AF Association
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Electrophysiologist

Please could someone advise me how you get to see one. I have seen a Cardiologist who recommended Amiodarone which I now have had to reduce as had given me overactive thyroid. I would really like a, referral to an EP. Is anyone entitled to see one on the NHS. Do you go through your GP or your Cardiologist. I live on Newport, South Wales, but have been advised there is a good EP called Dr. Barry at Morriston hospital. Can you asked for a specific hospital even if it is not your nearest? So many questions. Thanks x

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In England it is a simple procedure - go to GP, ask to be referred to the person of your choice - it is in the NHS Patient Charter as a right. But the wait to see one can be lengthy - our local hospital which is a regional Centre is currently 6+ months to see EP and Arrythmia Nurses holed clinics so they can be seen sooner.

You will get seen sooner if you can go privately Which many of us did at the start of our journey - cost circa £200-300 + tests etc.

You don’t have to see a cardiologist first - but many GPs seem to refer to the local cardiology department as routine but you could also ask the cardiologist to refer you?

However - I’m no expert - but from what I understand Wales operates differently and much more difficult to get a referral - but others from that region will have more knowledge and experience.

Every GP, every region seems to operate by their own protocols, very frustrating.

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Thank you. I will look at the charter for Wales. Also, find out how much a private consultation would cost. £300 would be OK, but then was concerned about the cost for further tests, scans,etc. Feel that I would benefit from seeing EP as Cardiologist not specialised in AF. Have just come off Amiodarone (over active thyroid) and waiting to next Cardiologist appt. Worried as don't know what he can suggest now. Ablation/Cardioversion not suitable because of enlarged left atria, so feel a if I am now a lost cause. Only on Xarelto now and 5mg of Bisoprolol and statin.

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amyrosie Here in North Wales it as the Cardiologist at the local hospital who referred me to an EP in Liverpool. There are no EPs working in North Wales. I subsequently had an ablation - my left atrium was found to be seriously dilated.

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Thanks Jenny. Has the ablation helped even though your left atrium was dilated?

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amyrosie yes, it has improved things greatly. Post -ablation I didn't feel my heart for 6 weeks. Now I get occasional mild AF which I can control with a single 100 flecainide tablet. A 2nd ablation will not be possible because of the fibrosis so if things deteriorate it will be pace & ablate.

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Hello

I paid to see an EP in West Sussex for exactly the same reason as you. The cost was £200 plus initial tests such as ECG however subsequent tests were made through the NHS. Am not sure whether this is morally wrong but it takes so long to get an appointment to see a Cardiologist in this area and my appointment for March has just been put back to May.

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Update. My May appointment has now been cancelled and no alternative date offered! Back to private I guess.

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I had a moderately enlarged left atrium and still had an ablation. Were you given a specific reason to be on Amiodarone (some stating it as the drug of last resort) and not another anti-arrhythmic drug? How long were you on Amiodarone before your thyroid became over-active?

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Hi cuore, I was on Amiodarone 6months before the overactive thyroid started. My Cardiologist said that ablation/Cardioversion would not provide a permanent solution because of enlarged left atria and that because of my relatively young age (65)I may benefit from Amiodarone - I am quoting this from the post consultation letter he sent to my GP (I always get him to print me out a copy) really want to see an EP now - Cardiologists not as specialist in this condition.

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Hi Amyrosie, with two ablations within 7 months, I have been taking Amiodarone for 6 1/2 months. Now in February I can cut down to weekdays only and in March , to 3 days a week before I am off of it. My blood test at about the fifth month showed my thyroid still to be fine, fingers crossed.

It is excellent that you are going to see an EP as your cardiologist appears to be stearing you down the wrong path and giving you advice in conflict with current literature. His reason for your taking Amiodarone astounds me especially since the literature discourages long term Amiodarone use, and the current literature, via the Cabanna trial, is placing ablation superior to drug treatment.

Your "enlarged left atrium" seems to be the focus. Before your EP appointment, I would suggest getting your left atrium measurement ( generally from your echocardiogram) and comparing it to normal so that you will be better informed. It may be that the degree of success is relative to the size of the left atrium, but not that it will be unsuccessful completely. There are no permanent solutions for AF.

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I saw an EP privately this week, having being initially diagnosed by a cardiologist a year ago. I was going to self refer but my GP agreed to do it for me. It was well worth the cost as I came out feeling more positive than I had for ages. Totally different to when I saw the cardiologist. The cost was £220 plus £100 for an ECG. Last year, a 7 day monitor cost me £400 and an echocardiogram £300. I went down this route due to the 9 month wait on the NHS. I hope this helps.

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Pam296. Was it an echocardiogram you had done privately for £100. Or an electrocardiogram?

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It was the electrocardiogram. The echo was £300.

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Amiodarone for short term use only.

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I have been reading a lot about AF this past week and as a newly diagnosed person am realising that a cardiologist and EP may have quite different agendas. My next move is to ask my cardoilogist if I can have an ablasion, but I suspect he'll tell me only if all the drugs don't work.

If so, I will want to go straight to an EP and try my luck there. It's got to be worth a shot.

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