor so I thought the following may be of interest.

I will be 70 next month, had AF but clear for the last nearly seven years after three ablations, still get occasional bouts of multiple ectopics and short runs of tachycardia but not on any meds for AF other than warfarin with max 84 day tests.. Had prostate cancer in 2011 which was successfully operated on ((full prostatectomy) followed by 33 sessions radiotherapy and three years hormone implants. Now on three monthly PSA watch blood tests . Have a flu jab every year and the old poo sticks tests whenever they come through the post (two years?)

About every six months I am asked to do a seven day blood pressure chart which I send in to the medical centre and am on losartan amd amlodopine for BP plus statin for cholesterol.

Once a year I have blood test for liver and kidney function, cholesterol, blood sugars and a few other bits and pieces and have weight and BMI checks at that time.

I have just received a letter from my old EP at Royal Brompton Hospital with an appointment for July this year. Thinking this may be a mistake I rang his secretary. Early last year I wrote to him regarding a bad bout of ectopics and how we could deal with them but never went up to London to see him and they thankfully stopped after taking a couple of days of medication and a session of Bowen to relax the vagus nerve. EPs secretary told me he just wants to see me to make sure and to catch up on things also to keep me active on the books.

So my point is that some of us are well looked after with considerable after-care but do wonder just how many and how much it depends on a) how well you bond with and work with your doctors and b) how good are the internal systems at your own medical centre.

Discuss! lol


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16 Replies

  • It is definately something of concern from several viewpoints. Emotionally I think the majority of people would feel reassured that checks were continued, annually at a minimum. I personally think that should include full bloods, an ECG - 48 hour holter perhaps and most importantly - an echocardiogram to check for structural changes for anybody with any diagnosed with a heart condition, structural or arrythmia.

    I have talked to many people who are very concerned that even their BP is not checked when they go to their consultations, unless they are symptomatic. There are many changes which could occur which would not be symptomatic and which annual, systematic checks would highlight. I talked to a lady with long term AF (20 years) last week who hadn't seen a consultant for 9 years! There being no automatic call back system from the RD&E cardiology and, until very recently no treatment offered other than medication.

    I would like to see a systamtic protocol developed which would be actioned nationwide.

    My own experience was even when my GP persistently asked for a consultant appointment, the consultant just wrote back to the GP that there was no need and suggested a regime of increasingly toxic drugs if the Flec & Biso didn't work. My GP being very informed on AF, the only one in the area who was, told me I was an ideal candidate for ablation so recommended I went privately which of course I did.

    We now have a new consultant who is far more proactive, thankfully!

    That is of course an ideal. Will it happen? No, never on the NHS because the argument would always be that it is not cost effective. But I wonder if anyone has ever done a study to see if it would be?

    My company used to pay for an annual health check, as did my husband's and certainly that included all of the above, holter ECG substituted by treadmill stress test. I think the cost then (1992) was the last one I had, was about 350GBS.

    We are talking about our goal being optimum health, not emergency and acute management which is all the NHS is headed towards.

    In my humble opinion, we as patients, need more for our emotional and physical well being.

  • I suppose we could all apply for a motor race license each year and get all of the above. LOL


  • Hi Bob, I posted yesterday that I had had my 6 months post-ablation review and I purposely stated that I was to be seen again in another 6 months. The doctor indicated that there was always going to be the possibility of new arrhythmia pathways opening up in the future. I do know that a 2nd ablation is not a possibility so a pacemaker would be needed.

    In parallel with this the Cardiologist at my local hospital has also indicated that he will see me every 6 months. In view of this I was somewhat surprised that the EP wanted to see me again at it is such a stressful traipse to their hospital. But, I can't complain about such good on-going care, can I?

  • Traipse is a good word. Seven hours travel for a few minutes consultation from North Devon to London and back is definitely a traipse! Worth it if it keep one happy.


  • None at all.

  • Still awaiting my 6 week check up from Papworth. Hospital following my cardioversion at beginning of December. My previous GP needed permanently chasing. Have moved Area, so off to see my new GP this morning x

  • The only person I see is my EP.

    If something outside of my usual irregular beat pattern occurs, enough to worry me, I would phone his secretary and book myself a private appointment.

    I'm actually due to see him soon on March 5th, which will be 6 months since the last appointment.

    If all is well, I see him annually.

    I'm on no medication yet, just PIP.

    I have also privately had 2x 'life screening' health checks, which looked for; Abdominal Aortic Aneurysm, Peripheral Arterial Disease and Carotid Artery Disease (all clear). I had my last Complete Lipid test carried out with them too.

    My GP practice is useless and I have no faith in them. I last went there over a year ago for something other than heart rhythm but wished I hadn't bothered. They don't check my blood pressure (I do it myself ), or give me regular blood tests. They have no ECG machine either and there is never a mention of my PAF or other irregular beats even though it will all be there on my records.

    (In case you wonder why I don't move from this practice; I live on the outskirts of NW London where we now have a very high level of EU citizens plus other recently arrived people, meaning the surgeries here are overly full. I'm told I cannot move to another GP surgery as practices here will only take on patients who have no GP. )

    This is also why I have an Alivecor and feel the pressure to learn as much as I can about all this myself.


  • My GP keeps me tracked for meds update and blood tests. Nothing from my local EP at all unless of course I am either referred back via GP or have to go into A&E locally. I will be interested to see how the London EP who is doing my ablation next week follows up, so far so good from him as far as communication is concerned.

