Urgent phone call from hospital after seven day ECG monitor

Posted , 6 users are following.

At the end of March (as previously posted) my BP shot up to 233/114 and my heart beat became irregular. I went to A&E and was kept in for two nights and allowed home as both had settled down on their own. It was arranged that I should have a seven day ECG monitor as I have had two previous cardioversions for AF. I have had an irregular heart beat for years put down to ectopic beats. 

I went into AF again at the end of the next week but this time my BP was lower than normal. My GP prescribed what he called an almost homeopathic dose of Bisoprolol 1.25 mg as he was aware that when prescribed a 2.5 mg dosage previously my heart rate had dropped within 36 hours to 36 bpm from an earlier 136. I began to sweat a lot when out walking and my BP would drop more than usual from exercise. Sometimes as low as 90/54 and I would feel light headed or dizzy it is difficult to distinguish between them. It also felt that my ‘heart’ was not giving me enough power and there was a dull ache in that area. I was also taking 50mg of losartan that usually made me light headed during exercise and my GP put the sweating down to a side effect of losartan but it had not previously had that effect on me. The light headed/ dizzy feeling could often happen even when sitting quietly at home as if the blood supply to my brain was momentarily halting. I have acid reflux/indigestion and am used to getting chest pains that mimic cardiac pain and I just ignore them. Now it was starting soon after walking but mostly a couple of indigestion tablets would bring up some wind and settle it. Indigestion also seems to be another side effect of Bisoprolol.

I had the seven day monitor fitted on May 14th. I was rather at a loss about filling in the symptom questionnaire with it and when to press the button to have an extra reading done because of them as I felt that what was happening was a side effect to my medications more than from AF. From the third day I decided to press the button and record what I was feeling and let them interpret it.  I had been taking both drugs in the morning but decided to take the Biso in the morning and the losartan at night but the side effects stayed the same.   

After returning the monitor I decided to take both meds at night. After a few days I had less problems during the day and was able to do more with much less need to force myself. On Monday we went to a local horse show and my only problem was a backache from standing around and some chest pain again helped by two Bisodol tablets. Yesterday I went to the races and felt OK. When I was out my wife had a call from a doctor at the hospital who wanted to urgently speak to me about the results of the seven day monitor and my symptoms. She gave him my mobile number but I had turned it off. He later called her back but I was still not home being marooned in the rail system due to an incident on the system. He said that he is not there on a Saturday but will contact me on Monday as he will want me to go to the hospital.

For once prompt reaction on their part. When I was discharged from hospital at the end of March I was told that it would probably be three months before I would get to see a cardiologist. I pointed out that my GP had referred me back to cardioogy at the begining of January as he was concerned about my heart rate being in the low 40's.They had note of that but wanted to wait for seven day monitoring results.   

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  • Posted

    Hi, so sorry about all your problems. I do think you are causing some yourself, like indegestion tablets . no no. Why wont you change your diet as the food you are eating obviously is no good ? If you are still being treated by a GP, that is disgusting. It costs me 30 GBP to see a cardiologist immediately, ever thought of doing that ? Good Luck Derek.
    • Posted

      Diet makes no differnce to my digestive system I have tried many variations over the years since it first started in the 1960's. Part of it is  caused by a hiatus hernia. I take a PPI and gaviscon but tablets when out and about and actually Bisodol is more effective than either of the others. I did actualy get relief from homeopathic treatment for several years but that also ceased to be effective.

      Where in the UK can you see a cardiologist for £30? Any private consultation now is at least £130 plus thousands for for the tests required. I went to see a surgeon privately when waiting for my aortic valve replacement. If I had gone ahead with surgery rather than wait for the NHS it would have cost £28K and the possibility of several thousand more if I had needed a pacemaker fitted.

      The aortic valve surgery was the cause of me initially going into AF. 

    • Posted

       I am not in the UK. Luckily. I wish you the best of luck, buy lottery tickets, what a ridiculously expensive country you live in, I would be long dead as I dont have 2 cents to rub together . . . . 
    • Posted

      Not as expensive as America or many others.
  • Posted

    You do seem to be having such a stressful time. It is very unusual to be contacted by a doctor from a hospital. If your symptoms get worse over the weekend perhaps you should go to A&E rather than wait until Monday? I do hope things improve soon, Derek.
    • Posted

      Much better since taking the meds at night but of course they are really designed for day time use when we are active to slow the heart down. 
    • Posted

      He actually phoned back this morning (Sunday...must be Mr. Cameron's 7 Day NHS)

      It was basically the result of the 7 day monitor. I was not in AF but had irregular heartbeats with up to 3 second gaps as I have been pointing out for years without reaction from consultants. So the diagnosis is at last tachybrady syndrome. First a prior procedure assessment and some blood tests and then a dual chamber pacemaker to be fitted in the next three or four weeks. He said that with the heart rate controlled beta blockers have less side effects but he wants me back on an anticoagulant and suggets one of the variants to warfarin rather than the new ones that I fear for uncontrolled bleeding. I told him that my side effects were less since taking my meds at night and he had no objection to that but did not have a reason for the side effects being less during the day....he actually says that the 'side effects' are symptoms rather than side effects..  

