Heart rhythm disturbances

Heart rhythm disturbances (arrhythmias) are common.

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.

There are numerous different kinds of fast heart rhythm disturbance (tachycardia).

There is also a slow heart rhythm disturbance (or 'bradycardia'), which if causes symptoms, can be treated with a pacemaker.

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.

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.

Heart rhythm services

Oxford Cardiac Rhythm Management (CRM) provides arrhythmia management for thousands of adults each year from Oxfordshire and surrounding counties.

Cardiac rhythm management is one of the fastest growing areas of modern cardiac medicine.

The service offers specialist investigations and treatments to adults for:

  • arrhythmias
  • arrhythmia related heart failure
  • syncope
  • assessment for sudden cardiac death
  • left atrial appendage occlusion, for the prevention of stroke.

The service also offers new and follow-up outpatient arrhythmia clinic appointments at the John Radcliffe Hospital, a community-based clinic in Bicester and peripheral arrhythmia clinics to surrounding District Hospitals.

Specific conditions include:

  • atrial fibrillation and flutter
  • ventricular and supraventricular tachycardias
  • cardiac arrests
  • bradycardia.

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 may be recommended as a treatment option. The service offers advanced ablation techniques including radiofrequency, pulsed field and cryotherapy ablation.

We also offer specialised cardiac implantable devices for specific clinical reasons.

An Implantable Cardioverter Defibrillator (ICD) is usually recommended for patients at risk of sudden death from rapid heart rhythm disturbances.

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.

Additionally, we are able to perform lead extractions, in the case that one or more wires from an implanted device needs removal.

Implantable cardiac device follow-up is also provided and delivered by both face to face appointments and by using home-based remote monitoring systems.

Facilities

The John Radcliffe Hospital features two electrophysiology catheter laboratories equipped with cutting edge technology.

These labs support complex cardiac mapping systems (Ensite and CARTO) and offer a full range of ablation techniques including radiofrequency energy, pulsed field ablation and cryoablation.

Our team

  • Colin Slade
    Cardiac Rhythm Management Lead
  • Jennifer Cole
    Head of Cardiac Physiology

Consultants

Some of our Consultant Cardiologists have a special interest in this area.

  • 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 Andrew Lewis
    Consultant Cardiologist, John Radcliffe Hospital
  • Dr Shawn Morias
    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
  • Dr Rohan Wijesurendra
    Consultant Cardiologist, John Radcliffe Hospital
  • Dr Angela Griffiths
    Consultant Arrhythmia Nurse

Arrhythmia Nurse Team

  • Leigh Isaac
    Arrhythmia Advanced Nurse Practitioner
  • Tim Dent
    Arrhythmia Specialist Nurse
  • Gemma Singanayagam
    Arrhythmia Specialist Nurse
  • Sarah Watts
    Arrhythmia Trainee Advanced Nurse Practitioner
  • Amy Wyatt
    Arrhythmia Specialist Nurse

Complex Device Nurse Team

  • Emma Sutherland
    Complex Device Advanced Nurse Practitioner
  • Rebecca Imms
    Complex Device Advanced Nurse Practitioner
  • Kerry Meenan
    Complex Device Specialist Nurse

We have a team of Cardiac Physiologists, who specialise in cardiac rhythm management.

We usually have two Clinical Fellows and two Research Fellows working in arrhythmia management (senior trainees with an interest in cardiac rhythm management).

Clinics

  • Tuesday morning
  • Dr Rajappan / Dr Ginks
  • Wednesday afternoon
    Dr Wijesurendra
  • Thursday morning (Bicester Community Clinic)
    Angela Griffiths
  • Friday morning
    Dr Bashir / Professor 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.

Follow-up and ongoing support

Patients referred to the Heart Rhythm Service have access to an arrhythmia specialist. Comprehensive care is provided through a multidisciplinary approach.

A full range of referral and treatment protocols are available for doctors.

Information leaflets are also available for patients on request or via:

Patient information leaflets

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

Cardiac Rhythm Management Office

Tel: 01865 220981

Secretaries

Dr Bashir / Professor Betts / Dr Wijesurendra / Dr Ormerod

Kayleigh Morris: 01865 220256
Email: kayleigh.morris@ouh.nhs.uk

Dr Rajappan / Dr Ginks / Dr Pedersen

Holli Richards: 01865 223172
Email: holli.richards@ouh.nhs.uk

Dr Angela Griffiths

Katie Sawyer: 01865 221070
Email: katie.sawyer@ouh.nhs.uk

Dr Gamble / Dr Lewis

Catherine Heath: 01295 229215
Email: catherine.heath@ouh.nhs.uk

Professor Herring

Vicky Bullen: 01295 224181
Email: vicky.bullen@ouh.nhs.uk

Dr Morias

Sandra Brown: 01295 229025
Email: sandra.brown@ouh.nhs.uk

Specialist Nurses

Arrhythmia Specialist Nurses

Tel: 01865 228994 (Voicemail)

Complex Device Specialist Nurses

Tel: 01865 220981 (Voicemail)

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.

Resources