Hi everyone, haven't posted on here for a while, hope you're all doing ok.
I recently returned from living in Spain, went to the local health centre this morning because I have been stuck in fast AF for 9 days and getting desperate.
I saw a newly qualified doctor. She got off to a bad start when she took my (wrist) pulse and informed me that my heart rate was absolutely fine, at 60bpm. I was so shocked I didn't say anything, why didn't she know about the apical-radial deficit in AF. When she eventually listened to my heart with a stethoscope she seemed quite surprised ... 'Oh it seems very fast now'.
I'm a qualified nurse. How on earth can a qualified doctor not know that the radial pulse won't indicate the true heart rate with AF?
Anyway, she said that because I've had AF for a long time there's nothing anyone can do for me. No chat about medication change or anything. Has the NHS really got so bad while I've been abroad? I asked for a cardiology referral a month ago, when I went online, none of the 'hospitals to choose from' had any appointments.
I feel quite shell-shocked.
I live on the Cheshire-Staffordshire border. Has anyone else had problems in this area?
Thanks, Wendy.
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Hiya Wendy .............. yes it is that bad - some areas maybe worse !!! 😂😂😂
I'm down at the pointy end of Cornwall and my surgery has gone downhill dramatically since CoVid. I am a bus driver so I am guaranteed of one face to face meeting with my GP a year ........ she has to give me a medical AND SIGN OFF ON IT before DVLA will renew my Bus Drivers licence.
The rest of the time its either a telephone discussion or they now use a thing they call e-Consult. Its an online form one fills in ( a box ticking exercise) and then supposedly your GP gets back to you in 2 working days.
I put a post on here, late July/early August headed something like ""Bisoprolol beats me at last ........."" you might find it interesting as well as some of the posted replies. There are only two things I use my surgery/GP for now ...... 1) Repeat prescriptions and 2) discussions on my meds with the Surgery employed Pharmacist. Credit where its due, the appointment of a Surgery employed Pharmacist is great because rather than ask your GP questions about your meds (which he/she cannot answer or they struggle with) you can now deal directly with the person who is the expert. 😂😂
Thanks. In Catalonia I lived in the middle of nowhere, but whenever I visited my GP or hospital in the nearest town, I had the fastest and most attentive care. One of the reasons I came back here was because the AF has become really bad, and I wanted to get things 'sorted out' without having to struggle with speaking in Catalan. After a month, I'm beginning to wonder if I did the right thing! in Spain I saw the cardiologist every three months; here, the online booking site says 'no appointments available' at all the three local hospitals.
I'm quite shocked. In Spain I could walk into the GP centre four days a week (without an appointment) and get seen face to face within ten minutes. They always did blood tests and an ECG.
My surgery is quite good and if needed I can usually see a doc the same day. Sadly, you will not find the kind of service you had in Spain here. We have to call the surgery as soon after 8am as we can, you leave your name and why you are calling with the person who answered the phone and they get a GP to call you back. This can be quite quick but can be half a day later. After a chat on the phone the doctor will then decide if they need to see you right away or whether you need medication. To be honest I think it's a good system. Before when people were able to make appointments, so many of them who had booked one didn't turn up. I live a bit in the sticks like Carneuny, but in Devon and I know from reports on here that a lot of people have difficulty getting an appointment the same day.
Sorry that this is the welcome back to the UK you've had.
I concur with Jean's report. A traige system is in place in most surgeries now. Receptionist takes details, nurse or doctor calls you (usually the former), if youre very lucky you’ll see a doctor in person. My AF kicked off in December 2019. Since then I've seen a doctor in person at my local surgery 3 times and none since March 2020. Literally none at all. That's how it is here now. Go private with someone at a good hospital who'll refer you for NHS treatment. Hate to say the B word as it's political - but think of a newly coined word that means ' to leave'.
Hope you get sorted. Many GPs ill informed about AF. I'd be inclined to write to your surgery and complain.
If you can afford it and are able to travel get an appointment with and EP privately. I had my ablation after seeing Dr David Fox privately and was treated at Wythenshaw which is an NHS heart and lung centre. I couldn't have had better treatment for it, and have just completed a year's follow up.
