What tests/treatment: Hi everyone. A... - Atrial Fibrillati...

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What tests/treatment

SeatonRover profile image
28 Replies

Hi everyone.

A new Year and a new member in UK

Diagnosed with A Fib just before Christmas after my FitBit started sending me notifications at end of October.

Had 24 hr ECG and condition is persistent. Under care of my GP but not on medication as considering blood thinners suggested by GP

I am considering paying to see a Specialist Consultant as I am a bit in the dark. My question is - is it worth asking (paying) for other tests eg Echo? Would that identify if I have a heart defect or disease.

To be honest I am very apprehensive about blood thinners and Beta Blockers because of side effects but I guess I am just in the "denial" stage at the moment.

I was shocked (excuse the pun) to hear from my GP that the local hospital says the cut-off age for Cardioversion is 65 - I am 66.

Any advice/thought greatly appreciated for this "newbie"

Happy New Year

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SeatonRover
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28 Replies
Jalia profile image
Jalia

That's strange to hear that the cut off point for cardioversion is 65! A new one on me. I've probably had about 10 at least since I was 65 ( now 78....last one about 2 months ago )

Have you asked to be referred to a cardiologist on the NHS? My husband has permanent asymptomatic AF , initially diagnosed on my Kardia device, is on anticoagulants.. aka blood thinners....and was given an Echo at our local hospital which gives much information about the state of your heart. We are both pleased that he is taking an anticoagulant to give extra protection against stroke.

If your GP is unwilling to refer you then you may be happier having a private consultation. Be prepared for a fee of about £250/300 for this. An echo would be in the region of £450.

SeatonRover profile image
SeatonRover in reply toJalia

Thanks Jalia - that is helpful.

Everyone has been so supportive and helpful in their replies, it has really given me a lift. I am very grateful that so many members have taken the time and trouble to reply. Having AFib still seems so unreal as I have always been fit and healthy, but I realise that the condition doesn't discriminate at all.

I am going to get a private referral to the Cambridge Heart Clinic as I don't think it is worth messing about waiting for the NHS with something so important. I still intend to get to the bottom of being told the NHS hospital's cut off for Cardioversion is 65 though.

Paulbounce profile image
Paulbounce

Hi Seaton.

Welcome to the forum.

I am considering paying to see a Specialist Consultant as I am a bit in the dark. My question is - is it worth asking (paying) for other tests eg Echo?

Think it's worth paying for a private consultant then explain you don't have health insurance and wish to be referred through the NHS - you sort of jump the queue a little this way. As for paying for other tests privately - this depends on your budget. It can add up though so be warned!

I was shocked (excuse the pun) to hear from my GP that the local hospital says the cut-off age for Cardioversion is 65

Hmm not sure about that one. Maybe it's the area you are in and their policy. However when I have had cardioversions many seemed to be over 65. I could be wrong but I haven't heard of 65 being a cut-off before.

To be honest I am very apprehensive about blood thinners ...... because of side effects but I guess I am just in the "denial" stage at the moment

Sorry, Seaton but I think you are in denial about taking anticoagulants (blood thinners). If I were in your shoes starting these would be foremost on my mind. The chances are you won't even know you're on them. I would get stuck into that one right away - a stroke from afib is no laughing matter.

Happy New Year.

Paul

SeatonRover profile image
SeatonRover in reply toPaulbounce

Thanks Paul - that is helpful.

Everyone has been so supportive and helpful in their replies, it has really given me a lift. I am very grateful that so many members have taken the time and trouble to reply. Having AFib still seems so unreal as I have always been fit and healthy, but I realise that the condition doesn't discriminate at all.

I am going to get a private referral to the Cambridge Heart Clinic as I don't think it is worth messing about waiting for the NHS with something so important. I still intend to get to the bottom of being told the NHS hospital's cut off for Cardioversion is 65 though.

I take your point re anticoagulants - you are right of course!

meadfoot profile image
meadfoot

I would ensure seeing a Electrophysiologist, a cardiologist specialising in the electrical activity of the heart rather than a cardiologist specialising in the plumbing aspect. They will give you the relevant tests and devise a treatment plan. If there is structural heart issues they will deal with your case as appropriate but if you have an electrical issue which you seem to be saying then an EP is your route.

