Background

My post as a clinical nurse specialist in devices commenced in January 2007.

It was initially funded by the British Heart Foundation, and is now a permanent nurse-led service at Harefield Hospital.

My patients

I see patients who are to receive an implantable cardioverter defibrillator (ICD) or biventricular ICD / pacemaker, including:

• Post myocardial infarction (MI) patients with a history of or who are at risk of life threatening arrhythmias
• Heart failure patients with proven ventricular dyssynchrony and poor left ventricular function
• Patients with genetic syndromes such as Long QT syndrome, Brugada syndrome, and ARVC (arrhythmogenic right ventricular cardiomyopathy)
• Patients with dilated cardiomyopathy often awaiting cardiac transplant

Patients are either seen pre-admission in clinic or receive a pre-admission phonecall. This is to discuss any tests that are required, instructions regarding medications and to answer any questions. 

Patients transferred from other hospitals are seen on the ward, and all patients are seen, often with their families, to discuss any further questions they may have while they are admitted. On discharge patients will be given a comprehensive information pack and details of a 24-hour helpline.

Collaboration with pacing department

I work very closely with the pacing department, and many patients are referred via this route, either with increasing arrhythmias, therapies or symptoms of heart failure.

The device clinic runs alongside Dr Mark Mason’s clinic in the outpatients department, which enables patients referred from the pacing clinic to be seen quickly and with the support of a consultant.

Research

There are always research studies taking place within the Trust which patients may be asked to participate in, if they are interested. However, there is no obligation.