I live in a major metro area and there is no after hours cardio nurse on call and it is laughable that a heart doc would be available. All my heart arrhythmia episodes that resulted in falls, or, ER in the worst case in the past 8 months were answered after a half hour phone wait with a triage nurse that couldn't advise anything but ER. ER can be a 30 minutes with HF. They have my chart. That wait while went I went there in my worst case, after lying on my bedroom floor for 2 hours before I could speak to rouse my husband to get me to ER. I nodded in and out of consciousness. I was treated like a drug seeker at ER.