I’d just appreciate others experience / opinion please. After years of worsening paroxysmal Afib I eventually saw an EP who changed my meds and wanted a follow up appointment in 3 months to discuss an ablation depending on my episodes. The appointment didn’t come so eventually I chased. Much to my surprise when I arrived at the hospital, my appointment was with a cardiologist who is almost starting again with monitors etc . She was perfectly pleasant but wasn’t impressed with my request to continue seeing my EP. She said my Afib may have transformed into another type of Arrythmia since I last spoke to my EP. I feel like I’ve gone to the back of the queue, starting all the monitoring etc again and none of it makes sense?
Appointment to see cardiologist after... - Atrial Fibrillati...
Appointment to see cardiologist after seeing an Electrophysiologist?
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Blimeyohriley
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BobDVolunteer
Typical NYMBY. Any arrhythmia needs an EP as they are the experts in the field.
Thanks Bob, that’s my thought. I wondered if I was being unreasonable with my frustration (not directed at the cardiologist but with the situation).
What does NYMBY stand for. We have a term ‘NIMBY’ we use in Aus but it means ‘not in my backyard’ and I somehow don’t think that’s what you’re referring to. 😂
yes. Cardiolgoists and EP seldom mix
I had 3 years under cardiology before asking to be referred to an EP just to have his opinion, 3 months later I had an ablation. The EP did reorder some of the tests again first though, they need the latest information on heart structure etc to make their opinion and advise the best treatment going forward. I would be pushing to get back under an EP. None of their tests ever captured my AF and it was my own ECGs from Apple Watch along with a new echocardiogram used.
Best wishes
Thanks Buzby62, I thought I was at the ablation stage which is why I’m quite stunned to be starting again. I even I had to challenge the fact I’d been diagnosed years ago with many episodes caught at the same hospital. It was all quite hard going. The cardiologist didn’t seem to know I’d even been diagnosed and thought it was my first visit initially. I had to explain the entire journey but didn’t seem to be getting through easily 😞. She was very thorough though!
Ring your EPs secretary and ask what is going on.This is unacceptable.
Thanks wilsond, that’s a good idea. I hadn’t thought of that.
Also email so you have a paper trail. I find them to ve very useful people.Good luck this is weird and stupid!
Yes. Definitely. And I’m better at communicating in writing - it’s suits my slow brain to give me time to articulate the facts (rather than babble). It also manages my tendency to show my irritation when I feel unheard in person. 😊
In the US, my primary care provider ordered the holter monitor, but then referred me to an EP and since then I only see my EP (no cardiologist involved). Can you directly set up appointments with an EP? Or at least call the EP to tell them that you'd like to hold that original, promised consultation?
Hi PurpleGirl05, thank you for your reply. I initially saw my EP months ago and he set me up with a 2 week holter monitor. I’d previously worn no end of monitors for various cardiologists. My EP then changed my meds. As I’d obviously been missed from their follow up appointment schedule I emailed to remind them and asked for him by him by name. But when I arrived at the hospital it was a cardiologist I saw. I think I’d seen about 5 different cardiologists over the years before eventually getting an EP appointment. He seemed to really understand the impact my Afib has on me (I’m very symptomatic in Afib and also have bradycardia) so it was a relief to see him. I will contact his secretary and explain the situation. 🤞🏻
Your GP should be able to refer you to your EP of choice explicitly. Ditto for hospital. You have the right to choose, but probably they just referred you to their favourite hospital for heart conditions (which normally would be fine).
you forget insurance plays a big part regarding doctors and hospitals and it also depends what hospital your doctor is on the staff of. It’s not as easy as you make it sound. It all has to work together. I have only been in heart specialty hospitals because that’s where PE normally works out. Depending on your system, you may find an EP yourself. We have lots of help here to communicate and then you follow his lead. It’s not always easy to go together, especially if you want it local my heart hospitals are at least an hour away, which isn’t bad. The best ones are further in Houston but we have a mini center closer with all the same hospitals smaller version most of the same good doctors the best of the best including DeBakey Cardiology
lay down
medicine has become so specialized and especially after retirement although with all of them a lot has to go through the insurance first the first step here normally is my GP sending a referral for a set amount of visits or a time. It’s too bad but doctors and others have taken advantage which is why the cost is so crazy.