As we have moved I recently asked my new GP to be referred to a local cardiologist but he told me they wouldn't want to see me unless something bad was occurring (and like many others, just trying to contact a GP is wuite difficult sometimes).
I would go down the private route again without a moment's hesitation.
Private is my only option, and at the best part of £1k (just for starters) is out of my reach ATM.
I'm near Dundee, and one of the docs at my GP surgery tried and failed to get me a cardiology referral — primarily, at my request, for an echocardiogram to check my afib isn't causing any wider issues. When I was based in SE England, I did this every couple of years, with my GP simply referring me to the local out-patients facility.
That, however, was pre-Covid.
Now — and despite my MSP's intervention — I have been told by NHS Tayside that I can only get a cardiology appointment if I am showing signs of actual heart failure, and even then I'd be looking at a year's wait.
The GP's solution is a local ECG once a year which, as we know, is just a limited snapshot. I can as easily monitor with my Kardia.
The same GP surgery (different doc) also failed to confirm my DIY diagnosis of shingles across one side of my face, eye, and scalp, instead referring me to Dundee's main teaching hospital eye clinic. Took the junior doctor there about two minutes to make the right diagnosis, but by then I'd lost a lot of time and it was too late to go the antiviral route. Seven weeks on, I still have residual shingles symptoms.
The eye clinic referral apart, all the GP had done was insist that I test for Covid, pressing a box of LFTs into my hand and urging I keep checking on a regular basis. That I had not one single Covid symptom — despite the ever-growing catalogue of those — made absolutely no difference: that was all she was interested in.
My sense is that the NHS is being rapidly dismantled now, and this is being confirmed by many who work within it and are now leaving in droves. It's clearly no longer fit for purpose, and I have resolved to stay away from it unless in extremis!
Totally agree with your last paragraph ............ this government - and it started with Matt Hancock in the CoVid days - decided the only way to fight Covid was to take funds away from what we knew and allocate them to what we didn't know .......... thereby forcing peeps ( in the longer run) to go private. I have had to go private twice, mercifully my AF is highly controlled and I have little need for my totally rubbish surgery and GP. This e-Consult system that is progressively creeping in with surgeries around the country is the end of what we knew.
This has been a long time coming and there's ample evidence that the Covid response has been used to help accelerate the process.
The NHS is now changing into a service where meeting a medic face-to-face is replaced by tech-driven distance consultations. Look at the 'NHS@home' concept, just for starters, where you're monitored — and your medication adjusted — by remote AI. We'll all be using wearable tech, so our every breath can be logged, our every move tracked!
You're quite right. I guess its only just caught up with me as apart from AF and some existing oesteoarthritic issues I've remained pretty fit, thus the dramas have eluded me until recently. Certainly I'm not my surgery's favourite patient and don't hesitate to give them as rough a ride as I consider reasonable. I also treat my local CCG with the same disdain and have already had to make a formal complaint about them and our local NHS Hospital Trust to their political masters in Westminster. It's become a loathsome organisation.
I would seriously think about returning to Spain if at all possible. I live in France and would not consider visiting the UK to see relatives I am so worried about falling ill there.
I was unable to get a GP appointment after I suspected a reaction to my Covid vaccine booster last year. I eventually managed to get a cardiology referral, which is coming up at the end of November!!! I’ve recovered now and I’m having my next booster tomorrow, so maybe the consultation will be of some use after all.
As John has said, yes, it has unfortunately got bad. Some people fare better with their surgeries than others, but all in all, since Covid, things have deteriorated.
I don’t think GPs know a lot about AF, mine certainly doesn’t. Yours sounds like that too. 😳 I must say it sounds like the health service was excellent where you lived in Spain and it’s a shame about the language barrier.
If you have been referred for an appointment with Cardiology, I hope that there might be something come up soon for you, but you wouldn’t get anything quickly on the NHS. If you can afford it, a lot of us on this forum end up going private for a consultation with either a cardiologist or an Electrophysiologist. You can do this off your own back without a referral ( check on Google, it should come up) and you’re likely to get an appointment within 2 weeks. The cost is around £200 - a little more if it includes an ECG etc.
