cowlady1
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cowlady1, March 11,  2018  6:28am EST

Cardiologist or EP?

I am interested in knowing how many of you are seeing an EP rather than a cardiologist...I have been in SNR since my diagnosis in early November.  Cardiologist never put me on a monitor and I found him to be dismissive and distracted.  If episodes were caused by holiday heart syndrome (which are his thoughts) does this mean I will be on drugs forever? 
  • Brianog
    Brianog, March 17,  2018  12:17am EST
    jimjames:It's unclear from the article if the people studied were in and out of afib on a regular basis. I'm assuming they might be since they used an implantable loop recorder.So while interval training decreased the per cent of time people were in afib compared to the control, it may not have the same effect on someone like myself whohas defined episodes, years apart. That said, I don't think I've ever been thrown into afib from intense exercise, but I have noticed that intense exercise can initiateirregular beats like PACs. Since I'm only three months from my last episode, not sure I'd take the chance training at 90% of max HR so will stick to a more moderate70-80%.JimJimI found that intense exercise would seem to cause pacs and pvcs as well.  Turns out for me at least the problem was that i wasnt drinking enough water. Once i changed that they mostly went away.Brian
  • jimjames
    jimjames, March 14,  2018  10:46am EST
    It's unclear from the article if the people studied were in and out of afib on a regular basis. I'm assuming they might be since they used an implantable loop recorder.So while interval training decreased the per cent of time people were in afib compared to the control, it may not have the same effect on someone like myself whohas defined episodes, years apart. That said, I don't think I've ever been thrown into afib from intense exercise, but I have noticed that intense exercise can initiateirregular beats like PACs. Since I'm only three months from my last episode, not sure I'd take the chance training at 90% of max HR so will stick to a more moderate70-80%.Jim
  • Brianog
    Brianog, March 13,  2018  7:43am EST
    MIC:Brianog, Good article. I think the study that you cite is based on the Norwegian University of Science and Technology's 4X4 interval training. You might be interested in reading about the method. See: www.ntnu.edu/cerg/advice. Thanks MIC. Great stuff in your link.  I started it a few months ago and find it harder physically but more interesting, so I'm much less bored while doing cardio.plus the added bonus of it taking less time.
  • MIC
    MIC, March 13,  2018  6:04am EST
    Brianog, Good article. I think the study that you cite is based on the Norwegian University of Science and Technology's 4X4 interval training. You might be interested in reading about the method. See: www.ntnu.edu/cerg/advice.
  • cowlady1
    cowlady1, March 13,  2018  4:44am EST
    Thanks to all for your great insights.   I do plan to see an EP....Wishing you a great day.Cowlady aka Regina
  • jimjames
    jimjames, March 12,  2018  11:55pm EST
    I have seen both and also read both online.  As a general statement I think EPs treat afib more agressively, are more apt to recommend a surgical procedure (ablation, watchman,etc), and put you on thinners. Cardiologists more conservative, less likely to recommend surgery, and more likely to recommend (or at least entertain) lifestyle changes and look for triggers. Before even doing an in depth history, my EP asked me if I had ever considered ablation. Not so coincidentally there was an ablation presentation loaded on his computer screen! My cardiologist, on the other hand, views ablation only as a patient driven decision if other treatments are unsatisfactory. He also ws less dogmatic about thinners. Getting input from both are fine but I would lean more on a cardiologist well versed in afib for a more objective and rounded approach. Jim
  • OUMike
    OUMike, March 12,  2018  7:25am EST
    Cowlady1,​Hello. I have been seeing both specialties (cardiologist and electrophysiologist). In layman's terms, here are the services they provide for me: ​--Cardiologist - Provided care since diagnosed with AFiB - 2007; cares primarily for all aspects about the heart and its systems, except electrical issues as noted below;​--Electrophysiologist (EO) -  Provided care since the need for a pacemaker was determined (2015);​  --EP: A specialist - focuses on the heart's "electrical issues" (heartbeat rate; pauses, if an issue; pacemakers; and so forth);Both specialists are doing a fine job; it is very comforting to have both providing guidance as a team; they both share notes andconfer about my situation as needed.Hope this helps you find your best path for AFiB care.​OUMike
  • dave205
    dave205, March 12,  2018  5:03am EST
    I see both a cardiologist and a EP. I also see a Vascular Surgeon. I have two heart conditions, Afib and a blockage in my carotid artery.  The Vascular Surgeon did an angiogram last year to determine the extent of the blockage after an ultrasound indicated 70% blockage. It turned out to be only a 50% blockage but once a year I see each of my three doctors just to be on the safe side.
  • MIC
    MIC, March 12,  2018  3:00am EST
    Bob, I am 100% in agreement with your advice. I also take indoor cycling classes. I go to 90% to 95% of my max then I drop down immediately. Before I had my first afib incident, I would stay at 90% to 95% for an hour class, 7 to 10 hours a week. I believe that my excessive exercise caused my afib. I think it was my heart telling me to slow down. Thanks for your concern. Excellent advice. MIC
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