I'm sorry, I hadn't noticed there were recent posts on this thread!
Wow, I was sorry to read that you have AF, too, now. Mike, the confusions you and your wife have experienced in her treatment sound very worrying and I hope you get satisfaction quickly.
Everybody has been very generous with their time and suggestions (you lot, I mean) for which a repeated "Thank You"! I've just re-read the thread and realised that there are a couple of links I haven't followed up, which I'll get on to immediately (Phil W, that publication you cited will be one).
As it is exactly a year since my TIA (mini-stroke) leading to a finding of an Ejection Fraction of 8 - 10%, I thought I'd sing "Hearty Birthday" and give a resume of to where I am up.
I'm still alive, having had a third of the allotted span for 75% of people with an EF/EV of <10%. However, I'm not too anxious about that prediction because exercise is a better predictor of life-span than EV and I'm sure it's very likely that as I already live in the recommended fashion I am almost certain to be in the 25%. Look on the bright side, Peter, it's better for the stress levels!
I never did get to see a NHS cardiologist. In fact, I have been discharged by letter because of the need for the NHS to concentrate on Covid. Yes, it actually says that in the letter. I don't feel the need to dispute this at the moment, because I feel fine just as often as I did before the TIA. But I've kept all the paperwork, just in case. Apparently my affliction should continue to be managed "medically", which I think means keep taking the tablets.
Every now and then, I take the wheelbarrow down to the chemist's. I am on statins, blood thinners, digoxin, beta blockers and an Ace Inhibitor, Ramipril. This seems to be a full house and I am a little confused as to why I need so much. Admittedly, the Beta Blocker level is quite low (5mg). I have a regular appointment with the Nurse Practitioner (always cancelled into a phone appointment) at which she up-titrates the Ramipril, as my kidney function has thus far remained unaffected by the administration. The next rise will get me to the intended 10mg.
What I want to insist on having is another echocardiogram, because I want to know if my EV has improved (it can) or deteriorated (it can). This will help me decide about how to manage exercise and life in general.
I feel fine. I very occasionally feel a little leaden-legged after a ride (I re-started in the New Year after more advice and ride most days, usually about 10 - 15 miles, occasionally more but so far not over 30, all at an easy pace) which I put down to the beta-blockers. I do feel a bit weary from time to time and I occasionally get a light-headed episode, usually on standing up quickly, and very short-lived. All these effects could be due to heart deterioration but are also known effects of the drugs. It's a bit of a conundrum, as I didn't have any effects until I started on the medication - but I also know I've got heart trouble!
(Apparently, Cardioversion and Ablation are not considered suitable in my case.)
I've had an angiogram, which confirmed my and my doctor's feelings that I haven't got any significant coronary artery disease. That was a big boost but leaves me with the question of why I've got the condition (AF and low EV). I think Chris suggested that AF can lead to EV, which seems very plausible. And the exercise over the years has led to an enlarged heart and possibly stiffening of the Left Ventricle, which the Ace inhibitor is intended to ameliorate.
So, I'm really determined to get another echocardiogram to see how the LV is shaping. I take my BP and pulse several times a week. The BP is where it always was (acceptably low) but the heart-rate, while it usually averages between 65 and 80 (I take an average of five readings) can vary enormously in one series of readings from 65 to 90. So I guess (know) I'm still fibrillating.
I'd like to know if I need to resign myself to my current bimbling lifestyle (I can do that and it's a lot more than many people are able to do) or whether I can eventually get back into the hills I love!
But I will be sensible (I hope). There is a lot more at stake than whether or not I can ride my bike.
Thanks for your interest and comments. Please keep in touch and let me know how you (and your loved ones) are doing.
Peter