Cardiologist

[DaveBr]

I have a question for all of you that have been diagnosed with AF for quite a while. How often do you have an appointment with your cardiologist. I was diagnosed about 6/7 years ago and as a result had a pacemaker fitted and put on medication. I was also offered an ablation but turned it down for several reasons one of which was because one of the specialist said it probably wouldn't work for me. The main hospital I was being seen at (Glenfield) then basically discharged me . It seems like I have been left to get on with it by myself with just my pacemaker check ups annually is this the norm

[secondtry]

Probably is the NHS norm.

I was diagnosed 10yrs ago and have an annual check-up with the same cardiologist every year paying privately. If I tried to get the same under NHS, no doubt it would be a battle.

For around £200, I consider this great value to have heart listened to, discuss medication, any changes to ectopics etc, any news re ablations etc. All helps to reduce my anxiety, another tool to keep AF at bay!

[Thomas45]

I went from Paroxysmal AF to persistent AF between six and seven years ago. There was no moment between annual cardiologist visits that I felt any different. Flecainide had worked for 12 years but was no longer working. I have no idea when it stopped working. My consultant, not an EP, gave me the impression that he thought he had failed to keep me free from persistent AF. He suggested I think about taking a Calcium Channel blocker, Diltiazem.

I read up that and discussed it with a GP who has specialist knowledge of the treatment of AF, and I decided that as my heart rate was normally on the high side of normal, that my persistent AF was asymptomatic, and that I had a history of bad reactions to many drugs, that I would not have any additional drugs for the time being. I deem my asymptomatic AF now to be permanent. My anticoagulant is my best friend. I suggested to the cardiologist that he discharged me to the care of my GPs, knowing that I can be referred back at any time. I have not needed to be referred back, and the medical practice, which is now part of a larger group, has its own AF specialist who will see me if I need help with my AF.

[Espeegee in reply to Thomas45]

I think you have been so lucky to have had what sounds like even handed care. I know this may seem a bit odd but your remark about having reactions to a lot of different drugs mirrors my daughter, it turns out she is autistic and has adhd and this is a symptom! I'm not for a moment suggesting this is you but it's such a curious symptom I thought I'd flag it up. Anaesthetic is particularly dangerous for her, we've nearly lost her twice because no one knew. I ought to add she's in her 50s now but has to be very careful with medication. She is very high functioning but her life has been blighted by no one realizing she was autistic, only diagnosed 2 years ago, it was like a huge penny dropping.

[Desanthony]

I have a blood test and consultation with cardiac nurse every year - I actually haven't seen the nurses since the October before lockdown but as I have a Kardia they call me we have a discussion about the state of my heart health and I send the Kardia reading to them and they then either e mail me or call me back. The blood test is done at my surgery and sent to the cardiac nurses. I have been told that I can call the cardio nurses up and make an appointment if I have specific problems or can be referred back at any time. I do wonder how long I would have to wait for an appointment with them these days as they only work Wednesdays at my hospital and are at other hospitals on other days and I imagine that like all areas of the NHS they are still trying to catch up with themselves.

[CDreamer]

Yes, it has been normal for secondary care to discharge you back to Primary Care when you have been treated and have been stabilised. You will no doubt be monitored - Pacemaker Checks, regular blood tests via your GP? So if anything arises that then does need attention you and/or your GP or Pacemaker Clinic would then refer you back to Cardiology. That seems a sensible system to me.

If you have an increase in symptoms you can ask to see your cardiologist. I found that difficult to come to terms with originally but thinking about it, I now feel that it would be a waste of resources for highly trained specialists to continue to see patients when there may not be any need.

I also agree with secondtry - if you can choose a cardiologist who has both private and NHS practices you can get a private consultation. My husband was concerned because he hadn’t seen a cardiologist and having moved house wanted to ask some questions. We were unable to get an appointment with cardiology so went for a private appointment. It seems that everything had been carefully monitored, nothing was amiss other than replacement box for his pacemaker within the next 6 months, which we already knew via Pacemaker Clinic.

[Omniscient1]

Follow-up? No. Not ever. A couple of years after I saw the consultant I got the GP to ask the question again, and got a 'no point' back. I no longer bother the GP for a periodic ecg. I get the annual 'vascular' check (blood tests) from the GP surgery, that's it.

[SteM]

I was diagnosed with AF back in 2007 and after cardioversion at the end of that year I was put on Flecainide.

Since then there has only been yearly blood test from my GP as a med review but no regular appointments with a cardiologist or the GP. I decided a few years ago to pay for a private consultation and researched to find an EP in my area with a good reputation who I could pay to see . It cost about £250 and I have seen him twice at 2 year intervals , he reports back to my GP with his findings/recommendations for medication changes as he has added Bisoprolol to my medication . In addition he also decided that additional test should be done (24 hour monitor, Echocardiogram) which would be very expensive privately so he requested my GP refer me to the local hospital so it could be done on the NHS. The only problem occurred when my GP failed to send the report back to him but next time I will make sure that link is connected myself.

[shorttail]

I was discharged from hospital after a severe undiagnosed AF episode, given drugs to take and after a follow up 3 months later with cardiologist was discharged back to primary care.

