2 seperate questions

[tom0985]

Hi,

1) My Ventricular ejection fraction was 65% in Nov 21’ at my latest echocardiogram last month (14months later) was 56%. I appreciate are both within the normal range - is the 9% drop a trend to be wary of it is normal for this figure to vary with no cause for concern?

2) I am on flecanide 100mg twice a day and signed off to not see cardiologist for 2 years now. Should I not be having tests (bloods etc.) to monitor this drug between now and when I see Dr next?

[CDreamer]

I think what one needs to remember is that the EF is a calculation is done by machine and operator and there will be tolerances between machines and slightly different interpretations between 2 operators and you may be feeling better on one day than on another so as long as you are within normal range - I would not be concerned. You would have to have to see the same operator who was working the same machine to make any meaningful assessment - do you know if this was the case? And you would have to be exactly the same biologically.

If it ain’t broke, don’t fix it but if you are symptomatic in any way then do see your GP to get an immediate rereferral.

You should be having regular blood test - your GP should organise these and monitor. Most people would be 6-12 monthly when stable. You should also monitor OCCASIONALLY your HR and BP and GP surgery will normally do this every time you have a blood test - but you can do it yourself if you have a home monitor, many of us do.

If there was anything to be concerned about it would be red flagged immediately and picked up by the team.

[tom0985 in reply to CDreamer]

thanks CDreamer - appreciate the response. To note - I’m 37yrs old with PAF and no other issues to note (heart structurally and functionally fine) I do get symptomatic AF but it is managed very well by the bisoprolol and flecanide at present.

I was curious at the EF percentage and it was a different doctor and 13months apart so I think as you suggest, there isn’t anything to worry about and could quite well be a higher figure than 56% at next echo for the meaningful reason as you suggest.

I don’t have blood tests booked in 6 month or 12monthly. Maybe I should email cardiologist and ask them to do a letter to GP. Is this required solepy to monitor due to flecanide usage?

I have a good idea of my HR (50-55bpm) and BP (130/85)

Thanks again

[Sniggetts in reply to CDreamer]

Hi CDreamer,

Sorry to hop onto this post , do you know which blood tests might be needed. I’m on diltiazem & flecanide now which is working really well for my AF . The cardiologist and Gp hasn’t advised any blood monitoring which I’m a bit concerned about now … should I be asking for certain ones?

Thank you always for your ongoing advice and encouragement, your a great listener & it’s lovely to have you back on the forum 😊

[CDreamer in reply to Sniggetts]

Hi - Well everyone will be slightly different but the essentials would be Liver & Kidney function and FBC - full blood count which look at things like platelets, haemoglobin, ferritin etc. Most monitoring would be every 6-12 months. Because of another condition I have a lot more and every 3 months.

Have you had a Thyroid Function Test? You may only need that once or very occasionally if symptomatic or on certain meds such as Amiodarone but worth asking.

Hope that helps.

PS - I think sometimes the noting of the necessity of these tests just slips under the radar.

[Sniggetts in reply to CDreamer]

Thank you so much for your reply, I’ll get onto them.

Take care 😊

[etheral in reply to Sniggetts]

Would make sure glucose and electrolytes are included..etheral

[Sniggetts in reply to etheral]

Thank you , will do. Having been in/ out of hospital Oct / Nov they were finally normal when I was discharged, so call the Gp in March for a re check if I don’t hear. 😊

[Territorial]

My ejection fraction is much the same was 65 on march 1 2022 when i first had heart failure and last week was 56 i think it can vary slightly but was after my 3rd heart failure..