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AFibbers Database

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New additions to the database may be submitted using the online form. Please restrict the entries to one per person.

You must include a contact email address and a password so that your data can be edited at a later date if necessary. Please check that the contact given is prepared to receive email enquiries about the entry. (The only time you will receive an email is if you ask for your password to be sent or if the database administrator sends an administration email to you). To make subsequent searching more efficient, it is strongly recommended that you also select appropriate categories by ticking the boxes provided. Please tick ALL categories which apply to you - either now or in the past.

To save space there are some abbreviations in the check list section:
CHF is congestive heart failure
GERD is Gastroesophageal Reflux Disease
PAC is premature atrial contraction
PVC is premature ventricular contraction
SVT is supraventricular tachycardia
WPW is Wolff- Parkinson- White syndrome

It is possible to remain anonymous by entering 'Anon' as your name. Neither your email address or password will be displayed in any page other than the one that you edit.

The Reset button clears the form if you need to start again.

Once an entry is submitted, it will be immediately entered into the database.

Alterations can be made later by logging in using your email address and password.

Statistics for the first 161 entries.

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Please contact the site editor at james@dialsolutions.com
to comment or to suggest amendments or corrections.

First Form™ software © Dial Solutions Ltd 1999