Cardiac rhythm management specialist nurse team
The cardiac rhythm management specialist nurse team is dedicated to providing expert nursing care to patients suffering from or suspected of cardiac arrhythmias.
The award winning team provides nurse led care in both the hospital and out-reach setting to ensure patients receive accessible and expert care for their cardiac arrhythmias.
The cardiac rhythm management team is a multidisciplinary team consisting of consultant cardiologists and a nurse consultant, specialist nurses, cardiac physiologists, health care assistants and administrative staff. The team at south tees are committed to providing expert care to patients suffering from cardiac arrhythmias.
Cardiac arrhythmias range in severity from benign conditions to a potentially fatal problem. They 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 nurse led out-reach service for arrhythmia patients is an excellent example and was awarded a regional health and social care award in 2008 of improving patient accessibility to arrhythmia services.
More recently the south tees blackout service established in 2010 is yet again another innovative service providing a joint venture for both neurology and cardiology in providing patients with rapid access to diagnosis of potentially life threatening causes of blackouts.
The specialist nurse team was established in 1998 and has now grown to consist of a nurse consultant and a team of 7 arrhythmia and epilepsy specialist nurses. On average the specialist nurse team alone see more than 4,000 patients within the various clinical settings per 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; these are One life clinic, Linthorpe road, Middlesbrough; Guisborough primary care hospital and the Friarage hospital Northallerton.
What do we provide?
South Tees arrhythmia service
This comprises of 3.5 full day clinics per week in two community settings. The patients undergo an echocardiogram (an ultrasound scan of the heart) and an electrocardiogram or ECG (a tracing of the electrical rhythm of the heart). Also routine recordings of blood pressure, height and weight etc. The patient is assessed by a nurse consultant or specialist nurse and further investigations can be performed such as 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 intervention ensuring an efficient and prompt service for all arrhythmia patients.
South Tees blackout service
Currently this service is run within the hospital setting allowing access both to cardiology and neurological input. Patients are referred by their general practitioner or the accident & emergency department having experienced two or more blackouts. They are seen by either an epilepsy nurse specialist or an arrhythmia nurse specialist. Patients will undergo routine electrocardiogram or ECG (a tracing of the electrical rhythm of the heart) and various other routine tests such as lying and standing blood pressure monitoring.
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. Also patients that 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 loop recorder or permanent pacemaker
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. Patients are usually pre-admitted one week before their hospital admission. The clinic appointment last approximately 45 – 90 minutes depending on the procedure the patient is planned to undergo.
Routine tests are carried out such as blood samples, a heart tracing called an electrocardiogram or ECG. This allows the results to be analysed prior to hospital admission and can help with the planned procedure. The clinic allows time to discuss the procedure with a specialist nurse and to sign a consent form.
Consultant review clinics
The specialist nurses work alongside the consultant cardiologists in their out patient clinics on a weekly basis. Patients that have undergone electrophysiology studies are routinely seen by a specialist nurse/nurse consultant 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. The appointment is planned for 20 minutes and a routine ECG is performed on arrival to the department.
Ward cover for elective and non-elective patients
The specialist nurses cover the cardiology wards, cardiology day unit 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.
Ongoing ICD patient support
- A fundamental aspect of the CRM specialist nurse role is providing support to patients who have undergone implantation of an implantable cardioverter defibrillator or ICD. The team visit patients before and after procedure to ensure both they and relatives are informed of their planned care. On discharge the patients have access to ongoing support by being provided with the arrhythmia helpline number as below. The team runs a patient support group meeting 2-3 times a year to allow patients to network with other ICD patients. These meetings also allow access to the specialist nurses should they have any questions or concerns.
- If ICD patients are travelling abroad they can access the companies (your ICD manufacturer) travel information by using the links below. This provides information on the nearest hospital they may be travelling to. If you cannot find the information you require however please don’t hesitate to contact the team.
- For patients who have an ICD and hold a current class 1 or 2 driving licence DVLA driving regulations will apply. The link for the DVLA driving regulations can be found below. The specialist nurse team ensure that all ICD patients are informed of the driving restrictions that apply to them; it is however the patients responsibility to inform the DVLA of their medical condition.
Patients are referred to the service via various routes including general practitioners and the accident and 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
- Long QT syndrome
- Brugada syndrome
- Patients who require or have undergone permanent pacemaker insertion, implantable cardioverter defibrillators, cardiac resynchronisation 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. Providing accessible support and advice to our patients, relatives and other healthcare professionals is an essential part of our service.
Arrhythmia helpline – 01642 282806
- Consultant cardiologists – Dr Nick Linker, Dr Simon James, Dr Andrew Thornley and Dr Andrew Turley
- Consultant neurophysiologist – Dr Simon Taggart
- Nurse consultant – Jayne Mudd
- Lead CRM specialist nurse – Angela Hall