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  • Blackouts | Dr. Raj Khiani | Special Interests

    Blackouts A significant number of people will experience a blackout in their lifetime. In most cases the blackout will not cause any serious harm and will never recur. In a small number of cases the blackout might be caused by a serious medical cause and patients may need specific treatment. What is a blackout A blackout is a transient loss of consciousness for a few seconds or minutes. There are a large number of causes of blackouts but when it is thought to have a cardiac cause it is called cardiac syncope. The causes of blackouts There are a large number of causes of blackout from a simple faint (neurally mediated vasovagal syncope) through to other more serious cardiac causes such as epilepsy, postural hypotension and psychogenic causes. Cardiac syncope is caused by a sudden lack of blood supply to the brain because of a low BP or a problem with the heart rhythm. Do falls represent blackouts There are a large number of causes of falls including mechanical causes, postural instability, low BP and a proportion of elderly people with unexplained falls may be caused by blackouts. When to seek medical attention Most patients with blackouts should see their GP to discuss the blackout. Many patients will have a benign cause of blackout such as a simple faint. However, a proportion of patients with high risk features will then need to be referred for specialist input for example by a neurologist or cardiologist. What tests would be required All patients with blackouts who see a specialist should have a 12 lead ECG recording, other tests which may be required include an echocardiogram, tilt-table test, holter monitor, some patients may require an Implantable loop recorder (ILR) as well as other specialist tests including a cardiac MRI. If the blackouts are thought to be neurological in origin then a MRI of the brain and an EEG may be required. Implantable loop recorder This is a device inserted under the skin in the chest wall on the left hand side. It is inserted under local anaesthetic as a day case procedure. The device is designed to monitor your heart rhythm continuously and is useful for patients who are having syncope to diagnose problems with their heart rhythm which might cause them to blackout. VIEW MORE CONDITIONS

  • CONDITIONS | Dr. Raj Khiani

    Heart Conditions Heart Failure Dr Raj Khiani - Consultant Cardiologist Heart failure is a condition in which the heart’s ability to pump blood and oxygen around the body is impaired. ​ ​ Learn More Palpitations Dr Raj Khiani - Consultant Cardiologist A palpitation is an unpleasant awareness of your heart rhythm. The causes of these symptoms vary from very benign conditions, right through to more serious heart conditions. Learn More Chest Pain Dr Raj Khiani - Consultant Cardiologist This Page is Under Construction ​ ​ ​ ​ Learn More Valvular Heart Disease Dr Raj Khiani - Consultant Cardiologist This Page is Under Construction ​ ​ ​ ​ Learn More Arrhythmia Dr Raj Khiani - Consultant Cardiologist Arrhythmias are abnormalities of the heart rhythm. These may cause symptoms such as palpitations, chest pain, blackouts (syncope), shortness of breath and dizzy spells. Learn More Blackouts Dr Raj Khiani - Consultant Cardiologist A significant number of people will experience a blackout in their lifetime. In a small number of cases the blackout might be caused by a serious medical cause and patients may need specific treatment. Learn More Blood Pressure Dr Raj Khiani - Consultant Cardiologist This Page is Under Construction ​ ​ ​ ​ Learn More General Cardiology Dr Raj Khiani - Consultant Cardiologist I have more than 20 years of experience in General Cardiology and have been a Consultant since 2009. I sub-specialise in arrhythmia as well as cardiac device implantation. Learn More Shortness of Breath Dr Raj Khiani - Consultant Cardiologist There are a large number of causes to shortness of breath which include: anxiety (hyperventilation), lack of physical fitness, anaemia, heart failure and high blood pressure. Learn More Pacemaker Implantation Dr Raj Khiani - Consultant Cardiologist Pacemakers are implanted cardiac devices designed to treat dangerous slow heart rhythms. ​ ​ Learn More ICD/CRT Implantation Dr Raj Khiani - Consultant Cardiologist This Page is Under Construction ​ ​ ​ ​ Learn More Back to main page

