Having been diagnosed with angina 10 years ago, Janet was used to getting out of breath when going uphill or in cold weather. She had learnt to live with this and hardly noticed it. But when she found herself getting very breathless walking up steps from the beach to the hotel during a holiday in Croatia she was concerned. On her return she consulted her GP who referred her to a cardiologist for an ECG. Thinking that she was being checked for angina, Janet was shocked’ to find out she had AF and to realise that this meant she may be more at risk of having a stroke. An echocardiogram showed a healthy heart which reassured her. She was prescribed warfarin followed by cardioversion to regulate her heart rhythm.

With a diagnosis just before Xmas and a holiday booked for February, however, Janet felt there was not enough time to start warfarin and has deferred her decision. She is concerned that the potential for excessive bleeding associated with warfarin may exacerbate another medical condition, and is not looking forward to the regular blood tests to regulate warfarin levels. To help her reach a decision she has spoken to her GP who has been supportive but has left the decision up to her. She has also sought advice from her local Atrial Fibrillation Association, and has discussed alternatives to warfarin with a nurse from the British Heart Foundation Heart Matters website. She was told that the alternative drugs are not as well tried as warfarin’. Friends with AF have had mixed experiences of cardioversion, leaving Janet unsure whether to have treatment or just to carry on as I am’. For the moment she has decided just to take aspirin.

Janet has been unimpressed with the care she has received so far for her AF. The consultant who diagnosed her was very rushed’. Janet felt pushed through’ the system and told what treatment she was to have with little explanation nor opportunity to think about it or ask questions. She has had no news about a follow-up appointment with the cardiologist to discuss her treatment although she has been contacted by the local anti-coagulation clinic on the assumption she will go on warfarin. She believes that individual views get swept aside’ in treating patients with AF and feels that healthcare professionals need to listen more to people’s concerns. Janet is unsure what might have caused her AF, although she suspects it is linked with the angina. Recalling a visit to the gym several years ago when she couldn’t find a pulse after exercising, she wonders whether it has actually been AF rather than angina that she’s been experiencing for the past 10 years. The diagnosis of AF has motivated Janet to invest a bit in my health’. She is conscious of what she eats, choosing a low fat diet, and drinks no coffee and very little wine. In an effort to get fit, she has paid for a personal trainer and is exercising 3 times a week. She feels a lot better in myself’ and has had no AF symptoms other than occasional flutters since getting back from her holiday. She is convinced that the gym is helping her.

A keen traveller, one of the major problems she has had since her diagnosis has been the difficulty of getting travel insurance while waiting for treatment. She describes this as a shock and a big disappointment’. However, as her GP was able to verify that treatment is not compulsory, Janet has been able to get insurance by paying an extra charge.

Interview held 25/01/12