Doc never sees me unless I ask.

[10gingercats]

I see cardiologist once a year and sometimes more often as happened recently when my af went 'a bit bananas'with slight faintings as well,Ended up in A and E and then my cardiologist called me in a couple of days after the A and E episode. .for an extra check up. and excho. I can call the cardios nurse whenever i need to and I have had some fantastic care

[Redders]

I was diagnosed about 25 yrs ago. I’ve had 3 ablations but still in permanent AF and was discharged from my cardiologist who said there is no more that he can do. That was about 10 yrs ago and not seen a cardiologist since. Not good

[blmbmj in reply to Redders]

Have you ever researched a Mini Maze procedure?

wolfminimaze.com/the-wolf-m...

[Dudtbin]

im with glenfield cardiology, they told me to go to gp if problem who would contact them or to ring the hospital for advice. Ive always found reception at glenfield very helpful and they gave me dr lasdans secretary number.

[rankin1st in reply to Dudtbin]

Hi my hubby under Dr Lazdam too, we call specialist nurses or email them on CRMNURSES (UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST) [e-mail] and they're always been helpful

[Mike11]

Just pay for a private consultation every year, which also gives you direct access to him/her at any time through their private secretary. My consultant even checked my situation recently when he was abroad on holiday and phoned me to initiate a new drug he wanted me to try, and his secretary emailed my surgery the next morning. Well worth the money as it gives you peace of mind.

[Prettyorchid]

In the US so it appears our system is different. PM in April, first check up 1 month later. Visits start with PM tech team where they checked the lead connections and operation. I also got a print out of my AF episodes. Second check up due to experiencing SOB. Constant AF since June, reason for SOB although I go to water aerobics daily, and I’m functioning, but I get SOB on any exertion, like showering/dressing. Next step cardioversion next Friday and a new Rx. (8th cardioversion). I appear to be a “complex” case 😵‍💫. I knew PM would not stop AF, but I was led to believe I would feel no symptoms 🥲

I’m paced at 70/130 so my HR cannot get to 190 as it did on my AF onset 6 years ago.

Would never be referred back to my PCP for cardiac issues. As a senior I am covered by Medicare and a secondary. The hospital is Cleveland Clinic. Fighting the fight to maintain a quality of life. 73 years young

[Buffafly]

I only see a cardiologist when things go pear shaped. Once when I had a query my GP contacted a cardiologist and I was given a phone appointment which was excellent. My only complaint with this system is that I never get to see the same person twice and the quality of cardiologists is very variable! I was finally referred to the AF nurse clinic which was a great experience as I had time to describe my symptoms properly and the nurse then referred me for a cardiology appointment but I’m not holding my breath.

[jwsonoma]

I haven't seen my cardiologist in person for about 4 years. He sends me an email reminder for my annual EKG and I have sent him emails with the occasional question.

I would ask to see your's if you have concerns. If that can't be done I would set up a relationship with a private Dr.

[Dodie117]

I was discharged by my cardiologist about 2 years after successful ablation with a promise he would prioritise me if I had future issues.

Now living I. Ireland with a medical card and amazeingly he sees me every six months!!

[JOY2THEWORLD49]

Hi

After seeing a Cardiologuist once under public. I had 3 x24-hr monitor s after before each change. But she discharged me with a H/R Day 156.

My locum Dr referred me privately. This H/Sp was interested and introduced me to CCB Diltiazem. Referred me back to public.

Last year the National H/Sp tried to discharge me but I objected.

I have an appointment in December 18mths later.

It seems if one is stable on meds they will push you off the list but tell your Dr that at anytime she/he can refer you back to the outpatients list.

Last November my H/R dropped further to 60s Day and still 47 at night.

There is no lower dose of Diltiazem now. I take 120mg. I'll be asking what do I do if I need a smaller dose.

cheri JOY. 74. (NZ)

[ChiMan62]

I’m in NSR and I’ve been instructed to notify my electro cardiologist if my AFib starts up. Otherwise I see my electro cardiologist every six months and my cardiologist every six months.

[pusillanimous]

I do not have a pacemaker. But when I was first diagnosed with AF, I saw the Cardiologist every six months for the first 18 months. I now see him annually, but see my GP every six months for renewal of my prescriptions and other checks. She will phone the Cardio if she has any questions about medication. I can phone his rooms direct for an appointment if I feel it is necessary (touch wood have not had to do so in the 7 years since my diagnosis)

[Vonnegut]

I only saw an NHS cardiologist soon after I was first diagnosed and only got help from an EP I saw privately! Since then I have only seen one once several years ago over problems with the anticoagulants that I no longer take as Flecainide has prevented episodes! I didn’t go for the pacemaker offered in a phone conversation by a registrar, as a friend who had been fitted with one had terrible trouble with it as it wasn’t fitted properly and in the end she had to have it removed!! It seems the NHS guys here are not that great sadly!

[frazeej]

I see the cardiologist every 6 months, with ecg, and usually an ECHO every 12-18 months. He says if I have a problem, call him. I'm in the U.S., on Medicare.