  • New Technology | Dr. Raj Khiani

    A SHOCKINGLY GOOD SOLUTION Dr. Raj Khiani | Consultant Cardiologist | Publications View Publication ZIO PATCH Dr. Raj Khiani | Consultant Cardiologist | Publications View Publication

  • Dr. Raj Khiani | Consultant Cardiologist | London and MK

    RESEARCH ON COVID-19 RESPONSE TO COVID-19 MY MISSION ​ To provide high quality, holistic cardiac care to all my patients, impacting both their quality and longevity of life. Dr. Raj Khiani Consultant Cardiologist ​ ​ Phone: 020 3598 9200 ​ ​ Email: drkhianisec@medserv.co.uk ​ ​ Qualifications: BSc (Hons), MBBS, MRCP, FRCP ​ Cardiologist in London and Milton Keynes Dr Raj Khiani | Consultant Cardiologist in London and Milton Keynes | About Me About Dr. khiani Dr. Raj Khiani is a leading consultant cardiologist working in London and Milton Keynes with over 25 years of experience Find out more > Dr Raj Khiani | Consultant Cardiologist in London and Milton Keynes | Conditions Conditions Dr. Raj Khiani treats multiple cardiac conditions including palpitations, breathlessness, blackouts and atrial fibrillation along with other cardiac conditions Find out more > Dr Raj Khiani | Consultant Cardiologist in London and Milton Keynes | Locations Locations Dr. Raj Khiani works in multiple hospitals located in London and Milton Keynes including Harley Street Clinic, The Wellington Hospital, Bushey Spire and BMI The Saxon Clinic Find out more > Dr Raj Khiani | Consultant Cardiologist in London and Milton Keynes | Contact Me Contact Me To book a consultation please contact Dr. Raj Khiani's Secretary on 020 3598 9200 or email drkhianisec@medserv.co.uk Find out more > TESTIMONIALS Dr Sharon Ann Rocque, GP Dr Khiani is absolutely fantastic, very knowledgeable and gives very appropriate advice. His mannerisms puts one at ease immediately and feel listened too. Treatment of patients is excellent and always hear positive reviews from his patients. Prof. Aji Kavidasan, Chest Physician and Interventional Pulmonologist Dr Raj Khiani is a consultant cardiologist with special interest in advanced cardiac devices, who is committed to providing extremely patient-centred care. Dr Rasha Gadelrab, GP A very approachable and respected cardiologist with very good communications skills. DR. RAJ KHIANI'S RESEARCH PAPERS Clinical and Imaging Findings in Cryptogenic Stroke Patients With and Without Patent Foramen Ovale VIEW PAPER Dr. Raj Khiani and 2 others New Technology MEMBERSHIP OF SOCIETIES INSURANCE CONTACT ME Dr. Raj Khiani Consultant Cardiologist ​ Phone: 020 3598 9200 Email: drkhianisec@medserv.co.uk ​ Send an email Share