  • Posted

    Hi Derek

    Your symptoms sound very similar to mine regarding the dizziness and lightheadedness which neither my GP nor my Cardiac Consultant seem to recognise as by products of fluctuating BP due to the AF medications or ? who knows what. They tried to infer to me that it was all in my mind, which it certainly was not.

    I think your recent experience illustrates too well why the NHS needs to be a 24/7 service for patients with conditions like AF. They are clearly not happy with your monitor results. I deliberately stopped taking my BP as it was going either too low or too high, and there was nothing I could do about it. It is, however, useful to know once your condition's stabilised.

    I would however urge you, if you feel at all unwell this weekend, to go back to A&E, which I know is a bind, but better safe than sorry.

    Good luck and let us know how you get on.

     

    • Posted

      Next wek they will say that I need a cardioversion or an ablation but that there is a waiting list for them and that I will need to be on Warfarin for a couple of months before they will do either. If they suggest Amiodarone again that will be refused by me because of past problems with it. 

      My experience with A&E is that they do nothing and want you to be seen by the consultant treating you when it suits him. It has never got me quicker treatment.

    • Posted

      Hopefully the results from your monitor will 'move you up the list' a bit. I take the point about Warfarin, because when I went in for my EP/would be ablation which didn't happen, two ops were cancelled because of the patients' bloods, so I know that they need to be right. Also try and get your GP to write and put a bit of pressure on as well.

      Totally agree re drugs : if anyone told me to take 5 mg of Bisoprolol again I'd refuse, whatever the results: it was a case of the cure being worse than the disease.

      Take it easy this weekend - do a bit of armchair racing!

      Best wishes

    • Posted

      Are seven day monitor results reliable? I have three times 1993, 2000 and 2001 had false positive stress ECG results and in 2011 a false positive stress echocardiogram result that resulted in angiograms that showed my arteries to be clear.

      Today did the heavy shopping, now some racing and then out to see the local summer cavalcade. Don't want a hospital appointment for Tuesday as that is my next racing day. I once many years ago had a weekend of irregular heartbeats. On the Monday I debated another day of rest, go to the doctor or go to the races.

      I went to the races . The first race was a thriller with two big priced ones that I had backed going past the post together. During the long wait for the Judge separating the pixels on the photo finish one of the trainers said to the other that it had his heart racing. I suddenly realised that mine had gone back into sinus rhythm:-)

      I said to my wife after this year’s Grand National finish that it should have put me back in sinus rhythm but somehow it didn't work that time.

      Doctors have for years told me that they no longer can influence hospital appointment or waiting times and it is better to contact them yourself.

      Results tend to come back very slowly from hospitals. My GP had to try three times to get a CT scan result I had outwith our local area. He also had a patient who had the same scan in Harley Street that he also had to chase up for a second time.

      At the audiology clinic that my wife goes to at a big practice messages flash up on their big screen. One says that hospital test results take a month to come through.

    • Posted

      Very interested in your comment about Bisoprolol as I've found it (2.5mg) best med I've taken for controlling BP and reducing my Afib episodes.As we're allo guinea pigs when it comes to meds, how does it affect you?
    • Posted

      I'm glad that it works for you as it probably does for the majority. Obviously Forums attract people with side effects and problems looking for advice.

      As I said in my opening post it brings my normally slow (or heart rate of the past fifteen years) down too much and very quicky. A nurse recently asked if had been an athlete in my young days as my heart rate is so low usually in the 40's.

      When taking Bisoprlol combined with Losartan the BP drop makes me light headed and with the feeling of a loss of power from my heart when walking. The problem for doctors is finding the drug that suits a patient quickly and with so many to choose from it is difficult. They all seem to have their favourites to use.

      I once had a consultation with a Professor at a major London hospital who put me on Perindopril and wrote of it in such glowing terms that my GP said that the practice was switching all of their BP patients to it. In my case the side effects were so bad that I was put back on Losartan about the one drug that had not previosly given me bad side effects. 

  • Posted

    Hi Derek, the doctor at the hospital is obviously very conscientious having worked out a treatment plan for you at the weekend!  I feel sure the pacemaker will sort all this out for you. How interesting that he said your side effects to the Beta Blocker are in fact symptoms. That's the kind of thing it's impossible to figure out as a patient, especially when the symptoms are so difficult to cope with. With very best wishes!
    • Posted

      Thank you for your good wishes. Perhaps beta blockers worsen symptoms:-) My symptoms were the same when in AF in December 2013 and starting on a beta blocker then.

      Having diagnosed me as having tachybradycardia and saying that I had not been in AF during the seven days and then speaking about blood thinners he then wanted me on them because of AF. I had  assumed that tachybradycardia was different from AF but Dr Google says:

      "Fast heart rhythm that occurs in bradycardia-tachycardia syndrome is often atrial fibrillation"

       

    • Posted

      I did have AF, but after ablation I no longer have AF but tachycardia (and bradycardia). I'm due for a further ablation for that. However despite no longer having AF I still have to take the Warfarin, not my favourite medication, so I hope they sort you out with an alternative.
    • Posted

      I mentioned ablation to him this morning and it is a possibility.  I also told him that I am interested in 'Watchman' and have had E-Mail discussion abut it with a private hospital.

      The WATCHMAN Left Atrial Appendage Closure Device is a proven alternative to long-term warfarin therapy for stroke risk reduction in patients with atrial fibrillation.

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