I’m sure there must be other things that can be done for you, so I wouldn’t personally take too much notice of what she said, especially if she didn’t know how to correctly take your heart rate 😳
Once you get to see a cardiologist, you could ask to continue to see them on the NHS, though I’m sorry to say, it isn’t likely to be every 3 months with the way things are. I get to see mine once or twice a year if lucky. I am sorry to continue with the doom and gloom, but they can be quick to try and discharge people ( even with our heart problems) too, so if problems arise, it’s back to GPs to be referred again unfortunately. Some of us try not to be discharged.
What medication are you taking? Have you tried some different vagal manoeuvres that might help? If this gets too bad, as it sounds horrible, you could always go to A&E which many resort to as well in these situations, as you shouldn’t have to suffer like this.
Thanks, I've had AF for years, tried all the various medication options/manoeuvres/complementary therapies, just on tablets for blood pressure and an anti coagulant now. I don't really want to go down the multiple ablations route, but I actually might go for a pace and ablate if they offered one, although they tend to keep it for the over 65s. Going private initially sounds like an option :o)
You don't say what exercise you do but my guess is (and I have done it for 8yrs) that regular daily x2 brisk walks of 1mile+ are beneficial on training the heart. In addition, my London Naturopath advises just getting your red cell magnesium levels and CoQ10 into the top quartile. Best wishes.
I used to be very fit, but since having regular AF (7-10 day intervals) I started struggling with the twice daily dog walking. And since the AF seems to have become permanent in the last month, I can't even walk round the supermarket without becoming breathless and having frequent stops. However I am persevering.
Alison had a minimally invasive (keyhole) Cox IV mini-maze procedure in London and has been in NSR for quite a few months since having it done. She did it privately but it's also available on the NHS (some places only).
I’m well over 65 and yesterday got the pacemaker fitted! Have tried every pill except Amiodarone and didn’t want numerous ablations. I saw both cardiologist and EP privately and had pm on NHS
Hopefully you will get offered something….so are you in persistent AF - do you usually revert to NSR? Being in fast constant Afib doesn’t sound right, for so many days and ( to me anyway) it sounds like you need to get the rate down at least, but I’m no expert. I’m paroxysmal myself and although I too have had it years ( many undiagnosed) I only used to have episodes now and then but am on daily low dose of Bisoprolol, which seem to help and keep them mainly away - at the moment anyway.
Yes it had been lasting for 2-3 days, but now it's the 10th day without relief. I had to hold back the tears leaving the GP's room this morning, when she said there was nothing she could do for me. She said that being in AF wasn't a problem and my observations were fine. I wonder if she would feel 'fine' if her heart rate was 150 for ten days.
150 bpm for 10 days is too high IMO. ( not medically trained )
My local hospital always advised to go to A&E if I was above 130 bpm for an extended period . I was usually 165 bpm resting sometimes up to 195 when in AFib. I did 8 days one time, 5 of them in hospital until bring cardioverted by flecainide infusion.
It was tiring.
However I have not been there since I had my ablation in 2018 so things may have changed.
I attended A&E mid morning for a suspected fractured rib but on taking Obs (HR 120) they moved me from a consulting room to the resuscitation room, had a cannula fitted and I think Soltilol given intro. Once they were confident I didn’t have an acute heart issue, I was moved to the ambulatory ward. I was fortunate to be allowed home that evening with a return appointment the next day where I was advised of my newly diagnosed AFlutter. In retrospect, I had been showing Paroxysmal AFl symptoms for several months and had been referred to a cardiologist by my GP (after ECG reading after high pulse noted whist at GP surgery) a few month’s earlier.
The moral is that A&E were sufficiently worried to fast track me, but be warned, once in the hospital, it can be hard to get discharged due to their cautious approach. It should get you in the system though.
Quite - and that’s why presenting at A&E may be best route for Wendy to get into the system (but maybe taking an overnight bag with her to A&E). It certainly worked for me with fast track to a cardiologist and after 3 months an extremely unsuccessful CV (went into persistent A Flutter) followed by an Ablation 3 months after (managed to get a cancellation) which settled me back into PAFlutter, and a 2nd successful Ablation (although now presenting with PAF) after a further 10 mths.
