David has always been active and involved in sport. One day at the gym, someone took his pulse and it was 140 beats per minute, and it stayed this way even when resting. David says he did not really have any symptoms, apart from light palpitations. He did also have headaches and a stiff neck. He remembers that five years before, he had some spells of dizziness, blurred vision and slurred speech, but never told anyone. Doctors think that these may have been TIAs or mini strokes. David saw his GP and was sent to a walk-in clinic at his local hospital. There he had two ECGs and was told there was a problem, even though he says he felt fine. David was referred to the anticoagulation department and put on warfarin and aspirin, as his cardiologist was concerned about his risk of stroke. He was also prescribed bisoprolol. He had regular blood tests to check he was taking the correct amount of warfarin. He found the tests an interference, especially in the early days when they were frequent, as his clinic did not have appointments but a wait your turn; system. It could take up to three hours, but he says the results were always given promptly. David has said to his cardiologist that he would prefer to take an alternative to warfarin that does not require blood testing. David feels that NICE may be putting cost before patient care in their decision on approval of a warfarin alternative. David was already taking tablets for high blood pressure and an ace inhibitor called ramipril, but changed from that as it gave him a dry cough.

In March 2009 David developed atrial flutter, and later atrial fibrillation. He had a cardioversion, but the effects of this did not last. A few months later, David had bad chest pains, and felt faint, hot and sweaty, had blurred vision and found it hard to think. He contacted his hospital and had an ECG and a brain scan (to check if he had had a TIA). The doctors said they thought he had angina. David was then sent for angiogram and treadmill test – a blockage was found and David was told that he would need stents or a bypass. This came as a huge shock to David and his family, particularly since he exercised regularly and was not overweight. David had a triple bypass, which he found very traumatic and painful. He was in hospital for eight days, and then slowly built up his strength at home and through a supervised exercise scheme at his local gym. During the bypass procedure, the surgeon also carried out a cardio ablation relating to David’s AF. Six clots were found which had not been detected by other tests. David feels very lucky that they were found. David was put on amiodarone and ezetimibe by the surgeon, but these affected his liver, and his cardiologist took him off them. His liver soon returned to normal. David does not think that his AF and other heart issues are linked.

A month after the bypass operation, David’s heart was still in AF and he had a second cardioversion which seemed to put his heart back into normal sinus rhythm. David is disappointed that a couple of months ago he had a spell where he felt dizzy and unwell. He saw his cardiologist and had a brain scan and a two day heart monitor. Some irregularities were found, so David is due to have a seven day monitor shortly. David had come off of warfarin and was taking aspirin to reduce his stroke risk, but his cardiologist now suggests that David take warfarin instead. David is happy to do this. He also takes 10mg a day of atorvastatin for cholesterol, an ace inhibitor, and 1.25mg of bisoprolol in the morning and evening. He carries a spray with him in case of an angina attack, but has only used it twice. David continues to exercise regularly and wears a personal heart monitor when he does. He sees his cardiologist once a year or sooner if he needs to. David also monitors his own blood pressure. David is very pleased with the care he has received. He asked specifically to see his cardiologist, who is a specialist in electrophysiology and has thoroughly investigated David’s symptoms. David’s cardiologist treats him as an equal, asks David his thoughts, and discusses his treatment in detail.

David experiences fatigue, but is not sure if that is due to AF or his other heart issue. David thinks that decision makers within the NHS do not pay enough attention to the thoughts and opinions of patients. He feels that decisions are sometimes made by people in management without medical experience, and that resources are not always used efficiently. David feels that money is directing care, rather than consideration for individuals. David raises the point that although some paperwork on decision making and consultation is provided for the public to access, in reality it is not in a format that a lay audience can understand.

David had never heard of AF before he was diagnosed, and feels it should be promoted much more, including government funding to raise awareness. He advises medical professionals to pay more attention to AF, as it is a silent killer.; David says that he gave posters about AF to his GP, but these were never put up in the surgery. He finds the websites of the Atrial Fibrillation Association and the British Heart Foundation very helpful and informative. David’s experiences have made him more aware of looking after himself and listening to his body. He advises people to find out about their condition and the treatments available.

Interview held 17.2.12