Appointment to see cardiologist after seeing an Electrophysiologist?

[Blimeyohriley]

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?

[BobD Volunteer]

Typical NYMBY. Any arrhythmia needs an EP as they are the experts in the field.

[Blimeyohriley in reply to BobD]

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).

[ForensicFairy in reply to BobD]

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. 😂

[BobD Volunteer in reply to ForensicFairy]

yes. Cardiolgoists and EP seldom mix

[Buzby62]

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

[Blimeyohriley in reply to Buzby62]

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!

[wilsond]

Ring your EPs secretary and ask what is going on.This is unacceptable.

[Blimeyohriley in reply to wilsond]

Thanks wilsond, that’s a good idea. I hadn’t thought of that.

[wilsond in reply to Blimeyohriley]

Also email so you have a paper trail. I find them to ve very useful people.Good luck this is weird and stupid!

[Blimeyohriley in reply to wilsond]

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. 😊

[PurpleGirl05]

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?

[Blimeyohriley in reply to PurpleGirl05]

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. 🤞🏻

[Omniscient1 in reply to Blimeyohriley]

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).

[ForensicFairy]

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.

[Omniscient1 in reply to ForensicFairy]

Same here if the gp is awake.

[graceprius]

Go back to EP. They specialize in electrical engineering of heart. All EPs are cardiologists but highly specialized. I am in United States.

[Blimeyohriley in reply to graceprius]

Thank you graceprius

[opal11uk]

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.

[Blimeyohriley in reply to opal11uk]

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.

[Vonnegut]

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.

[Blimeyohriley in reply to Vonnegut]

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.

[Vonnegut in reply to Blimeyohriley]

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.

[LadyLawson]

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.

[secondtry]

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.

[Blimeyohriley in reply to secondtry]

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.

[secondtry in reply to Blimeyohriley]

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.

[Afibflipper]

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

[Blimeyohriley in reply to Afibflipper]

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 🤷‍♀️

[Singwell]

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.

[Blimeyohriley in reply to Singwell]

Thank you Singwell, I have considered doing that.

[MaryCa]

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.

[Blimeyohriley in reply to MaryCa]

Thank you MaryCa, yes my mind went to the possible unnecessary extra costs. Just purchased a Kardia for that very reason. 😊

[MaryCa in reply to Blimeyohriley]

It's absolutely a bonkers waste of the NHS's money (assuming you're in the UK and not Ireland and the HSE)

[madknit]

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?

[Blimeyohriley in reply to madknit]

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.

[Afibflipper]

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