  • A Shockingly Good Solution | Dr. Raj Khiani | Publications

    A Shockingly Good Solution A 61-year-old year old man has become the first patient at the RFL to receive a new type of implantable defibrillator, designed to both ‘shock’ his heart into rhythm if it should speed up and provide his doctors with real-time information. Issac Williams, from Kingsbury in Brent, (pictured with Dr Khiani and physiologist Cheryl Ralph) underwent the procedure at BH - the arrhythmia hub of the RFL at the beginning of December. The equipment – an implantable cardioverter defibrillator (ICD) was inserted under local anaesthetic via a vein just below his collar bone, with leads inserted directly into his heart. The battery sits under his collar bone just beneath the skin and is connected via a smartphone app with Bluetooth connectivity, to Issac’s own mobile phone. Cardiology consultant, Dr Raj Khiani, who carried out the hour-long procedure to insert the Gallant device said it detects any dangerous speeding up of the heart rhythm and delivers a ‘jolt’ if necessary. This is a lifesaving technology used to resuscitate patients at risk of cardiac arrest from their heart condition. Dr Khiani explained: “In some patients with heart failure there is a possibility that their heart rate will speed up to a dangerous fast heart rhythm. The ICD will then deliver a shock, which the patient will feel as a jolt. This shock will restart the heart from a cardiac arrest back into a normal rhythm. The patient might collapse to the floor but the difference is they will get up and walk away. They then give us a call and we can assess the data from an app which has been downloaded onto their own mobile phone. ICD technology has been around for years but the big step forward is that patients can be home monitored via an app on their own mobile phone. Before if someone had an ICD they would face six monthly check-ups at the hospital for the rest of their lives but this does away with that as we can now monitor their ICD remotely - we only have to bring patients into hospital if we need to reprogramme the defibrillator.” The technology is only available for new implants and can’t be retrospectively added to current pacemakers or defibrillators. It is suitable for people who have had a life-threatening abnormal heart rhythm, as well as for those for whom tests show they are a risk of having one, such as those who have heart conditions, including some patients with cardiomyopathy. Dr Khiani adds: “The data is encrypted and secure and allows information about the ICD, including battery life function of the leads, as well as any treatment delivered by the device, to be downloaded directly via the cloud to the team working in the hospital. This means we can monitor patients very closely from home and this reduces the need for the patient to come into the hospital for a face-to-face appointment. This has been especially helpful during the COVID pandemic to minimise the risk to patients by reducing the number of visits to the hospital.” Dr Khiani concludes: “Patients who will benefit come from all age groups – from children to the elderly. We carry out approximately 500 pacemaker operations a year at Barnet Hospital and an additional 200 complex device implantations a year, including ICD implants such as this device. This is the first device to market but we know others are on their way.” Issac, a railway ticket collector, said: “I feel good in myself and glad to have had the procedure. It’s enabled me to get back to work and living my life.” Back To New Technology

  • Zio Ambulatory ECG Patch | Dr. Raj Khiani | Publications

    Zio Ambulatory ECG Patch The Zio ambulatory ECG patch is a new way to continuously record the electrical activity of your heart while you go about your daily routine. ‘Ambulatory’ means that you are not required to be stationary, as is the case during a typical ECG recording in a clinic. Many heart problems are only detectable during activity and will not appear in a brief test in your doctor’s office. The patch is delivered to your home address and inside the box are clear instructions on how to apply it to the chest. The device can record an ECG for between one and fourteen days and, once applied to your chest, you can exercise and shower as normal (after 24 hours). When the recording period is complete, simply remove the patch and return it by post using the box supplied. Your recording will be analysed typically within two days and a report sent to your Cardiologist for review. (Images courtesy of iRhythm Technologies Ltd) Back To New Technology

  • About Me | Dr. Raj Khiani

    About Me Dr. Raj Khiani - Consultant Cardiologist in London and Milton Keynes I am an experienced General Cardiologist committed to providing holistic, patient focused care. I believe in making an accurate diagnosis and providing a clear explanation to my patients. I treat the whole patient and discuss the cardiac diagnosis along with its physical and emotional impact on the patients health. I work as a sub-specialist in cardiac devices, arrhythmia and heart failure. I led the arrhythmia service at the Royal Free Hospital between 2016 and 2019 and now concentrate on training medical students, junior doctors and cardiology registrars as well as consultant colleagues in advanced pacing techniques. My current research interests include risk stratification for sudden cardiac death in scleroderma cardiomyopathy, COVID-19 and advanced pacing including optimisation of cardiac resynchronisation therapy and His bundle pacing. I see patients with all common cardiac symptoms including: chest pain, palpitations, shortness of breath and blackouts. I am able to manage all common cardiac disorders including: atrial fibrillation, blood pressure, ischaemic heart disease, heart failure and valvular heart disease. I am registered with all major insurance companies and also see self-funding patients. Qualifications BSc (Hons) MBBS MRCP (UK) FRCP Imperial College, University of London - 1994 Royal Free Hospital School of Medicine, University College London - 1995 Royal College of Physicians, London - 1998 Royal College of Physicians, London - 2011 Experience UnderGraduate Training - Royal Free Hospital, London - 1995 Cardiology Registrar - Papworth Hospital, Cambridge - 2001 Research Fellow - South Manchester University Hospital - 2002 National Training Number - London Deanery, South Thames Rotation - 2004 Specialist Registrar/Senior Registrar in Cardiac devices - Guy’s and St Thomas’ Hospital - 2007 Specialist Registrar in Cardiology - Royal Sussex County, Brighton - 2004 Cardiology Specialist Registrar - St Georges Hospital, London - 2006 Consultant Cardiologist - Milton Keynes University Hospital and Honorary Consultant Cardiologist at John Radcliffe Hospital - Oxford - 2009 Consultant Cardiologist - Royal Free Hospital School Of Medicine, London - 2015 to Present Back to main page

