Cardioversion

[Hellie54]

I had a cardioversion last year in Wythenshawe NHS cardiac unit which put me back in nsr. The staff were brilliant - professional and their attention to detail was very reassuring. Stupidly I was careless taking my meds (dronedarone) and I've flipped back into af. I am really struggling. I've been told it will be several,months before I can get another one done on the NHS so I've enquired into getting it done privately. They can do it next week at a private hospital. Should I take this opportunity or would it be wise to wait?

[CDreamer]

I think it entirely your choice - if you can afford it or have health insurance cover which will authorise. Be aware that these procedures cost a lot, lot more than you imagine and you have to consider costs if things are not straightforward.

My husband had one done privately for the same reasons last week - same Doctor’s - same procedure - hospital had all the same equipment. Unfortunately it didn’t work but the drugs are making him feel better, thankfully. Are you asking on moral grounds or concerns that something will be different? You are the one suffering, just do your homework on who would be performing it privately and the facilities the hospital has. If it is a BUPA or Nuffield I would be reasonably confident that all would be in order.

[Hellie54 in reply to CDreamer]

Many thanks for your reply. I am just concerned that the BMI hospital will not be 'as cutting edge' as the NHS specialist unit. My consultant has done his best to reassure me but if it wasnt for the long waiting list I would definitely choose NHS. I no longer have private health cover as I've just retired.

[BobD Volunteer]

If you are anticoagulated I can't see why there is such a delay. I have had DCCV within 24/48 hours of an attack at my local hospital.

Remember DCCV is not a cure so maybe time to see your consultant again to discuss the way forward. Interesting that you were_(are) on Multaq (dronedarone) as this drug never really gained favour. It was hailed as a new hope when it was first approved but after some problems in US manily due to inappropriate prescribing it seemed to go out of fashion.

[Hellie54 in reply to BobD]

Many thanks for your reply Bob. My consultant prescribed dronedarone before my previous cardioversion because it is effective in maintaining a normal heart rhythm. He's reasonably confident that if I continue to take it twice daily it will keep me in nsr after a successful cardioversion. Cardiiversiions are performed on alternate Tuesdays at the Wythenshawe hospital and I have been told there is a long waiting list.

[Hellie54 in reply to Hellie54]

I also take rivaroxaban and Bisoprolol

[CDreamer in reply to BobD]

Very long list at RD&E

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When my EP team (NHS) finally got round to suggesting a DCCV for my persistent atrial flutter, I was put on propafenone supposedly for 2 weeks beforehand to improve the chances of success. When I got an appointment for a further 2 months later, I cancelled it, feeling that if the ablation had not fixed it, a DCCV after 4 months had no chance of sustained success.

I might have been a little unnerved when another EP casually mentioned that because I have minor heart block and pauses, I was somewhat more at risk of having a cardiac arrest, but not to worry, they could easily sort that out.

To answer your question, I have no confidence in the local private hospital here, and would be very wary of the resuscitation expertise available. In any event, I couldn’t have justified the expense.

With hindsight, I feel that it was the insane bureaucracy of the system that led to the delay. As soon as I recognised that my ablation had failed, I rang the cardiac unit and was able by chance to speak to the duty cardiologist (who happened to be the Professor) and was told that I should speak to my EP next week. A sequence of repeat echo then further delay for OP appointment, meant that when I saw the EP he was clearly surprised at the date I had been given for the cardioversion, but made no effort to bring it forward.

I think that medics may no longer have the same degree of control over prioritising treatment, and some may feel powerless to influence local policy. I also wonder whether some are so overwhelmed by their workload, that they can’t keep track of what is going on with their patients.

So my advice to you (finally, sigh ...🙂) is to get in touch with the consultant to let her know what is going on, in the hope she can get this done quickly, as it should be. If you go privately, ask for details of how many cardiac procedures are done weekly, because that will give you an indication of the skill and relevant experience of the staff if things should go wrong. My impression is that outside London, it’s better to go the NHS route when resuscitation may be necessary, if the wait time is reasonable.

[Hellie54]

Hi Oyster I'm sorry to hear of your experience. I agree that consultants probably feel overwhelmed with their ever increasing workload and although I feel my condition warrants early intervention, I guess most patients waiting for cardioversion feel the same.

I will take your advice and gather as much information as possible before I make my decision. x