I have been taking beta blockers since 2009 successfully and anticoagulation for ten years. The concerns re stroke are real and although you rightly are concerned and all this is new to you you will come to terms with the best treatment as you move forward.

The key is getting with a specialist medical team you feel happy with. A GP with the best will in the world is just that - a general practitioner you need a specialist in your corner. Push for specialist care dont take no for an answer. Best wishes.

SeatonRover profile image
SeatonRover in reply tomeadfoot

Thanks Meadfoot - that is helpful.

Everyone has been so supportive and helpful in their replies, it has really given me a lift. I am very grateful that so many members have taken the time and trouble to reply. Having AFib still seems so unreal as I have always been fit and healthy, but I realise that the condition doesn't discriminate at all.

I am going to get a private referral to the Cambridge Heart Clinic as I don't think it is worth messing about waiting for the NHS with something so important. I still intend to get to the bottom of being told the NHS hospital's cut off for Cardioversion is 65 though.

meadfoot profile image
meadfoot in reply toSeatonRover

Good for you. Best wishes for a speedy return to full health.

Hello Seaton, others have already covered some of the important issues for recently diagnosed AF patients. A lot depends on how the AF is affecting your quality of life. If you are in persistent AF then it’s likely you have been in AF for sometime without being aware ie asymptomatic. Often it’s only when you become aware you have AF, that the symptoms become more noticeable. There are a number of things worth considering as they can have a significant impact on what is called your AF burden.

1. Lifestyle changes if appropriate, will make a major impact. All the commonly known culprits apply so healthy diet, sensible exercise, avoiding alcohol and caffeine and all the other boring things associated with a healthy lifestyle will really pay dividends and will be welcomed by medics.

2. AF is what we call a mongrel condition and affects different people in wide variety of different ways. GP’s are very often not the best people to help you establish a treatment plan specifically designed for you and your AF. If your GP accepts that cardioversions are not suitable for anyone over 65 then you really do need to change your GP first thing in the morning! A CV is one of the primary procedures used to determine if someone with persistent AF can be reverted to normal sinus rhythm and if it’s successful, even for a short while works, this is an indication that other (invasive) procedures such as an ablation, might be the right route for you to find a longer term solution to treating your AF.

3. By all means see a specialist to help you to establish a treatment plan and if it’s possible, especially given the current situation, a private consultation will be the best route. I suggest you seek to find an Electrophysiologist (EP) because they are cardiologists who specialise in the electrical issues associated with arrhythmias whereas cardiologists often focus on the plumbing!

4. Others have spoken about medication. At least your GP has made you aware of the medication normally associated with AF but I wonder if he/she has made you aware of the risks and consequences of not taking prescribed medication. The important things to consider is protecting yourself against the increased exposure to stroke risks as determined by scoring 1 or more on the CHADsVASC score (Google). Secondly, to avoid long term heart damage, beta blockers or calcium channel blockers help to keep your heart rate within normal range, ie 60 to (less than) 100 bpm.

Most people see their anticoagulants as their best friend as exposure to a life changing stroke is scary.

Take a look at the information contained within the AF Association webpages, they are very informative…….

heartrhythmalliance.org/afa...

Good luck, hope this helps.

SeatonRover profile image
SeatonRover in reply to

Thanks Flapjack - that is helpful.

Everyone has been so supportive and helpful in their replies, it has really given me a lift. I am very grateful that so many members have taken the time and trouble to reply. Having AFib still seems so unreal as I have always been fit and healthy, but I realise that the condition doesn't discriminate at all.

I am going to get a private referral to the Cambridge Heart Clinic as I don't think it is worth messing about waiting for the NHS with something so important. I still intend to get to the bottom of being told the NHS hospital's cut off for Cardioversion is 65 though.

in reply toSeatonRover

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CDreamer profile image
CDreamer

Can only echo comments above - yes if you cannot get a referral through the NHS be prepared to pay for a private consult - but you will still need a referral from your GP.

Essential tests IMHO - bloods - especially thyroid, BP, ECG, echocardiogram to look at the heart structure and dependant upon those results possible further tests to see if there is any underlying condition which could cause AF.