do your research first if you’re going to pick out your own EP my first episode, I was blessed to find my incredible Cardiologist worked closely with an equally incredible EP many of them work together that way, even though it’s not required it’s like anything else you find someone you like to work with and you’re on the same page. I am hoping my new EP has a good one because I am not thrilled with my only reason I stayed as long as I did was because of my EP I had little to do with the Cardiologist until recently.
I met with my EP and I knew I had the right one for me. I had made a list of questions and he gave answers before I got to ask them. I always felt swaddled safety with him. He had an incredible team as well. I’ve already spoken with some of the team for my new one I like them already.
best of luck make sure you get your ducks in a row I of course, would prefer someone closer to Unfortunately, the two don’t come together I would rather travel and have the best of the best.
Understood Dawn, I was referring to the UK system. Sounds like you have got to grips with your treatment over there.
I realize that someone else just before you was actually in the states. I believe I confused the two of for being so nice lol oh, it’s hard to come to grips also. I took a serious fall last week all week I was ready to pull my hair out because there were too many fingers in the pie. Most of the time it is more intimate than that the more people you involve the more of a mess you end up with. I knew nothing about a fib, etc. five years ago until I woke up face down on the floor. There is a huge learning curve and we never learning just like my EP told me about his job. There’s always something changing. We are different. You really can’t compare other than the basics of where a fib seems to come from and what might help. Give us quality of life. Just remember everything is like a Band-Aid.
feel better💕
Hang on in there Dawn. Learn as much as you can from the association's website. Knowledge is power. Best wishes.
trust me I have had an incredible doctor. My PE is also a professor and when he saw my interest and the questions I ask he began to treat me as a student as well as a patient. Sadly, he left six months ago. Sad for me because I miss him, but I’m also very happy for him. He is director of a very well-known university in a North Florida heart hospital. He created what I have for a pacemaker because they did not have one for at the time HIS pace bundling was just being pulled out along with other things he created as he worked on he had promised I wasn’t going anywhere and he kept his word. Evidently, I horrified them after my cocktail in the OR asking if they have had many people die in there while working on them. Whenever I woke up, he would be my hand telling me I wasn’t going anywhere. He is young humble thinks outside the box and so much more, and I have been blessed to find a doctor similar to him. In fact, if he took the resumes and removed the names, it would be hard to figure who was who
The knowledge is power you will see. I have quoted on here over and over again that’s how you get away from being scared of what’s going on. People get too absorbed and get into stuff they shouldn’t. I know how long it took him to become who he is and as he states you never stop learning. I don’t pretend to understand everything such as the HIS pace bundling. it is up to us to decide the priorities of what we are learning about after all we aren’t going to operate on ourselves. Most of us are smart enough to question the right things I don’t mess with stuff I shouldn’t lol a perfect example is the pacemaker that I have well it was state-of-the-art two years ago but you should see what he’s working with right now. Doctors like him are very big on quality of life for us. He was not the favorite child at the hospital because some procedures are obsolete. They were better than nothing at the time, but even on here I see certain things overused. this is when people should be asking questions and thinking about the trauma that your heart takes with each ablation or cardioversion. Slow and steady the race unless it is truly a matter of life and death for you. Even with that he made sure he got it right because I was on the brink. they almost lost during a cardioversion only my second. Because of an ablation, my heart was so scarred and damaged. I could not have another ablation and I now had heart failure. I am hanging in there fine. I don’t like what’s going on now because everything has been going so well since I got my pacemaker. I arrived in a wheelchair. I left in a wheelchair but only to the car because of protocol. Then I was able to stand up and get into the car on my own for six I unable to stand up, brought tears because of the pain in my chest. My goal usually on here is to try to not overstep and make people realize we are all different pay attention to your doctor or question if you must and don’t be afraid. The things I’ve learned from mine made me stronger and unafraid. Unfortunately, I don’t have my doctor right now to talk to although I do hear from him in fact twice last week and he is still there for me and if I really wanted to, I could call him, but I have to let him go. he did his part and beyond that because I’m still here and alive and now he’s helping others the same way. I have no trouble hanging in there. I have been stuck between a rock and a hard place with him being gone for six months and they have not replaced him and I don’t have faith in my That’s my problem right now. Since the day in the OR they started calling unique I was thinking of changing my name legally to that lol I have a tech and an engineer when there are certain situations who ever would’ve expected to become such royalty lol new to with a heart just like would I ever have expected what they have done for me.
