Cardiac Rhythm Management (CRM)
Heart rhythm disturbances (arrhythmias) are common.
Our care for patients includes assessment, full diagnostic investigation, medical and procedural treatments, and follow-up in outpatient clinics.
We see and treat thousands of patients each year with the latest technology, caring for the people of Oxfordshire as well as patients from the surrounding counties and further afield including the Channel Islands and Malta.
Our team
Some of our Consultant Cardiologists have a special interest in this area.
Consultants
- Dr Yaver Bashir
Consultant Cardiologist, John Radcliffe Hospital
- Prof Tim Betts
Consultant Cardiologist, John Radcliffe Hospital
- Dr James Gamble
Consultant Cardiologist, John Radcliffe Hospital
- Dr Matt Ginks
Consultant Cardiologist, John Radcliffe Hospital
- Prof Neil Herring
Consultant Cardiologist, John Radcliffe Hospital
- Dr Julian Ormerod
Consultant Cardiologist, John Radcliffe Hospital
- Dr Michala Pedersen
Consultant Cardiologist, John Radcliffe Hospital
- Dr Kim Rajappan
Consultant Cardiologist, John Radcliffe Hospital
Other staff
- Jennifer Cole
Lead Cardiac Physiologist
- Rachel Bates
Lead Cardiac Research Nurse
Consultant Arrhythmia Nurse
Angela Griffiths
Arrhythmia Specialist Nurses
- Leigh Isaac
- Tim Dent
- Sarah Watts
- Amy Wyatt
Complex Device Specialist Nurses
- Becky Imms
- Emma Sutherland
We usually have two Clinical Fellows and two Research Fellows working in arrhythmia management (senior trainees with an interest in cardiac rhythm management).
Heart rhythm disturbances
Any rhythm other than the normal (or 'sinus') rhythm can be considered a rhythm disturbance (or 'arrhythmia').
An arrhythmia may cause no symptoms, or may result in:
- dizziness
- loss of consciousness
- an awareness of the heartbeat (palpitation)
or other symptoms including:
- fatigue
- shortness of breath
- chest discomfort.
It is extremely helpful to have an ECG at the time of a patient's symptoms, in order to diagnose the underlying heart rhythm and give the most appropriate treatment.
If a patient has symptoms that suggest a slow heart rhythm (or 'bradycardia') a pacemaker may be needed.
There are numerous different kinds of fast heart rhythm disturbance (tachycardia).
A consultation with a member of our team, along with findings of investigations, helps to determine the cause of symptoms related to a fast heartbeat.
Tests
We routinely do a heart tracing or electrocardiogram (ECG) when we see patients in our clinic.
Other tests that may be necessary are:
In some circumstances a cardiac electrophysiology study may be recommended.
Treatments
Some kinds of heart rhythm disturbance do not require treatment and it may be enough to reassure patients that there is no cause for concern.
Sometimes, tablet treatment may be recommended, either as regular medication or using a 'pill in the pocket' (as and when needed) approach.
In some circumstances, a catheter ablation procedure may be recommended.
Implantable Cardioverter Defibrillator (ICD) therapy is usually recommended for patients at risk of sudden death from rapid heart rhythm disturbances. We have the expertise to implant either transvenous or subcutaneous ICDs.
Cardiac Resynchronisation Therapy (CRT) (or 'biventricular pacing') is a pacemaker treatment which aims to recoordinate the heart's pumping function, and is suitable for some patients with heart failure. This can be combined with the functionality of an ICD when appropriate.
Clinics
- Tuesday morning
Dr Rajappan / Dr Ginks
- Wednesday afternoon
Dr Bashir / Prof Betts / Dr Ginks / Dr Rajappan
- Friday morning
Dr Bashir / Prof Betts
We work with Gloucestershire Royal Hospital and Royal Berkshire Hospital to deliver clinics locally for patients in those areas.
Appointments are arranged following referral by a GP.
Research
We are actively involved in research and there are opportunities for patients to take part: ask a member of the clinical team about ongoing research relevant to your condition.
Contact us
Wards
- Acute Cardiac Care Unit: 01865 572675 / 01865 220126
- Cardiology Day Case Unit (CAS): 01865 572616
- Cardiology Ward: 01865 572676
- Critical Care: 01865 572644
- Rapid Assessment Unit (RAU): 01865 572955
Secretaries
Dr Bashir
Tel: 01865 222045
Dr Betts
Kayleigh Morris: 01865 220256
Email: kayleigh.morris@ouh.nhs.uk
Dr Rajappan / Dr Ginks
Holli Richards: 01865 223172
Email:
holli.richards@ouh.nhs.uk
Specialist Nurses
Arrhythmia Specialist Nurses
Tel: 01865 228994
Email: orh-tr.arrhythmianurses@nhs.net
Complex Device Specialist Nurses
Tel: 01865 221667
Departments
Please visit Pacemaker and ICD Clinic
Find us
Our Outpatient Arrhythmia Clinic is in the Cardiac Outpatient and Echocardiography Department, Level 2, John Radcliffe Hospital.
Pacemaker and ICD clinics take place in Outpatients Blue Area, Level 2, John Radcliffe Hospital.
How to find the John Radcliffe Hospital
Pacemaker follow-up appointments can also take place at the Horton General Hospital in Banbury.
Links