Non-invasive cardiology is used to diagnose arrhythmias, coronary heart disease and heart failure.

The non-invasive cardiology department is used to diagnose heart arrhythmias (irregular heartbeats), help diagnose coronary heart disease, aid multiple screening programmes, and carry out follow-up checks after cardiac surgery, angioplasty and ablation. It also supports specific channelopathy and cardiomyopathy clinics in both paediatrics and adults. 

Almost all patients will pass through non-invasive cardiology on their patient pathway and, with the expanding electrophysiology arrhythmias ablation services offered, the department plays an important diagnostic role within the Trust.

ECG Holter monitoring

The department offers continuous ECG Holter monitoring over 24, 48 and 72 hours, and five and seven days. Patients are fitted with a small monitor at hospital which they wear at home while carrying out their normal daily activities. Once the monitor is returned to the department, it is analysed by the cardiac physiologists for heart rate and rhythm, irregular heartbeats (arrhythmias) and structural changes.  

Read more about ECG Holter monitoring.

24-hour blood pressure monitoring

If your doctor suspects high or low blood pressure (BP) or if you have symptoms of fainting, they may request this test. It involves wearing an inflatable cuff around your upper left or right arm and a small monitor worn around your waist. The cuff will inflate and deflate at regular intervals over a 24-hour period. The monitor is fitted at hospital and you can continue with your normal daily activities at home while the test monitors your blood pressure. The report produces a range of blood pressure readings throughout the day that include very useful information for your doctor.

Read more about 24-hour blood pressure monitoring.

Exercise tolerance tests (ETT)

Exercise tolerance tests (ETT) are mainly used to help diagnose the cause of chest pain, palpitations, shortness of breath and fainting while exercising. ETTs are also a useful screening tool for patients who have a family history of sudden cardiac death. A 12-lead ECG is constantly monitored by the cardiac physiologist for irregular heartbeats. To help the diagnosis, blood pressure is recorded every three minutes and the amount of oxygen in the blood can also be recorded if required. 

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Cardiopulmonary exercise testing (CPET)

Cardiopulmonary exercise testing (CPET) is similar to an ETT but it also measures how your lungs are working and muscle function. It is mainly used to assess the wellbeing of patients with congenital heart disease and patients who are having or have had surgery. It is also used to grade heart failure in a range of patients with different cardiac diseases. It is a comprehensive test involving the measurement of a 12-lead ECG, VO2, VCO2, (oxygen consumption and carbon dioxide production), respiratory quotient, ventilatory efficiency, blood oxygen saturation and blood pressure at rest and on exertion. The test is a very comprehensive test and plays a part in doctors’ clinical decisions.

Read more about cardiopulmonary exercise testing.

Patient-activated recorders

Patient-activated recorders are used to capture symptomatic arrhythmias that occur less often. The small device is attached to the patient and records the ECG on a continuous loop. When the recorder is activated by the patient it records a past and future ECG. This method requires input and co-operation from the patient, but is a very successful way of discovering if an irregular heartbeat is causing fainting and palpitations.

Read more about patient-activated recording.