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Pauline

Age at interview: 69
Age at diagnosis: 65
Brief Outline: Pauline had her first episode of AF four years ago and was diagnosed in hospital. Two years later, Pauline had another episode and her medication was changed from bisoprolol to sotalol; she also takes aspirin. She has not had an episode for over two years.
Background: Pauline is a retired housekeeper and lives with her partner. She has two grown-up children. Ethnic background/nationality: White British.

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auline has always had problems with indigestion. Four years ago she got up in the morning and felt dizzy, and had palpitations that did not stop. She lives in sheltered accommodation and used the community alarm in her house to call for an ambulance. She was taken to hospital where she had an ECG and was prescribed bisoprolol. She stayed in hospital for a few days. She found that the bisoprolol (a beta blocker) slowed her down a bit. She was quite relieved when she was told she had AF, as her mother had a heart attack at quite a young age, and she was worried it could be that. Pauline knew about AF because she had heard on the news that Tony Blair had it, and felt reassured that he was able to continue with his usual life. She believes AF is related to her indigestion problems, and also wonders whether the summer heat affected her in some way.

Pauline was symptom-free for two years, but then one night had an episode of rapid heartbeat (220 beats per minute) and palpitations. Pauline went into hospital again, and her medication was changed to sotalol. She also had a cardioversion under general anaesthetic. She says that when she woke up afterwards she felt immediately better. She wore a mobile heart rate monitor while she was in hospital.

Pauline sees her cardiologist once a year, and is very happy with the care she receives. At her last appointment, she had a routine ultrasound of her heart and did a treadmill test. This involved her heart rate and rhythm being monitored while the treadmill speed was increased. Afterwards, the nurse kept her lying down until her heart rate was back to normal and she could go home.

She describes an episode of AF like running a marathon, but not being able to slow your heart rate down no matter what you do. She was told that her first episode was atrial fibrillation and her second was tachycardia (where the heart beats too fast, but is not erratic as it also is with AF). Pauline says for her, the tachycardia felt the same as the AF. Pauline also has low blood pressure, but finds eating a banana helps her to feel better.

Pauline takes 75mg of aspirin daily, is still on sotalol, and also takes frusemide (a diuretic). Pauline has not had an episode of AF for over two years now. She says she would be afraid to stop taking her medication, but is not concerned about the future. She eats healthily, and avoids large amounts of caffeine or fatty foods, as she finds these can trigger her palpitations.

Pauline advises people with AF not to worry, as it can be treated in a number of ways. She does not belong to a support group, but advises people to join one and share their experiences if they are worried about their AF.

Interview held 29.12.11
 

After experiencing palpitations and dizziness one morning, Pauline spent three days in hospital.

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Yes, I woke one Sunday morning, in the summer, four years ago. I’ve always had a bit of a problem with indigestion and I had palpitation, and I got up, dressed and had breakfast, and went to get up from having my breakfast to wash up and, well, really, you know, I was quite dizzy and sat down here on the settee. I knew something was wrong, wouldn’t, my heart palpitations wouldn’t settle down at all. In fact, they got more rapid. Fortunately, we’re here, sheltered accommodation, so I was able to use the intercom and within about, oh, five or ten minutes the paramedics were here, and they wired me up and took me off to the local hospital, where I was given some treatment. I’m not sure what it was but it sorted it out and then I was in, taken into care with a heart consultant, I suppose, although he is a doctor, so I suppose he wouldn’t be, he would be. Anyhow, I spent about four days I think in hospital and I was on medication and was then able to come home.
 

Pauline thought her AF might be linked to indigestion or to summer heat.

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I’m sure it is linked to the indigestion and this nerve from the stomach. I’m sure it is. I can’t think that I was particularly stressed at that time. It was both times in the summer. Whether the heat has anything to do with it. There could be a question mark there and I am always better in the winter, not better but I’m a winter person. I flag, I wilt [laughs] in the summer. I’m not a not a heat person at all. So maybe that was something to do with it but big question mark there really. 
 

Cardioversion successfully restored Pauline’s heart rhythm.

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They could have done it sooner but because I’d had some breakfast, they had to wait, and they came round and said, “Look, you’ll just be out for a few seconds really. It’ll be fine.” And they did say that if it didn’t work then I’d probably have to go to [city name] for something other but, “It will work. It’ll be fine. Don’t worry about that.” And so of course, they came around and put me out and then, of course, as soon as I came round I knew that everything was fine, because my heart wasn’t racing. 
 

Alongside taking medication for her AF, Pauline makes sure that she eats a healthy diet.

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No, I haven’t tried any alternative treatment other than what the cardiologist has recommended. I wouldn’t stop that, ever. I’d be too afraid to stop that, but I do make sure that what we have to eat you know, is healthy, make sure we have enough fruit and things like that and don’t eat, I only have one thin scraping of butter a day on my toast in the morning, big treat [laughs]. That’s it. Then it’s the Benecol, you know, the cholesterol free stuff. And I only have one cup of coffee a day and that’s in the morning. Make sure I drink plenty. Don’t have a lot of strong tea. Anything so I don’t get the palpitation or anything that would aggravate it.
 

Pauline is full of praise for her cardiologist.

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Oh, he’s lovely. He really is. It’s always, “Nice to see you again, [own name]. Now sit down. Now how have you been?” “Fine.” “Any problems?” “No.” “Good.” And then he just says, “We’ll have a little check.” And then this time he said, “Well, you haven’t done the treadmill for a couple of years or, and then I think you ought to do that.” “Okay.” Which I did and he takes good care of me and if I feel, he always says, “Now, don’t forget. If you’re worried about anything, you know where I am.” So you can’t ask for better than that can you?
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