At the very least.

[jonjub]

At my last consultancy i was ‘handed back into the care of my gp’. This was probably about a year ago or a bit less. I am taking the usual medication ie anti-coagulation and beta blocker, also take amlodopine for hypertension. Question is, what should really happen now in terms of monitoring or say an annual check-up, medication review? Would appreciate a bit of guidance/informed thoughts.

[CDreamer]

Mmmm... there doesn't seem to be any standard protocol, depends very much on GP practice. Sounds like the hospital consultant have discharged you, which is normal practice.

My surgery does an annual 'Healthy Heart' review where bloods are taken thenwhen the results come back - a week later - you see a practice nurse who reviews results, weighs you, takes BP and takes a history. If there are any concerns they refer to GP who if they have concerns refer back to Consultant.

I have monthly bloods for other conditions but the annual one is glucose, cholesterol, liver & kidney which should be done every 6 months with NOACs.

If there is a specialist unit then you can (well I can) just ring consultant's secretary and ask for an appointment or contact his Arrythmia nurse.

It really seems to be a lottery as to what happens and I think many people seem get concerned about a lack of follow up protocol.

I agree with Goldie - I self-monitor with BP, pulse and Kardia ECG so I can then contact the specialist directly with an ECG to review, mainly because there is no GP who is competent to read ECGs, then if there are concerns I get an appointment.

[jonjub in reply to CDreamer]

Thank you for a very comprehensive response. I have no arrangement for direct contact with hospital just advised to talk to gp if concerned. So, will enquire with surgery for a check-up.

[jonjub]

Yes still paf but no incident as such for two years. Regular palps and ectopics. Medication seems to be helping to control/suppress any ‘attacks’.

[CaroleF]

As far as a medication review is concerned is there not a 'review date' on the prescription? Mine (hard copy) has one and these are twice a year - for me.

Blood tests have varied in frequency as my medications have changed, but as CDDreamer has said I think these should be every 6 months if taking a NOAC.

Currently, I have an annual review with the cardiologist, but it sounds as if you are now out of the cardiologist's hands. However, on the odd occasion when I have had a query that only the cardiologist can answer my GP has emailed him and received a pretty prompt reply.

If I were you I'd ask for clarity on your own situation from your GP Practice Manager. They surely have some sort of protocol for these things.

[jonjub in reply to CaroleF]

Yes review dates do appear on prescription but told not to worry too much about it. I will make a point now of seeking a review procedure. Thank you for your comments.

[CaroleF in reply to jonjub]

Mmmmmm.... re medication review dates - my GP Practice makes a point of chasing you up if you haven't made a 'review' appointment at roughly the right time. But I have no idea if all their patients are treated the same.

[momist in reply to CaroleF]

CaroleF I am on medication for something totally apart from my PAF and yes, there are review dates on that prescription which repeats each 28 days. In over 30 months I have never been consulted/approached for these reviews, my GP just ticks the box when needed. My specialist appointment for condition that was due in July and has twice been delayed and will now not be until January. Maybe it depends on what the treatment/problem is?

[CaroleF in reply to momist]

Yes, momist . Maybe it does depend on what condition is being treated and/or the protocol for these things at GP Surgeries. At a different Practice from the one I currently attend and for a non-AF condition I too never had a review and nor was I chased up. Whether one considers this important I guess depends on how one is getting on with the medication and on the severity of the condition.

Sorry to hear your specialist appointment is delayed. Have you made clear to the hospital that you would be available for a 'late cancellation' (if you are)? For a non-AF condition early this year I was given a late cancellation. The waiting list was said to be 30 weeks and I hadn't even been given an appointment, but I was then seen in under a fortnight from referral.

[Hidden]

Where are you? In Shropshire we have the RADISH programme for anyone with heart issues and other things. They do blood tests etc annually which covers most of the usual things. Maybe they have something in your area?

[jonjub in reply to Hidden]

I am on the East Surrey/West Kent border and under the care of East Surrey Hospital. No programme publicised or that i am aware of. It may just need the question to be posed.

[Buffafly]

Interesting.....my asthma medication is reviewed annually by the nurse but I have had no review for Rivaroxaban. Last blood test I had was Feb 2016! Maybe a little chasing up is needed?

[Hidden]

I think it's down to your GP practice. I was discharged from cardiologist after 2 yrs AF and told to 'come back if any problem'. Had increasing problems for 7 years and GP just would not refer me back. I always thought there was a budget implication of some kind and that that was the barrier.

Annual reviews lasted 5 minutes and focussed on thyroxine dose, as low thyroid function was a trigger for my AF, but not really on the AF itself. No ECG taken etc. Finally got ECG which showed a few ectopic beats and doctor said 'maybe you don't have AF, just lot of ectopic beats. I need to see evidence of AF' (because you are so stupid you wouldn't know that your heart was jumping around your chest). I stopped short of inviting him to my bedroom at 2.00am to show him the evidence.

In reality I think this 7 year gap before seeing a specialist maybe did me a favour in keeping me out of the hands of medics.

The message for me, in hindsight, is that if you don't get the follow up you need then be prepared to get another doctor.

[Mike11]

I get twice yearly full check-up at my GP which includes taking BP and loads of blood tests, monitoring weight, answering questions on general condition, and an ECG every other visit to see if anything is changing.

[jonjub in reply to Mike11]

Thinking i should consider moving to a new postcode.

[Meeko]

For rivaroxaban I get 6 month blood test via GP. I'm in PAF with bouts of tachycardia which bisprolol stops. Had a letter saying consultant would be seeing me soon but was very busy. I live in Cambridgeshire. I have read we afibs should have an echocardigram annually to check on heart muscle thickness etc. That seems very sensible to me.

[Hidden]

It depends on your medication. If you're taking amiodarone or dronedarone you will need regular liver function tests.