It sometimes pays to get a 2nd opinion of the GP and that is one area this website is a godsend
If your heart has been at a rate of 150 for 10 days, then without doubt, you should go straight to A&E. Your GP sounds pretty hopeless. She should have arranged an ECG with one of the surgery nurses right away.
I’ve read your reply and what others have said. And no, I’m sure she wouldn’t like it, having a heart rate in the 150s for 10 days 😳
I think personally if you are still in Afib this morning, it might be worth considering A&E and like some have said, it will get you on the system, if anything,
I was thinking about what you said about going on a system and looking for appointments, this was a system that my GP operated a few years back but now mine ( and others who’ve replied) get appointments in the post after being referred. It might be worth checking exactly what you are meant to do in that regard. I think they can also do an urgent two week referral for urgent cases, which I think this is?
If all this fails, Please consider trying to get an urgent appointment with your GP and ask for another doctor and be firm. I myself have become more cynical and weary of some medical professionals this past few years and due to some experiences, I don’t agree with everything they tell me anymore and I used to hang onto their every word. Don’t be worried about telling them if you disagree with what they’re saying. The GP yesterday was wrong to let you leave the surgery feeling like you did and I’m sure she was wrong in telling you that nothing could be done. This shows how little she knows about Afib. People on this forum know far more.
Please get someone to help you get that rate down at least and please keep badgering people until you get answers. Unfortunately we have to do a lot of chasing with Afib, otherwise nothing gets done.
Please, please come back and let us know how you get on?
Don’t be surprised, I’m a retired medical microbiologist and a consultant colleague took my pulse many years ago and proclaimed that my heart rate was fine, this was shortly before I had an episode in the street and was admitted to my own hospital where I was diagnosed with AF . Long story short, I now have a defib pacemaker and four meds.
I used to rib her a lot about her diagnostic skills………however it happens. I’ve been asked to have a scan with contrast to assess my EF and three times I’ve turned up and three times there has not been a Dr available which, I suggest is rather poor and I still haven’t been given a date for an attempt!!!
HI Sim, What is a defib pacemaker? My heart rate is now going below 40 and I am trying to get the GP to give me a referral for a pacemaker. I was to have a heart stress test last week but they would not do it as I have AF and didn't realise any my heart beat was going between 33 and the low 40s.
Hi Wendy, there are a number of types of pacemakers, mine has the ability to act not only by pacing my heart but should the pacemaker senses dangerous rhythms, it delivers shocks. An ICD can help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest (SCA). Most new ICDs can act as both a pacemaker and a defibrillator. Many ICDs also record the heart's electrical patterns when there is an abnormal heartbeat. They last between seven to ten year’s before they need replacement. Mine has never needed to shock me in four years.
Measuring the pulse at the wrist and expecting an accurate answer seems to be a common misconception for A.F.
My pulse measured at the wrist will appear to be in the 70's but when checked against my ECG monitor will be 95 to 105 and if I exercise 90 at the wrist can easily be 130 to 140.
A.F patients need to be aware of this it is important to keep control of your heart rate and minimize the risk of heart failure.
I have had a similar experience with several G.P's over the past few years.
Here is an extract from the current NHS A.F. web page
To check your pulse:
sit down for 5 minutes – do not smoke or drink caffeine before taking the reading
hold your left hand out with your palm facing up and elbow slightly bent
firmly place the index and middle finger of your right hand on your left wrist, at the base of the thumb (between the wrist and the tendon attached to the thumb)
using the second hand on a clock or watch, count the number of beats for 30 seconds, and then double that number to get your heart rate in beats per minute
At rest, a normal heart rate should be 60 to 100 beats per minute. In atrial fibrillation, the heart rate can often be considerably higher than 100 beats per minute, and each individual beat is erratic.
My question is that as the NHS recommend aiming to keep AF resting HR below 90, do they mean 90 actual ECG measurement or 90 counted at the wrist?
When I first experienced AF I didn’t know what it was so went to my local A&E.
The doctor put me on a low dose of Bisoprolol (2.5mg) and said the intent was to keep my resting heart rate below 90 so as to avoid strain on the heart.