If all clear then discuss treatment options of which cardioversion is one but one that may determine future treatment options.

If you have been recommended for anticoagulants please consider - I hate taking meds, beta-blockers most of all and I haven’t had any since 2014 and am much better for it but do look at your stroke risk factors, anticoagulants will help to protect you from stroke which when you have AF you will be at much higher risk.

Best wishes.

SeatonRover profile image
SeatonRover in reply toCDreamer

Thanks CDreamer - that is helpful.

Everyone has been so supportive and helpful in their replies, it has really given me a lift. I am very grateful that so many members have taken the time and trouble to reply. Having AFib still seems so unreal as I have always been fit and healthy, but I realise that the condition doesn't discriminate at all.

I am going to get a private referral to the Cambridge Heart Clinic as I don't think it is worth messing about waiting for the NHS with something so important. I still intend to get to the bottom of being told the NHS hospital's cut off for Cardioversion is 65 though.

Tommyboy21 profile image
Tommyboy21

When I was first diagnosed it was from GP recorded on ECG in site. But it was a case of just pescribed biosoprosol and out the door. I unfortunately ended up with an overnight stay in hospital. But this actually was a good thing in the end. As I immediately got chest/heart x-ray then echo 3days later. Also put under arythmia nurses team at ninewells who are great. Got meeting due for ep to discuss a possible ablation as meds don't really work for me. I think it just depends on your area how quickly things move along.

SeatonRover profile image
SeatonRover in reply toTommyboy21

Thanks Tommyboy21 - that is really helpful.

Everyone has been so supportive and helpful in their replies, it has really given me a lift. I am very grateful that so many members have taken the time and trouble to reply. Having AFib still seems so unreal as I have always been fit and healthy, but I realise that the condition doesn't discriminate at all.

I am going to get a private referral to the Cambridge Heart Clinic as I don't think it is worth messing about waiting for the NHS with something so important. I still intend to get to the bottom of being told the NHS hospital's cut off for Cardioversion is 65 though.

Suesouth profile image
Suesouth

I had a cardioversion in October in Devon, and I’m 72

Singwell profile image
Singwell

Nothing to add here. If you werent diagnosed in hospital your GP should be requesting a cardiology appointment as a matter if course. Accept nothing less as it's your right. I paid to see the hospital cardiologist and waited for my echo test before paying again to see an Electrophysiologist. No regrets. Just depends if your local hospital had an EP. Mine didn't. Also worth doing your own homework by reading The AFib Cure by Dr John Day and checking out the York Cardiologist YouTube channel - a reliable source of information. And stay tuned- we're a helpful lot!

SeatonRover profile image
SeatonRover in reply toSingwell

Many thanks for your steer

Ppiman profile image
Ppiman

If you have AF and are over 60, I believe an anticoagulant is 100% required but the need is worked out by a calculation of stroke risk called Chads score.

The two scans that are useful are an ultrasound of the heart (i.e. an echocardiogram) and a cardiac MRI. You should be given the first on the NHS quite quickly, but the second is less likely or will depend on the echo results.

This article gives some more information:

bhf.org.uk/informationsuppo...

Steve

SeatonRover profile image
SeatonRover in reply toPpiman

Thanks Steve for the reply and the link

Jumper42 profile image
Jumper42

Ditto to everything previously said.

My first episode of AF was back in February - eventually referred to Cardiac Arrhythmia clinic but was not until October. Decided to be patient but following a very in nerving episode of AF in August decided to see consultant privately- well worth every penny! He Explained what what happening, started me straight away on Edoxaban and rather than wait for NHS. Echo - probably a further 3 to 4 months I paid and had the procedure the following week - as this was all ok was started on Flecanide 100mg pill in pocket!

I then used the NHS appt. (End of Nov) as a follow up - where I was seen by advanced nurse practitioner- wonderful lady ! We discussed lifestyle changes , weight loss etc and long term care plan .

Best money I’ve ever spent!

It seems on doing my own research the only long term plan is ablation!

I am currently taking the AFib diagnosis a bit at a time!

This web site is very useful and gives reassurance regarding a way forward.

