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Diagnosis and treatment

Our work can be split into two areas - invasive and non-invasive.

Non-invasive procedures

Some diagnosis and treatment takes place outside of your body, so there's no need for needles or surgery. Non-invasive procedures include

  • ECG (electrocardiogram), which records the electrical activity of your heart over time. It can detect abnormalities or disturbances in rhythm.
  • Holter monitoring, where a portable device is attached to your chest to record your heartbeat over 24 hours, or longer.
  • Cardiomemo, which is another portable device used to record your heart's activity when you're having an attack of symptoms.
  • Tilt table test - you lie on a table which is slowly tilted to a 60 degree angle. This can reproduce the cause of a blackout, and help us to understand why it happens to you.

Invasive procedures

These involve keyhole surgery to find and treat the cause of your cardiac rhythm disorder, or deal with the symptoms.

They include

  • catheter ablation
  • fitting a pacemaker
  • fitting a defibrillator.

Catheter ablation

If you have an abnormal heart rhythm or arrhythmia causing palpitations, your doctor may recommend catheter ablation to treat it.

An abnormal rhythm or arrhythmia may occur when your heart's electrical pulse is diverted from its normal route because there is extra tissue causing a short-circuit, or when abnormal behaviour of cardiac tissue generates extra electrical activities.

To ablate means to use energy (usually heat energy) to cause scar tissue to form. Catheter ablation destroys this extra tissue, re-routing your heart's electrical impulses to make it beat normally again.

We usually carry out catheter ablation using a local anaesthetic alongside light sedation. It involves passing thin wires into your veins from the top of your leg or shoulder.

Our doctors use specialised imaging equipment to measure your heart's electrical activity and find the short circuit (where there is extra tissue blocking your heart's electrical pulse).

They can often find the problem area in minutes. Radio frequency energy is then used to destroy the areas causing the abnormal rhythm.

We are also one of the first centres in the UK to use ablation treatment for atrial fibrillation, or irregular heart beat.

A routine ablation procedure can now be performed as a day case, with a long-term success rate of around 90 to 95%.

Pacemaker

A pacemaker is fitted because your heart beats too slowly, too irregularly or you're at risk of blackouts. It stimulates contractions of the heart, and includes a pulse generator and either one, two or three electrode leads. The pacemaker is usually fitted to the upper left side of your chest and the lead is secured in position in your heart.

The pacemaker gives your heart a signal to contract each time it heart fails to produce its own signal.

Pacemakers usually last six to ten years before they need to be replaced. Surgery to replace a pacemaker is now carried out as day case treatment at the Wessex Cardiac Unit.

Defibrillator

If you have a very fast or irregular heartbeat, doctors may fit an implantable cardioverter defibrillator.

This is a device implanted under the skin on the chest wall. It monitors your heart rhythm, senses if there is about to be a severe disturbance in it, and delivers an electrical impulse or shock to stop the abnormal rhythm, allowing your heart's normal rhythm to start again.

Defibrillators usually last five to eight years before they need to be replaced. Replacement surgery can be carried out as day treatment at the Wessex Cardiac Unit.

We are one of very few centres in the UK with a high level of experience in this procedure.

Heart failure therapy

Our unit was also one of the first in the UK to start implanting heart failure therapy (cardiac resynchronization therapy) devices.

This involves placing a pacemaker lead to the left side of your heart to resynchronize heart contraction.

The therapy is now an established treatment for selected heart failure patients and can improve your heart function, quality of life, and minimise hospital admissions.