It wud be nice to know your meds, state of your irregular H/B and your symptoms.
I found NZ bad enough.
After in hospital for diagnosed stroke, AF, rapid & persistent and 4 days later thyroid cancer spotted on a carotid arteries scan.
No follow up for cardiac.
Asked for permission to do a biopsy of my thyroid, having said yes, I had to follow the thread back and ask when I was having the procedure.
Then again hadn't seen surgeon, then anaesthetics, then voice box check. Honestly I was forgotten because I was referred internally.
Its a big hospital Northland, I had an Encrinologist Dr looking after and calling what meds to be on. I said no to Metoprolol. but still I got 3 x 23.75.mg. I told her it would make me breathless.
I struggled with it as no Dr would suggest anything else but I was not controlled with 186 H/R day Avge.
At 2 years 3 mthe I asked to see a cardiac specialist.
Again left on Bisoprolol uncontrolled with day H/R of 156.
A private cardiac Special came to rescue.
Now on CCB Diltiazem twinked to 120mg am and 2.5mg Bisoprolol BB pm.
Controlled now.
123/72. 77-88 H/R Day and 47 H/R night.
Worth going to a private cardiac specialist who is interested in you.
You have to play telephone lottery to see a gp at my surgery - ring st 8am everyday and see if you can get through before all the appointments are gone - can take days of trying … got a nurse appointment and the surgery waiting room was empty - before Covid was always full - absolutely terrible - would suggest private cardiology appointment for referral to ep
I can’t see anything improving any time soon either, if at all.!!!😢
If you’re lucky enough to have the funds to pay then it’s a different story.?
I hope you manage to get sorted wendy. Best wishes.Ron.x👍
welcome back,sadly the NHS is just not working, literally. Private route is the only way to go, I did see cardiologist within 2 weeks privately,but my hip replacement is 6 weeks, far better than over 12 months on the nhs !
Even private hospitals are now finding it harder to find appointments for you due to extra workload.
A pulse difference of the order of 70bpm (150 vs 60) sounds unusual and I presume the wrist pulse was irregular, too? You had a weird experience with that doctor, for sure.
I gather that the UK has significantly lower patient to GP ratio compared to Spain and many more of our GPs are part time, worsening the problem. Covid brought many more to retire, too, and yet more to go part time. It seems GP salaries and pensions allow this to happen. A similar situation has happened with our dentists. Many people have been forced to pay for private dental care.
Another issue in the UK is that those that many people can now afford private consultations and are willing to pay for them, thus reducing the burden on the NHS and, in a way, relieving the government of the need to address what might well otherwise be a dire situation.
The UK government is responsible for doctor numbers and doctor salaries (and pensions) and, in my view, needs to be held to account, but it doesn't seem that this will happen since many people now appear to hold the view that both major parties are as bad as each other.
Surely the doctor should refer you to a cardiologist? I've never heard o making an appointment for yourself, usually the doctor has to go direct to them and they will send you an appointment. I would go back to your GP and ask to see another doctor.
My thoughts,ring 111 and tell them how long you have been in AF,and at what rate. Failing that,go to A n E.
Depending on the result,if ypu still get nowhere,look up your nearest Electrophysiologist and self refer. This costs 200 or so. Initial appointment within weeks,then they can transfer you to NHS list.
I would also put in a strongly worded complaint to the Practice Manager without delay,this was a disgraceful consultation!
move on to new doctor. I am just in hospital being discharged for third ablation. One doctor was just awful. No hope for me. Then I thought no. Get a whole new sweep of doctors and write everything thing down which I did. Every insult every misunderstanding everything that took Hope away. Got new doctors and they said that I would not have a quick fix and this has been true but I do feel this time I hope all will go well but if not they have plans. Most doctors and nurses don’t have a scoot about Afib.
I would go straight to A&E. I had an episode a couple of years ago where I went into fast Afib. I spoke to 111 and they sent an ambulance. They took me straight to A&E. How is your breathing? I was getting very breathless and was in respiratory failure when I got to the hospital. The episode lasted only about 3 hours. I returned to sinus rhythm when I got to the hospital. I think they will take it seriously if you've been in that state for so long.
