AF - appt with arrhythmia clinic by phone, is this usual?

[Green264]

I had an appt at the rapid access chest pain clinic a couple of months ago, whilst there I had an episode of my 'funny heart beats'. The Nurse palpated my pulse and said it was AF, they couldn't refer to the other clinic so I had to go back to the GP to get the referral. I now have an appt in April, but its a phone appointment, is this the norm??

In the meantime I have had a long weekend of almost continuous irregular HR, it isn't rapid, if anything it goes slower, misses beats, jumps around etc. I have had chest pain, some shortness of breath and dizziness, and just feel generally awful!!

This is all new to me and I'm not sure what I should be doing, they started me on bisoprolol 2.5mg and aspirin. I'm worried....

[guineacat]

Phone appointments seem to be the normal now. I find it ridiculous I've never been seen by a consultant. I have a cardiac nurse ring me every few months. It seems once you are referred they give you treatment and just phone to see how it's going

[CDreamer]

AF is incredibly common and it feels very scary I know, however it is not immediately life threatening and therefore tends to be not given the priority that other cardiac issues are.

Your GP should be able to arrange a 24 hour monitor to record what your heart is doing, the results of which will inform treatment. Asprin is not used normally in AF unless you have other heart conditions or have had heart surgery? First line treatment would normally be Anticoagulants unless contraindicated for other conditions. Your GP should also arrange for blood tests and advise accordingly - if unable then signpost them to the links below. We AFers have found we sometimes have to be expert patients.

Often GPs are not well informed about AF unfortunately you will find excellent support and knowledge over on the AFA patient forum on HealthUnlocked where you will find 20,000+ of people who suffer with AF and Atrial Flutter and some other arrythmias. The support and depth of specialist knowledge is outstanding with some doctors contributing.

If you have slow AF I personally would question your GP about the use of any beta blocker.

May I suggest you visit the AFA - Atrail Fibrillation Association who are the experts in arrythmias for latest information.

heartrhythmalliance.org/afa...

heartrhythmalliance.org/afa...

Very often you will speak with an Arrythmia Specialist Nurse over the telephone as first contact who will triage you. The nurses are normally excellent and certainly the ones I have had contact with will get you seen very quickly for emergency treatment if warranted. The wait to see an Electrophysiologist is often long unfortunately, far, far too long because too many patients and too few doctors.

AF is very uncomfortable and feels very scary but is very rarely life threatening although sometimes it can feel as though it is.

With the symptoms you describe however ie: dizziness and chest pain you might want to ring 111 for advice or visit urgent care centre or dare I say A&E for an ECG and immediate assessment if you stay in AF for more than 24-48 hours and are not being seen as an out-patient and are concerned.

Best wishes

[Green264 in reply to CDreamer]

Thanks so much for your response. I have read quite a lot since the nurse said I had AF, and I have seen that aspirin isn't first line treatment, I will ask about that when I have my telephone triage, but in the meantime I suppose its better than nothing?? I feel OK today, but if I have another episode like this weekend I will call 111 for advice. My partner has been cross with me this weekend for refusing to call 111 ...

[meadfoot]

An excellent response from Cdreamer, says it all really. It seems we are mostly subjected to phone apps now which really isnt good enough forinitial assesmment and treatment but often ok for ongoing monitoring. Best wishes.

[Hidden]

A good meaty reply from CDreamer with some excellent points brought up.

The simple answer is yes to your question and in my option it will become the normal in this post { you know what } world.

Take care

[wilsond]

Echo all that CD said,and also endorse the AF Association forum,its a great source of support and information.Agree that initial chat on phone will instigate investigations to confirm your arrythmia which will form a treatment plan.

AF is a strange beast but there are methods of taming it,including lifestyle, medication and proceedures. I have had all 3 and now stable ,touch wood.

Ask about anti coagulation definetly ,no value in taking aspirin for AF Im afraid!

Keep well hydrayted.

Best wishes and hope AF settles down soon.

[Tomza80]

Hi, I cannot comment on the appointments as I in South Africa. However bisoprolol will help slow down your hear and make it work less hard. It is quite a strong drug and you will need time to adjust to it. I have no experience with Aspirin but I understand is to prevent blood clots since AF can make them easy to form.

[Bestman2021]

You should go to A&E. This is not normal. You need attention from a cardiac specialist or team

[Blange]

I’m on Bisopralol myself.I remember when I first started I was just like you very worried.I have random episodes of tachycardia and very high BP.they were just coming on out of nowhere it was awful and frightening.I started on 2.5 which really slowed my heart down to sometimes in the 40s and I would be dizzy and breathless.but these are normal side affects that I no longer get.I told my doctor and he dropped me to 1.25 which is a low dose but I’ll be honest it’s helped me a lot.I still have the odd attacks once a month or longer.the Bisopralol doesn’t stop them but keeps my HR below 100 which is better .I would say I understand you will be nervous as anything to do with the heart is terrifying.but you will be ok once you get a few weeks in you won’t even know your taking them.my friend has AF and he takes 2.5 and it’s helped him no end.try not to take any notice of reviews or you will never take anything.yes it can cause side affects but so can paracetamol and any other meds.it’s the person.good luck and you will be glad you started

[Green264 in reply to Blange]

I have just had a telephone appointment with my GP and he has suggested doubling the dose of bisoprolol to 5mg to see if this is effective with the irregular HR. He said only go to A&E if o feel like I am having a heart attack!! I'll see how the increased meds work, I guess it's just a bit of trial and error with all this!

[Blange in reply to Green264]

yes you will find your balance with them.it’s hard I know but obviously try not to worry to much as that’s going to make it worse.just try to be positive and before you know it you will be settled and your HR will settle down.my HR was 210 at its highest.so I know what your going through.good luck 👍👍

[Sleepybear987 in reply to Green264]

Hey!! I just got diagnosed with AF after going to A&E (which honestly, go if you're having trouble but like someone else said, AF is not the most understood condition). It's a long journey from here but once you find your balance, you'll be able to sort it out and get on with it. I'm 6.25 currently and it's decent

[Noviceartist]

Hello Green264 - sorry you've been experiencing such a horrid time with erratic heartbeats - I do empathise. I went to the GP about a year ago with worrying palpitations which were difficult to control. I was subsequently diagnosed (after ECG, Echo cardiogram and MRI) with valve disease and have been on a low dose of Bisoprolol since (1.25mg). I did worry a lot about this at the beginning because I experienced light headedness and feeling dizzy with an already low heartbeat but my body seems to have got used to the dose and the palpitations have greatly reduced. My pulse is very low but I don't feel faint with it luckily and have somehow got used to it.

I don't know so much about tests for AF but ectopic, irregular heartbeats are quite common. As others have said, consult with cardiac nurse if you're worried and hope things improve for you soon.

[Pheasant1234]

I’m on 1.25 bisoprolol. It’s been the best thing ever for me. No irregular heart beat and feel much better. Really a good thing for me.