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London Cardiovascular Project

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Arrhythmias

Introduction

A cardiac arrhythmia is the medical term for an irregular heart beat or abnormal heart rhythm.

All services across the patient pathway delivering arrhythmia care, must ensure that more patients with cardiac arrhythmia are identified for investigation and treatment.

Rates of electrophysiological intervention and device implantation remain lower in London and the UK than would be expected for the size of population.

The London review found a wide variation in device implantation and electrophysiological intervention rates across the capital. Services in London need to correctly identify these patients, manage their treatment by teams experienced in arrhythmia care, and provide equitable access across London.

Implementation

The London Cardiac Networks are responsible for implementation with the North West London Cardiac and Stroke Network leading the collaboration.

Project aims

Provision of a world-class electrophysiology (EP) service across London through the development of provider networks with specialist sites and emergency on-call service for these patients

  • Hospitals should work in networks to deliver these services, working closely to provide a coordinated service, with more cross-unit working of staff.
  • Complex electrophysiological procedures should be delivered at central units within networks.
  • Clinical expertise should be available in every hospital in the network to ensure patients receive the highest levels of care.
  • Activity should be audited - performance and outcomes of services should be a mandatory for all units.

Central units should also be encouraged to offer specialist expertise to their referring hospitals. They should:

  • Provide clinical support 24 hours a day, seven days a week so that urgent and emergency arrhythmia cases are managed promptly and appropriately by a specialist.
  • Offer to undertake clinics in referring local units.

Implementation update

  • Quality standards have been signed off for device therapy and ablations.
  • Quality standards for emergency arrhythmia services and arrhythmia clinics are approaching sign off for the end of January 2012.
  • Central unit assessments have been completed at Barts and the London, Harefield, the Heart Hospital, King's, the Royal Brompton, St George's, St Mary's, and St Thomas'.
  • Local unit assessments will take place between January and March 2012.


The Arrhythmia work aims to provide a world-class electrophysiology service across London.

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Pan-London meeting minutes

Project documents

Model of care (summary)
Model of care (detailed)
Patient perspective
Responses to engagement
Case for change
Co-dependencies framework
Financial analysis

More on the
patient perspective