Sadly it’s that bad and scary. I was fortunate that we get private healthcare through work or I still wouldn’t have been seen yet.
Obviously I don’t know if finances could allow you to have a private consultation to an EP to get opinion - sometimes following that they will see you nhs after
One of the reasons I've avoided a long held desire to move to Spain is that our NHS health care system is the best and free at the point of 'easy' access and that I'd struggle with the language and communicating my AF and other issues. As others have pointed out that is most definitely no longer the case with an increasingly evident degradation of what we once held dear. As my daughter has resided in Spain for over 14 years now and given the worrying situation health care in this country is now in maybe I should reconsider again.
HI Wendy, Can I ask a dumb question, I was referred in March this year re a second ablation where do I look online to find out if there is anywhere else to go. I have been referred to Blackpool and live in south Lakeland so I don't know if there is any choice for me.
I don't know what to say. I live in the US and every time I've been in afib, I've gone to the emergency room and have been admitted to the hospital. I've not been successful with IV meds to convert to NSR, so have always needed cardioversion.
I thought all doctors, even those you see regularly asked about medication changes, Rx and/or OTC, at least that's been my experience. The doctor you saw sounds way too nonchalant for me. I don't know if you've been dx'ed with chronic afib, but I would think meds could be tried, and at the very least you would be taking an Rx anticoagulant. And I also think something should be done to lower your heart rate.
Time for a new doctor. Every day there are new things to be done just read on here and see the mini miracles especially getting a mini the people have gotten. Do not give up she sounds like an idiot
Bad, you can say that again. I have never seen a NHS cardiologist, only afib nurses. That's not to say they don't do a good job. I'm on the waiting list to see an EP, could take years. I guess I'm not an urgent case, but i would still like a check up now and again. Afib seems to be the forgotten epidemic. I have been forced to go private although i can't really afford it. I know some on here have good doctors and cardiologists, i guess its luck of the draw. I too lived in Spain for a bit, and i could phone the doctor and sometimes see him same day for believe it or not, 30 euros
Someone should start a petition or am i being over dramatic.
Hi, if your heart rate is 150 and has been for 10 days it’s 111 or A&E for you. Sorry to be blunt but get on to it. My GP called an ambulance to the surgery when mine was 140, she said it was unsafe for me to go any other way. Yes treatment is fab in spain my mother broke her wrist she had weekly check ups until the plaster was off then twice weekly physio for 6 weeks
I pay for private consultant who can and will send a directive to my GP. I get nothing from GP, but next week I’ve a GP appointment to sort out, hopefully problems I have and I’ll be addressing the lack of cardiac care.
Mmmm, I get grilled by an unqualified receptionist as to why I need an appointment, as a qualified Complementary Therapist of 25 years training in some cases better than a nurse I object. I don’t call for an appointment till I HAVE to, sadly I’ve not had a lot of positive results over the years. I really really need to have a good 1 2 1 with a qualified person as I’ve had abject pain for 4/5 months in head and neck, I’m really thinking it’s the ‘new meds’. Well she wanted to give me a phone call that you have to stay in all day waiting! Now considering this I’m feeling is drug related, I have to wait till next Friday and it was Tuesday I called 🤷🏼♀️ I won’t have a dr I don’t know or doesn’t know me and I can’t understand. Medical services in England are hit or miss. None of the drs want to work a full week, to me it seems like just a side line to some of them. My previous GP I never saw has gone off on maternity leave and I was expected to wait till she came back, which is not guaranteed!
recently I’ve paid to see a shoulder consultant, not productive so far, an MRI plus 6-7 osteopathic treatment that usually 1/2 work! So you can see my medical bill AND NO answers!
Sorry I haven't managed to get back on here, but I had computer issues.
It's now been a month and I haven't had a good day with the heart, I feel resigned to having permanent AF. I haven't plucked up the courage to go back and see another doctor, but I'll go this week if still no improvement. I'm struggling to walk even short distances. But I feel okay in myself, managing to stay positive most of the time anyway.
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What does AF feel like, and when should you go to a hospital?
How do you feel when in AF?
Visit to GP re sudden rise in pulse rate ( regular) for next to no reason