it has been frustrating when they don’t know why I’ve been so sick since November not Heart-wise that continued strong and still does. I just had a transmission done on the second of this month and they let me know everything was fine. Yes I don’t have to go anywhere or see anyone I could be taking a bubble bath while they are doing it lol I am4 seven and my doctor would know before I would if there’s an issue unless there is a total breakdown of the system. because I had a Doctor Who spoke not at and really respects me. I have learned a lot of things that many probably will never know is going on out there and I feel like right now is a pretty good time to have a fib, even if there’s no cure. People just have to lighten up a little bit stay out of the parts they don’t belong in and listen to their doctor sometimes it seems like they are looking for things to be worse than they actually are. Common sense is pretty important if I had a palpitation last week for 20 minutes that is not the end of the world I feel bad for people, but sometimes I just wish they would think things out before they freak out my first a fib, I woke up on the floor faced down into concrete. Of course I worked law enforcement. Maybe that’s why I take things, and rational. I wish I could share it with other people. It would be so much healthier for them.
now I feel like someone cut the umbilical cord too early. That’s my problem once I connect with my new PE. I’ll be fine. I’m fine already. My flutter is still the major problem when I get feelings which you get even with a pacemaker they are annoying. I want to yell at them lol I try to keep a sense of humor. I am a visual person so I try to visualize to think and understand about what’s going on.
thank you for your note
I had moved so someone referred a and immediately he sent me to the EP he works with. Only since October have I begun to see the again. For two years, it was only the EP that I would call as they say the EP is electrician. Cardiologist is the plumber with a fib, etc.. You need an electrician. After about a year of my pacemaker I was then cut back on visits to everyone until then some more monthly again with the PE. Unless there’s a problem with my pacemaker, it is all about the cardiologist now I think of him as a GP for the heart regarding meds, etc. the PE moves on to the others that need his surgical proficiency, etc..
I had the holter two weeks it told them nothing. EKGs were also not you’re not active in an episode there’s nothing for it to see. The loop implant took less than an hour with a local within two weeks they had answers. They may have thought a fib, but then they had proof
unless you have other heart issues right now if you’re only dealing with a fib, it’s the PE that you want. I had a fabulous one. He just moved out of state, but I think I found another diamond. I will see him in a few weeks.
I really don’t understand your medical system.
I’m in Australia. Our GPs refer you to cardiologists and or EPs depending on what is happening. For me personally my GP referred me to my cardiologist, who in turn realising it was a conduction issue, referred me to my EP.
I saw my EP for about 2 years, as well as my cardiologist - my appointments were roughly 3 months apart EP-3m-cardiolgost-3m- EP etc - so 6m between the visit with each individually.
Eventually my EP was happy at my progress on meds and he handed me back over to my cardiologist. I now only see my cardiologist and if I need anything going forward (pacemaker etc) I will be referred back to my EP but will still see my cardiologist during this time most likely.
Same here if the gp is awake.
My GP initially referred me to a cardiologist, but since there is nothing structurally wrong with my heart, per se, that dr. referred me to an EP since Afib and all arrhythmias are electrophysiological in nature. I haven't been seen by a cardiologist for 15 years now. My EP does chest X-rays to check for mechanical functioning only if needed or he suspects something has changed in the "root cause" of my electro-system. So, the short answer is that if you don't have anything going on with the actual heart functioning, there is no need for a cardiologist.
