Cardiac Rhythm Management Specialist Nurse and Arrhythmia Nurse Consultant Team

CRM team banner

The cardiac rhythm management (CRM) nurse team is a dedicated team providing expert nursing care to patients suffering from or suspected of cardiac arrhythmias.

The multi-award winning team provides expert nurse led care in both the hospital and out-reach setting to ensure patients receive accessible and specialist care for their cardiac arrhythmias.

The wider team within South Tees is a multidisciplinary team consisting of consultant cardiologists; nurse consultant; specialist nurses; cardiac physiologists; health care assistants and administrative staff.

Cardiac arrhythmias range in severity and can have a profound effect on people’s lives and therefore early diagnosis and treatment is imperative and is what the team strives to achieve.

The innovative and multiple award winning nurse led out-reach service for arrhythmia patients is an excellent example of improving patient accessibility to arrhythmia services and diagnosis.

The South Tees blackout service established in 2010 is yet again another innovative service recognised both nationally and internationally as a centre of excellence.

The service provides a joint venture involving neurology and cardiology, providing rapid access, assessment and diagnosis for patients suffering from blackouts. In addition the implantable cardiac monitoring service comprehensively supports the existing nurse led and general cardiology clinics in providing a high level of expertise and diagnostic capability.

The specialist nurse team was established in 1998 and now consists of nurse consultants and specialist nurses in both cardiac arrhythmias and epilepsy. On average the specialist nurse team alone see more than 4,000 patients within the various clinical setting every year.

Where are we based?

We are based at The James Cook University Hospital and a variety of community settings across Middlesbrough, Redcar and Cleveland; and the Friarage Hospital, Northallerton.

What do we provide?

South Tees Arrhythmia Service

Pacemaker

This comprises of 3.5 full day clinics per week in two community settings. The patients undergo assessment via a virtual or face to face appointment.

The patient is assessed by a nurse consultant or specialist nurse and further investigations can be performed such as electrocardiograms (ECG); blood pressure recordings; ambulatory heart rate monitors to aid diagnosis. 88% of our patients are managed solely within the community setting and therefore have no need to visit the acute hospital.

The service ensures that patients with more benign heart rhythm problems are managed efficiently within the community service. Patients can however be referred to our consultant cardiologists should they need further specialist intervention ensuring an efficient and prompt service for all cardiac arrhythmia patients.

South Tees blackout service

This service is run within the hospital setting allowing unique access both to cardiology and neurological input. Patients are referred by their general practitioner or the emergency department having experienced blackouts or loss of consciousness. They are seen by either a cardiac rhythm specialist nurse or epilepsy nurse specialist.

Patients may undergo ECG and various other routine tests. A specific and accurate assessment is carried out in order to reach a diagnosis. Patients are asked to bring a witness or a written witness account as this is extremely useful in aiding diagnosis. Further investigations such as ambulatory heart rate monitors are available.

If a diagnosis of epilepsy is suspected the patients are then seen by a consultant neurophysiologist or epilepsy nurse consultant. Also patients who are suspected of an underlying abnormal heart rhythm can if required be discussed with a consultant cardiologist and referred for further investigations such as an implantable cardiac monitor or permanent pacemaker.

Implantable cardiac monitor (ICM) implant and follow up service

CRM team

A pioneering cardiac rhythm management (CRM) allied professional service was developed in 2015 utilising the Medtronic Reveal LINQ

Implantable cardiac monitoring devices and advanced remote monitoring technology. Advances in technology have allowed for implantation in a procedure room by cardiac rhythm management specialist nurses and cardiac physiologist.

Following implant, all patients receive remote monitoring equipment and access to a nurse-led telephone helpline. Daily assessment, management of patient transmissions and follow-up care by scheduled telephone appointments are coordinated by the specialist nurse team.

The development of a cardiac rhythm management allied professional implantable cardiac monitor service with use of remote monitoring has resulted in significant reductions in referral to implant time; implant to diagnosis times, with high levels of patient satisfaction.

Performing implantable cardiac monitor implants in a procedure room has resulted in cost reduction, improved utilisation of cardiac catheter laboratory slots and consultant cardiologist time for more complex procedures, and the development of advanced skills within the specialist nurse team.

Pre-admission clinics for cardiac devices and electrophysiology studies

These clinics are led by our team of specialist nurses to ensure patients are well informed of their planned procedures. They are conducted via a virtual or face to face appointment usually 48hrs prior to their hospital admission. The clinics allow time to discuss the planned procedure and any pre-operative requirements.

Consultant review clinics

The specialist nurses work alongside the consultant cardiologists in their out-patient clinics on a weekly basis. They are conducted via a virtual or face to face appointment. Patients that have undergone electrophysiology studies are routinely reviewed by a specialist nurse for their subsequent follow up appointments.

The specialist nurse is able to assess and management ongoing symptoms and discharge patients. Working alongside the consultant cardiologist allows the opportunity for the patient to be also reviewed by a consultant if required.

Ward cover for elective and non-elective patients

The specialist nurses cover the cardiology wards, cardiology day unit, surgical pre-assessment and general hospital wards daily. An essential part of the specialist nurse role is to ensure patients are informed of planned procedures and supported throughout their hospital stay. This includes patients that are admitted to other areas of the hospital requiring cardiac procedures as part of their treatment. The specialist nurses undertake nurse-led discharge on all elective cardiac device and electrophysiology patients ensuring streamlined care and follow up.

Diagnosis

Patients are referred to the service via various routes including general practitioners and the emergency department.

Patients referred to us are likely to be suffering from:

  • Atrial fibrillation
  • Atrial flutter
  • Atrial tachycardia
  • Supraventricular tachycardias
  • Structurally normal heart VT
  • Atrial and ventricular ectopics
  • Wolff Parkinson White syndrome
  • Sinus bradycardia
  • Sinus node disease
  • Vasovagal syncope www.stars.org.uk
  • Cardiac syncope
  • Epilepsy www.epilepsysociety.org.uk www.epilepsy.org.uk
  • Inherited cardiac conditions
  • Patients who require or have undergone permanent pacemaker insertion, implantable cardioverter defibrillators, cardiac re-synchronisation therapy, implantable loop recorders and undergoing electrophysiology studies and radiofrequency ablation.

The patient helpline

The team prides itself on providing ongoing support to all arrhythmia patients who are under our care. They provide an accessible support and advice to our patients, relatives and other healthcare professionals as an essential part of our service.

  • Arrhythmia helpline – 01642 282806

Who’s who

  • Consultant cardiologists – Professor Nick Linker; Dr Simon James; Dr Andrew Thornley; Dr Matthew Bates; Andrew Turley; Dr Mike Chapman
  • Consultant neurophysiologist – Dr Simon Taggart
  • Nurse consultant – Jayne Mudd
  • Lead CRM specialist nurse – Angela Hall

Contact details

Cardiac Rhythm Management Specialist Nurse Team
The James Cook University Hospital
Marton Road
Middlesbrough
TS4 3BW

Tel: 01642 282806

Useful links