  • Oh dear Pat thats not good, fortunately I live in a small hamlet in North Yorkshire, the down side is our GPs are pretty useless. Fortunately like you

    we have saved our pennies and if we are really worried or feel we need

    more information we go private. I saw a doctor a couple of weeks ago

    for another matter unconnected with my af, I had a bowel op, two actually,

    which we paid for due to our GPs mis diagnosis, I have struggled along for

    6 years and finally caved in, gave way to tears, the ladies reading this will

    understand, saw a GP I hadnt seen before and she produced a box of tissues

    and wonder of wonders some new medication for me to try I could have

    kissed her, the juries out on whether its successful or not. I dont expect

    there to be any change to overall patient follow on treatment, I think if you

    are lucky, as Bob seems to be thats fine but otherwise you must look after

    your own interests. Just one last comment, the ( expert) who performed

    my ops, on my final visit which cost £190 said 'take immodium'. great!

    Sorry for the saga it still rankles, Shirley.

  • It took a good while to get the diagnosis in the first place. I've had high BP for many years and some ten years ago I was given a Ambulatory Blood Pressure test when I noticed that half the time the cuff would inflate a couple of times and then give up without registering - just as happens pretty much all the time now. I mentioned it when I returned the kit, but the nurse just looked at the readout and said everything was fine, without offering any explanation for the failed readings. I now believe that it was AF that caused the missed readings, even back then.

    Since diagnosis, I've never seen an EP only a cardiologist at my local hospital. I was put on a shedload of toxic drugs including straight in on 80mg statin daily - which I've managed to ditch.

    I've been referred back again and both times they have seen me and sent me on my way or in their words, released me to the care of my GP, They've never called me back.The second time I had a cv which was unsuccessful.

  • Hi, Have had PAF for past 13 years with little follow up, don't have frequent episodes but they do tend to last 12 to 48 hours. Have seen cardiologist at local hospital but not a positive experience at all so have seen a cardiologist nearby but out of my area. Much more positive experience and investigations carried out by some very professional and kind staff so no complaints there at all. Am now discharged again. Have PIP and warfarin ,I suppose there is no real reason not to be discharged but it would be nice to know even if it was every couple of years. Best wishes Kath

  • To Kath + Upsidedown,

    My EP told me they are under pressure to discharge back to the GP. Fortunately for me he thinks this is all wrong. EP said this government do not want to pay the consultants for specialist appointments and thinks GPs can do their job!(can you believe it?) If consultants don't refer patients back to their GP as soon as possible, they receive stern warnings telling them their patient figures for referring back are too low.

    I told my EP I had no faith in my GPs and do not want to be referred to them, so he keeps me on annual appointments. That way the door is always open.


  • Hi Pat, That's interesting and explains a lot. I know it will mean re referral but at least now I feel I have found some one who cares and I feel I can trust and that helps. best wishes Kath

  • Really interesting reading. I have seen a Cardiologist and EP who both discharged me back to GP care after just one consultation. When I specifically asked to remain under hospital care the EP told me to go to Boots and buy my own heart rate monitor! I didn't.

    My GP suggested an annual checkup - just BP and pulse check - no blood tests - but it is up to me to make the appointment. Unsatisfactory in my opinion. Even my cholesterol is not tested anymore.

    I am very thankful that my GP diagnosed my AF (asymptomatic) but I do have concerns over the condition of my heart and wonder how I will know if it is deteriorating without regular echos.

  • I get called in for an annual BP and full bloods check at my surgery and this has been done for some years. I think it is because I take atenolol and need a liver and kidney function check. They do cholesterol, haemoglobin and I forget what else. It was last week and I get the results tomorrow. This is an appointment with my INR nurse not my GP. She asks me how much I drink, what do I weigh (BMI is 21) and suchlike.

    After my first ablation I had a three month hospital check and nothing further for the next couple of years. I've had two echoes in 6 years and the last was almost 2 years ago.

    My husband had no annual checks, but asked to have a Well Man appointment and they did bloods, BP and so on, but no routine prostate screening although he was 72. He asked for this and they grudgingly said OK. Within days he was whooshed off for scans and biopsies and months of rather nasty treatments including implants and radiotherapy. But fine again, mostly, now.

  • Hi , i am new to the site and have been diagnosed with paroxysmal AF since November.I am a 45 year old female and my diagnosis has been complicated by the fact that I have had unstable angina in the past and was fitted with a coronary stent in 2011 .The AF gives me angina type symptoms eg. breathlessness and chest pain .I had been discharged by the cardiologist in May as my angina was well controlled .I had an A&E admission in October with some follow up scans booked.The AF proved elusive and was not picked up so I plucked up the courage to ring my consultants secretary who made me an appt to see him .He was shocked to learn I had been admitted to the hospital he had worked in ! He had not been informed , this has happened once again in November where the ECG documenting my AF went missing and again he was not informed of my AF thus delaying treatment !This has taught me a valuable lesson , I always ask for copies of my ECGs and I contact the consultants secretaries to check that referrals have been sent .I feel that it is due to this new approach that I was able to capture the AF myself with the help of my gp and thus informed my cardiologist who has now referred me to an EP .I have always worried about what other people think and so being pro active is not easy for me but I have found that the hospital admin staff very understanding and helpful .PS I was already on bisoprolol 5mg which was upped to 7.5 mg and then to 10 mg which made me feel unwell. The gp.suggested that I have 5mg morning and evening and I seem to tolerate it better. I have found this site very reassuring and helpful ,thanks.

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