I think that’s my disappointment- no structural issues with my heart, it’s all electrical and that’s an EPs speciality. Hopefully I’ll get the confusion sorted this week 🤞
Go back to EP. They specialize in electrical engineering of heart. All EPs are cardiologists but highly specialized. I am in United States.
Thank you graceprius
Ablation is not the be and all of treatments, she wants to see if your condition and heart have changed in anyway and to treat it as it is now, yes recommendation may still be an ablation but if you can be treated without then go with it, at least for now. Tests will reveal if there has been any changed, either good or bad. In my history it has been the cardio who has referred me to the EP as necessary.
Hi opal11uk, oh yes, tests aren’t a bad thing. It’s purely because I’ve already been down this route and have already been referred to the EP. My med route is now exhausted due to my bradycardia - both EP and cardiology agreed on this.
Poor you. But things might be that way here in parts of the UK- I only got to see an EP privately after what the NHS doc had told me to take daily proved too much for me to take (the lowest dose of Bisoprolol - 1.25mg- and it was the pharmacist who had been concerned about that!) Of course if it might be another form of arrhythmia - a Kardia might be able to detect it for you if you had one and have you had an echocardiogram? That is usual after the original diagnosis to check the structure of the heart is ok.
Hi Vonnegut, I had the same issue on bisoprolol 😊. Oh yes, I’ve had numerous echocardiograms (heart structure ok), numerous ecg’s and holter monitors over the years, all resulting eventually in seeing an EP. Funny you should say that, I’ve literally just invested in a 6L Kardia as I became concerned I was being advised to go to A&E next episode so they can capture the arrhythmia again in case it’s “transformed”. If I can avoid A&E I will. It’s blummin chaotic (was there recently after I took a hard knock to the head and I’m on anticoagulants). I’d rather spend a bit of my savings and capture an episode myself to send in. Of course I’d go if I had concerning, unusual symptoms and I’m not at all suggesting we don’t go to A&E but I’ve had this for so many years I know my usual pattern / symptoms. They’re just getting more frequent.
Well done on finally getting a Kardia, and if it turns out that Flecainide will help you as it did me, it works very well as a PIP, ending episodes in a few hours. The money I was finally billed for after seeing the lovely private EP was definitely well worth it. I just heard he has retired now but plans to write books about heart conditions. Now taking Flecainide regularly has virtually put an end to AF episodes for me even now I’ve reduced the first dose of the day which I’ve just taken. And as I no longer have AF episodes, I’ve stopped taking the anticoagulants as I’m not “at risk of stroke”! The EP who prescribed the Flecainide for me initially, told me I wouldn’t be at risk of stroke unless episodes continued with a high heart rate for a longer period than mine ever did so I stopped taking them and still here at 81.
What a great good news story. Nice to hear. Unfortunately Flecainide didn’t work for me. My med options are exhausted now due to my bradycardia. I will hopefully get to see my NHS EP again when I speak to his secretary and explain the situation 🤞
Good luck and hope you get something that does work for you (and that eventually it will be realised how different we all are).
if you have a spare £250 I suggest you make an appointment with a private EP. You can then take things from there. They will write to your GP with the recommend treatment which need not be done privately.
We all have different experiences with the medics. My experience is that you can talk to a cardiologist about different medications, whereas if you talk to a carpet salesman (aka an EP) you will be sold a carpet (aka an ablation).
I was offered an ablation by an EP but instead chose pills, which worked v well for 10 years. AF burden has now increased and offered an ablation again by a different EP; currently researching which ablation will be best for me.
Hi secondtry, it is interesting the different advice from even different cardiologists (I’ve seen 5 now I think). I’m quite pleased my EP was keen on trying different meds first. He and the cardiologist both sing from the same hymn sheet in that I’m very limited in my med options due to my bradycardia. I’ve pretty much exhausted that route now.
