Device procedures

Your pre-admission appointment will take place approximately 1-2 weeks before your date of admission and will be carried out on video by a clinical nurse specialist (CNS). We will let you know by letter or email the date of your pre-admission video appointment and what you need to do access the appointment. 

During your appointment, the nurse will talk to you about your planned procedure, what to expect when you are admitted to the hospital, and address any questions or concerns you may have.

The nurse will also take details of your medical history, any current symptoms, allergies and current medication, and height and weight (in metres and kg). Please make sure you have an up to date prescription list with you for the appointment. The nurse will let you know about any medication you need to stop taking ahead of your procedure. 

Your video appointment

The video appointment will take 30-40 minutes. The letter or email you will have received will contain a link to a secure video platform on which your appointment will take place. 

When you open the link, you will be taken through some simple steps to ensure your video and microphone are set up correctly. You will then be asked to enter your name, date of birth and telephone number. No information will be stored. You will then enter a virtual waiting area where one of our nurses will join you when they are ready.

If you do not have access to the internet, or are unable to access the video platform, do not worry, we will telephone you to carry out your pre-admission appointment. 

Please have a pen and paper with you to write down any important information. If you are a non-English speaker, please ensure you have someone with you who will be able to translate. 

We will try to carry out your appointment at the exact time on your letter, but please bear with us if there are any delays. 

COVID-19

To limit the chance of admitting patients to hospital who have COVID-19 but display no signs or symptoms of the disease, we are testing all patients prior to their admission to check if they are carrying the virus. This is to ensure we keep you as safe as possible and reduce the chance of spreading the virus to other patients and staff.

The risks of having COVID-19 around the time of the treatment depend on the type of treatment and your risk factors. Generally, cardiac procedures can carry much greater risk of complications and death if COVID-19 develops around the time they take place.

Restrictions remain in place for admission to hospital. During the pre-admission appointment, the CNS will provide restrictions that you will be required to adhere and COVID-19 testing that you will undergo to prior to admission.

Blood tests

Before you are admitted to hospital, we will need up to date blood test results. We may be able to get these from your GP if you have had blood tests recently. If not, we will arrange for the tests to be carried out at Harefield Hospital.

Some patients will also need to have a test for MRSA (methicillin resistant staphylococcus aureus). This is a common organism carried harmlessly by many people. We will let you know during your video appointment if you need to be tested for MRSA, and if you do, we will arrange for this to be done at the same time as your blood tests. If testing for MRSA is required, this and the other tests will be carried out 72 hours prior to your admission to ensure we have enough time to get the results before you are admitted to hospital.

You will be admitted to hospital on the day of your procedure.

If you are being admitted to our acute cardiac care unit (ACCU) on Oak and Acorn wards:

On the day of admission, before leaving home, telephone Oak Ward on 01895 828648 to confirm a bed is available.

If you are being admitted to Cherry Tree ward (day case unit):

You do not need to telephone before you leave home. Please arrive at the hospital at the time given on your admission letter.

Medication before your procedure

Before your procedure, some of your medication may need to be stopped. If this is the case, the nurse will discuss this with you. 

We will talk to you about anti-coagulation medications such as warfarin or DOACS (direct oral anticoagulants) e.g. apixaban, rivaroxaban, dabigatran and edoxaban, at your pre-admission appointment.

What to bring with you

Please bring:

• all your current medications (in their original containers)
• pyjamas or a nightdress, dressing gown, well-fitting slippers and trainers or shoes
• toothpaste and toothbrush

Towels and liquid soap will be provided for you at the hospital.

Please note: You may want to bring your mobile phone or computer tablet. Please remember you are in control of your valuables and we are not responsible for damage or loss.

Eating and drinking before your procedure

Do not eat anything for six hours before your procedure. You can drink clear fluids (water, orange squash, fruit juice (without bits), tea/coffee without milk) up until two hours before your procedure.

Further information

After you are admitted to the hospital, we may need to remove hair from your chest before the procedure. Please do not do this yourself before you come to hospital.

You will be allocated a bed on Oak ward, Acorn ward, or Cherry Tree ward. These are mixed sex wards. However, all of the wards are split into single sex bays. You will be cared for in one of these single sex bays.

When you arrive, please report to the ward reception, where you will be shown to your bed or to the day room, until your bed is available. You will then be seen by a nurse and a doctor. If you need to have any medication before your procedure, this will be given to you by the nurse. You may have a cannula (a thin plastic tube) inserted into your arm/hand so that we can give you any medication needed during the procedure.

Device procedures

Device procedures are carried out in a cardiac catheter laboratory, which is like a small operating theatre. In the room there will be a doctor, nurse, cardiac physiologist and radiographer.
Some procedures are performed under a general anaesthetic and some under a local anaesthetic. Your clinical team will discuss this with you before your procedure.

Immediately after your procedure you will be on bed rest and attached to a heart monitor. You will be able to eat and drink as soon as you are fully awake. 

You may be attached to a cardiac monitor until your device has been checked and you have had an X-ray, this is usually done two hours after procedure, but may take place the following morning.

Being discharged from hospital

Depending on your discharge assessment, you may be discharged from the hospital on the night of your procedure or the next day. You will be given a copy of your discharge summary, which will also be sent to your GP to inform them of your procedure. You may be asked to alter your medications, any changes will be discussed with you before are discharged, and your discharge summary will also inform your GP of these changes.  

If you go home the day after your procedure you may be asked to vacate your bed the following morning and take a seat in the dayroom. In most cases you will be ready to go home by approximately 1pm. 

Arranging transport

You will not be able to drive yourself home after your procedure, so please ensure someone can collect you from the hospital after you have been discharged.

Advice on when you can resume driving will be discussed at your pre-admission appointment. 

Recovery

Most people recover quickly from their procedure, but it is not uncommon to experience symptoms such as tiredness, and bruising around the wound site. You should avoid heavy lifting and vigorous exercise for approximately a month after the device implant to avoid the device lead being moved out of place.

Follow-up care after treatment will be arranged by our pacing department at Harefield Hospital. Follow-up appointments are usually face to face in the pacing clinic and via your home monitoring device that will be given to you when you are discharged. 

Your long-term follow-up care will either continue at Harefield or with your referring cardiologist.

Please click here for procedure videos and e-consent forms.