ECG on Monday for AF - I'm anxious - Advice sought

[Steve101]

I would welcome the advice of people that have been diagnosed with AF.

I have had an irregular heartbeat on occasions, for the last 9 days I have had a irregular heartbeat, that was detected by my blood pressure monitor and my sister who is a nurse. I went to see the GP yesterday (they arranged a same day appointment). The GP has booked me in for an ECG on Monday (2 days away) and blood tests (as he is already thinking of prescribing anticoagulants). He has also booked me in for a heart scan early in the New Year. He believes it is AF. I am 65 years old, if I'm honest I am very anxious, and would welcome your advice. The questions I have in my mind are:

- Can an ECG conclusively identify AF

- If AF is found would you recommend going on blood thinners. Would you recommend Warfarin or one of the newer generation of blood thinners, any particular blood thinner you would recommend.

- The GP is also talking about Beta Blockers, do you take those with blood thinners?

- He is also talking about getting my hear back in sync with an electric charge whilst sedated - any thoughts

- Depending on findings he is talking about possibly referring me to see a cardiologist. If the GP does not consider a referral to a cardiologist is not necessary , I am thinking of paying privately to see one - would you recommend that?

- What questions should I ask the GP?

Any advice and thoughts would be much appreciated.

Steve

[Padayn01]

Hi Steve as far as I know when IHB is showed up on your BPM it only suggest if your heart beating to fast or slow that’s when the IHB indicator comes up

[Buffafly in reply to Padayn01]

My BP monitor detects arrhythmia, shows shaky heart symbol.

[Steve101 in reply to Buffafly]

That’s what mine does.

Steve

[BobD Volunteer]

HHello Steve and firstly relax and draw breath. There are millions of us around the world with AF living fullfilling lives. First advice os to go to AF Association website and read till you drop and keeop asking questsions.

First thing is anticoagulation (they are not blood thinners) and yes these are a really good idea. AF makes us five times more likely to have a stroke so go for it. I've been on warfarin with zero issues for fifteen years but the drug does need regular( I my case monthly) checking whereas the newer drugs (DOACs) are take and forget Note the order !

Beta blockers won't stop AF but they will control heart rate during events. There are rhythm control drugs but GPs can't usually prescribethese without consultant level input so get to see a cardiologist and if possisble an Elecdtrophysiologist who is a cardiologist who specialises in rhythm disorders.

Yes an ecg will show AF (if it is happening at the time). There are quite specific signal s whioch I won't bore you with right now. If your AF is paroxysmal (comes and goes) you may need to weaar a holter monitor for a while to catch it.

Direct current cardiovwersion (DCCV) is where they shock your heart and it may return you to normal sinus rhythm (NSR) even if only for a short time. It is a useful tool as it may sign post other treatment if you feel better in NSR.

It sounds like your GP is doing a pretty good job if he has arranged an echocardiogram ( ultra sound scan) so soon as this is quite important to see if your heart is otherwise normal as again this can dictate some treatments.

Ask any specific questions and we will try to answer.

[Steve101 in reply to BobD]

Thank you for your very helpful response.

Much appreciated.

Steve

[Goosebumps]

Steve. There are many people on this site far more adept at answering the health related questions that you have posed.

But I will tackle The private cardiologist one from my perspective. If the GP refers you to an NHS cardiologist this can take several weeks, even a couple of months or more. The cardiologist will probably want an echocardiogram done before he can see you.

The cost of a private Echocardiogram at my NHS hospital is not expensive about one twenty and a private visit to a cardiologist about two twenty.

Well worth it to cut out many weeks of anxiety.

You can go back into the NHS system afterwards.

[Buffafly]

Anticoagulant - Apixaban.

[Finvola]

Hello Steve and welcome to our forum where you are amongst friends who understand exactly what you are feeling. We’ve all been where you are today.

My first comment is the most difficult of all to believe - don’t panic or worry about what is going on with your heart.

An ECG will show what your heart is doing at the time. If AF is present, it will be detected. If nothing shows up, a 24 hour monitor can be fitted to detect arrhythmias.