My HR was low and therefore I was just put on Flecainide and no usual accompanying BB or CB. It worked well with other lifestyle changes incl Mg & CoQ10 supplements for 10 yrs.
Hi I’d had years of AFib which had gone from Parox’ to Persistant. I was put on an anti arrhythmic Flecainide which changed it from Fib to Aflutter - treated with a 3rd ablation
To be honest I personally would refer back to EP - perhaps depending how long ago you saw the EP I would call the secretary of who it was you saw - tell them you never received a follow up & could they get you another appointment to be seen. It may be an error that you got that other appointment. Hope you get sorted quickly
Hi Afibfipper, yes, the more I’ve thought about it, I think it’s because my EP appointment was so long ago (they forgot the follow up appointment) that I’ve been referred back to cardiology. It all quite disappointed and upset me but it’s settling with me now. I’m going to contact my EP’s secretary and explain the situation. I can’t fault the attention etc from the cardiologist it was just the disappointment and feeling I was covering the same old ground again. I do constantly struggle with the admin side of the NHS. No matter what the issues my battles are always there 🤷♀️
I have had success in these situations by contacting Patient Liaison. I'd call them first and explain you are confused and upset (rather than making an outright complaint). If you have paperwork etc that also helps. Hopefully they will then liaise with cardiology and you'll get your appointment with the EP.
Thank you Singwell, I have considered doing that.
EPs are arythmia specialists, regardless of the arythmia. Fight for an EP appointment. Absolute waste of money to redo all the tests Do ECGs yourself to present to EP on a kardia preferably as they do seem to accept these.
Thank you MaryCa, yes my mind went to the possible unnecessary extra costs. Just purchased a Kardia for that very reason. 😊
It's absolutely a bonkers waste of the NHS's money (assuming you're in the UK and not Ireland and the HSE)
I too was told that I'd have a follow up appointment in 6 months time with my cardiologist.......8 months down the line I telephoned to ask when my appointment would take place. 2 weeks later I received one for 29/01/24(5 weeks later) 5 days before it was due it was cancelled and another one (9:15am, telephone follow up) for 11/02/25 was given.......sat waiting all day, no one rang , made a complaint about it to the trust and they've apologised and made me another appointment for 23rd of April, the stress and anxiety is not doing my heart any favours and I feel that no-one at cardiology cares I only hope my appointment takes place this time.What is happening to the NHS?
Oh gosh, that’s dreadful. I don’t think many of the cardiologists always understand how anxiety inducing it can be. I’ve learnt to live with it now but hate that feeling of not knowing when it’s going to kick in. Particularly if I'm away from home as I am very symptomatic. I hope it all gets resolved for you.
Patient Liaison was mentioned - yes I forgot about them but I’ve used before for a different dept - things were sorted quite quickly by them
I'd prefer what has happened as a second opinion would be very worthwhile. An EP in the UK is a cardio with a little extra training: both treat arrhythmias and both know what is best for you.
Steve.
Hi Steve, that’s a good take on the situation and I did like the way the cardiologist was so thorough.
Hi
I do not know where from
But is so sad and disappointing
Looks like NHS I went to see F2F the GP other day to discuss my medication to my surprised she did not read the previous notes and I have to explained my situation
The medic in England behaves like Gods and do not like any question
It is your life and only you can look after it
suggest be firm , not to be afraid and ask to see the EP even she thinks your situation has change
Hi papillone, some of the medics don’t like being questioned or even if you know a little bit about your condition. Thankfully I find these are few and far between but frustrating indeed when we come across them! I will contact my EPs secretary today.
If they will do new tests, such as imaging, you might welcome additional information. Important to know the heart structure, valve and vessels conditions, before allowing EP go in to modify the heart via ablation.
Hi FitnessGotFibbed, yes, can’t have too much information particularly in terms of our health 😊
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Is it common to continue on Flecainide after ablation?
