A Cardiac Device implant performed in our Cath lab
The Cardiac Device service at SaTH is based at the Princess Royal Hospital, Telford. We perform and subsequently follow up over 600 implant procedures a year to include Pacemakers, Implantable Cardiac Defibrillators (ICDs), Cardiac Resynchronisation therapy Pacemakers (CRTP), Cardiac Resynchronisation Therapy Defibrillators (CRTD) and implantable loop recorders (Reveals). We also implant a small number of Subcutaneous ICDs per year.
You may be referred by your Cardiologist for one of the above devices for a number of different clinical reasons – usually an ‘arrhythmia’ which is an umbrella term for a fault with the electrics of your heart. This may be a slow heart rate/rhythm, certain cases of heart failure or you may be at high risk of a dangerous heart rhythm due to a specific heart condition. All devices are offered based on national guidance issued by NICE (National Institute of Clinical Excellence).
The majority of implant procedures are done as day case procedures, under local anaesthetic with X-ray guidance in our Cardiac Cath Lab. If you have a Reveal device it is likely to be implanted by our Arrhythmia Nurse Specialist under local anaesthetic in the Cardio-respiratory department. With a Reveal device you will only be with us for approximately an hour.
Prior to your procedure you will be contacted by our Arrhythmia Nurse Specialist for a Pre-Assessment. She will discuss the procedure with you, take some up to date bloods if necessary and an MRSA swab. She will also discuss with you any restrictions that will apply, relative to the device you are having. This may include temporary driving restrictions that will apply, these restrictions are DVLA regulations and therefore legally binding.
With the exception of Reveals – which are a diagnostic tool as opposed to other Cardiac Devices which are a treatment, all Cardiac Devices need follow up for the rest of your life. All follow up clinics are held at the Princess Royal in the Cardio-Respiratory Department. They are run by a small but experienced team of Cardiac Physiologists which specialise in Cardiac devices. There will have been a Physiologist present during your implant and they will have seen you for your device check later in the day, after your original procedure. You will not see a Doctor at your follow up checks unless the Physiologist feels the need to consult with them.
These follow up appointments may only be every 12 months or they may be more frequent depending on the device you have and/or the clinical need. We assess the programming of your device to ensure it is suitable for your clinical needs, we also look at the condition of the leads and the battery capacity – amongst other things. As and when your device comes towards the end of its battery capacity we will arrange for you to have a new device which is again usually performed as a day case procedure.
The Pacemaker Clinic, where all Cardiac Devices are followed up, is a part of the Cardio-respiratory Department at the Princess Royal Hospital and where you will need to come for your follow up appointments. They can be contacted on 01952 641222 ext 4216.
Remote follow up
Remote follow up means we may issue you with a piece of communications equipment which you have at home and sends us much of the information we require from your Cardiac device. This means that you will not necessarily have to attend every clinic appointment we book for you. We can look at the information we receive and contact you if there are any problems or if you need to come in, we physically need to see you if we need to make any changes. We follow up all Reveal devices this way and some of the other Cardiac Devices we implant.
Please look at the following links for further information:
Arrhythmia Alliance: A coalition of charities, patient groups, patients, carers, medical groups and allied professionals. Although these groups work together under the A-A umbrella to promote timely and effective diagnosis and treatment of arrhythmias.
The British Heart Foundation has information about tests and treatments for a number of heart conditions, including those concerning your heart rhythm.
The NHS choices website has some useful information also:
NHS Choices: Pacemaker Implantation
NHS Choices: Heart Failure Treatment