Anti coagulants are normally prescribed if a patient meets certain criteria determined by his/her CHADsVASC score: explained here

clincalc.com/cardiology/str...

Beta blockers which slow your heart rate are usually the first step in getting things under control and do not interfere with anti coagulation.

DCCV or cardioversion delivers an electrical charge to shock the heart back into rhythm and can give short or longer term relief.

An appointment with a cardiologist - in my opinion - is essential and preferably with one trained in heart rhythms known as an EP or electrophysiologist.

A private appointment is useful but be careful about paying for tests such as an echocardiogram or stress test which could pump up the cost.

Will have a think about questions for your GP and add anything else. In the meantime, follow Bob’s advice and visit the AFA website at heartrhythmalliance.org/afa.

[Steve101 in reply to Finvola]

Thank you so much.

I feel better knowing other people are going through the same and are there to support you.

I appreciate so much people taking time out to respond.

[Finvola in reply to Steve101]

I’ve only ever taken Apixaban, so have no experience of Warfarin which needs regular blood monitoring to stay in anti coagulated range. The four modern AC’s work on a different part of the anti coagulation process and need half yearly kidney and liver function tests. Your blood test will determine if you are suitable for one of the new ones.

You could ask your GP about follow up of an ECG which shows nothing untoward. I had repeated ECG’s showing as normal because my AF went away each time I saw my GP!! A 24 hour monitor would have caught it.

Lifestyle changes are very important in managing AF and your GP may be able to offer guidance, depending on your medical history. There are links between sleep apnoea, overactive thyroid, sports and AF.

The greatest problems I had after diagnosis were stress, anxiety, worry, fear and lack of knowledge. Knowledge is power and helps to control the ‘what if’ demons.

[Steve101]

Thank you Finvolva - very helpful.

Steve

[pusillanimous]

I don't live in the UK. but I'm surprised that you have to wait so long for an ECG .Whenever I have been to my GP and need an ECG it is done during the appointment (there is a special room and one of the sisters will 'wire' you up). The longest wait will be in the waiting room if the ECG machine is in use, or for the results if the doctor is with another patient, but it is all done at once.

[Bronte23]

Hi Steve101, The ECG results will confirm whether or not you have Afib. If Afib is detected

I recommend the following:

• Read as much as possible about Afib. Read the posts written by all the amazingly helpful folk here. Also look at the video on You tube by Dr Sanjay Gupta, York cardiology.

• Then, if you can afford it, pay to see a cardiac electrophysiologist. Again do some research so that you find one who is highly thought of. Use the appointment time well - have a list of questions ready.

• It saddens me to recommend a private appointment. The problem is the NHS is crumbling. You need a lengthier appointment than the NHS will provide and you need information and guidance now (not in two or three months’ time).

• It takes a good while for us Afibbers to get our heads round the problems we face. Most folk feel anxious so talking to an understanding expert really helps. You can see a consultant privately straightaway and once you have received advice, can still have treatment on the NHS. I travelled to see a highly qualified consultant in London. I took my medical notes for him to look through. He charged £250 and spent 45mins with me, then provided me with a letter setting out his advice. (Best money I have EVER spent!) I chose to share this letter with my GP and my local cardiologist ( who is not a cardiac physiologist). Since then I have had superb NHS help and I certainly feel less anxious.

[Steve101]

Very helpful - much appreciated.

[LaceyLady]

Steve, I have SVT & AFib. I’m 62, my cardiologist said something ‘when I get to 65 treatment may change’. I was taken to A&E and couldn’t get my HR down, ended up in ICU. The Dr there put me on Rivoxaban, anticoagulant and Bisoprolol. I have a private Cardiologist that I’d consulted when husband had private healthcare. We now have cover for serious things, but have an excess. So I paid the consultation fee, not too bad and very worth it. I had to stop the Rivoxaban and lower dosage of Bisoprolol, dr had overdosed me 🙄

Yes, breathe try not angry anxious, I did, I’m a bit more relaxed now, but pay to see a cardiologist, saves your anxiety and he can refer to his NHS clinic.