SeatonRover profile image
SeatonRover in reply toJumper42

Thanks Jumper42

Comforting to know that I am not alone although it does all seem a bit unreal still

Scout1947 profile image
Scout1947

I was diagnosed with AFib in July 2021 at my local A&E, who said they would refer me to a Cardiologist. Jump forward to February 2022 still haven’t heard from Cardiology, although I have had some tests done, and it’s now my 7th visit to A&E. After 17 hours and still waiting for a heart monitor to become available I decided to discharge myself. I went home and ‘phoned the nearest suitable private hospital and got an appointment for 3.00 that afternoon. Best thing I’ve ever done. He explained to me what was happening with my heart, got an ECG done and changed the meds A&E had prescribed. In September 2022 I paid to have a Cardioversion which, unfortunately, didn’t work for long. As we can’t seem to get the meds right my Cardiologist talked about an Ablation and asked my GP to refer me to his NHS practice so he could carry on treating me but as an NHS patient. Now awaiting my first NHS Cardiology appointment which should be next month. I felt uncomfortable paying, as I know there are lots of people who can’t, but where your health is concerned you have to put yourself first. I must also repeat what others have said on here. Blood thinners are a necessity with AFib. My Cardiologist impressed on me very early on that that was my most important medication and that I mustn’t ever miss a dose!

SeatonRover profile image
SeatonRover in reply toScout1947

Thanks Scout1947, very relevant and helpful advice - thank you for sharing your experiences.

Desanthony profile image
Desanthony

I decided to pay to see a cardiologist and then an Electrophysiologist (EP) as my local general hospital had not got a cardiologist so I was unable to see a cardiologist for at least 14 months int he time they were looking to appoint another at our local hospital. This was the best thing I did. I am with Benenden health care - used to be called Post Office and Civil Service Sanitorium Society. so its a "Friendly Society" and for £13.00 a month with prior arrangement I can claim back payments for consultations and get £1500 towards diagnostic tests and scans and also in some cased have procedures and operations at their private hospitals. Always been glad my wife got me into this scheme as it has become worth it's weight in gold - I am at the moment waiting for my second cataract operation - had my first last month with them - I wouldn't even have seen a consultant yet on the NHS. Payments for consultations vary between about £150 to £300 - always check when you book. Diagnostice tests and scans vary in cost so as I think someone already suggested you can ask to have these done on the NHS under the consultant you have seen privately - which means you get this done quicker than waiting for it all on the NHS. Never heard of a cut off age for cardioversion. I had my first cardioversion at age 74 and had another 16 months later and another about 10 months after that and another about 10 months later. All in all the 3 cardioversions kept me in NSR for nearly 3 years and I only missed out on an ablation due to Covid as I was due my ablation the April after lockdown started then in the October there was a Covid outbreak in the cardio unit at the hospital so my procedure was cancelled. Thankfully that last cardioversion kept me in NSR for 16 months so between lockdowns again I asked about ablation and EP decided to do all scans again and it was found that my heart had remodelled itself and it was decided that an ablation or another cardioversion was unlikely to work again. I am now in pemanent low rate Afib - resting heart rate averaging mid to late fifties and now and again during exedrcise it peaks at 130 for a few seconds. Carrying on as normal gym at least 4 times a week and my only problem is growing older. Been taking apixaban - anticoagulant for nearly 7 years and have no problems.

All the best.

SeatonRover profile image
SeatonRover in reply toDesanthony

Many thanks Desanthony

I will certainly look into Beneden. I wish I had taken private medical insurance out when I retired 4 years ago.

just wondered if any of these replies have been helpful.

TracyAdmin profile image
TracyAdminPartner

Welcome to the Forum, I am sure you will find all the Members advice helpful. If you would like any advice or information, please visit the AF Association webpage: heartrhythmalliance.org/afa/uk or contact our Patient Services Team: info@afa.org.uk or call the helpline 01789 867 502.

SeatonRover profile image
SeatonRover in reply toTracyAdmin

Thank you Tracy

I can't believe the kindness of members sharing their advice and experiences. It is both comforting and helpful practically. My own situation still seems very unreal and I understand that I am not alone in such initial feelings.

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