  • Heart Failure | Dr. Raj Khiani | Special Interests

    Heart Failure What is heart failure? Heart failure is a condition in which the heart’s ability to pump blood and oxygen around the body is impaired. What are the symptoms of heart failure? The main symptoms include shortness of breath on exertion, swelling in the ankles, or abdomen and lower back because of fluid retention; as well as lethargy and weakness. What are the causes of heart failure? The most common cause of heart failure include heart attacks, high blood pressure and dilated cardiomyopathy (in which the main pumping chamber in the heart becomes enlarged and weakened). There are a large number of other causes of heart failure including valve disease, anaemia, thyroid disease, heart arrhythmias, cancer treatments such as chemotherapy, viral infection or excessive alcohol consumption. What tests will I need to diagnose heart failure? Your cardiologist will take a detailed history and examination and is then likely to move onto further tests, to confirm the diagnosis of heart failure. There a number of tests which can be done to diagnose heart failure. The basic tests include an and . Further tests might be necessary to look into the causes in more detail and these might include: a cardiac MRI, an angiogram of the heart arteries and a monitor. These tests will be organised in selective patients after detailed discussion with your cardiologist. ECG echocardiogram (echo) holter What treatments are available for patients with heart failure? While heart failure is a serious heart condition, your quality and quantity of life can be significantly improved by a number of possible treatments. This might include: Medication Regular medication such as beta-blockers, diuretics and blood pressure medication can be helpful. They need to be started cautiously and the doses gradually increased with careful monitoring of your blood pressure and blood tests (such as kidney function). These tablets are usually taken life-long but together they can have very significant impacts on reducing both the symptoms of heart failure and improving life-expectancy for patients with heart failure. Pacemakers and Implantable Cardioverter defibrillators In some patients pacemakers maybe helpful in reducing the symptoms of heart failure and reducing the risk of hospitalisation with symptoms of heart failure. Implantable cardioverter defibrillators (ICDs) are sophisticated types of pacemakers, which can treat dangerous slow or dangerous fast heart rhythms, in patients with heart failure. This can be done either because the patients has suffered from a dangerous heart rhythm already (secondary prevention) or because their cardiologist believes they are at risk of developing dangerous heart rhythms in the future (primary prevention). The ICD can be combined with a pacemaker in a device called CRTD and this device can help improve both quality and quantity of life as well. Further information about pacemakers and ICDs can be seen in the section of this website. pacemaker How can I help keep my heart healthy? There are a number of life-style changes you can make to keep your heart as healthy as possible, including: 1) stopping smoking 2) reducing or even stopping alcohol 3) taking regular exercise such as a brisk walk of at least 30-40 mins per day 4) eating a healthy diet 5) reducing your salt intake 6) keeping a healthy weight 7) watching your weight regularly (a sudden increase in your weight, might reflect an increase in fluid retention in your body) 8) restricting your fluid intake What about emotional wellbeing? Low mood, anxiety and depression are all common in patient living with heart failure. Exercise can often be helpful in improving these symptoms and a graded exercise programme should be done in consultation with your cardiologist. Some patients can also benefit from counselling and in some cases medication may be required. Please discuss these options with your family doctor. Useful websites The following websites can provide useful further information about heart failure including their causes and treatments: British Heart Foundation Pumping Marvellous Cardiomyopathy UK VIEW MORE CONDITIONS

  • Arrhythmia | Dr. Raj Khiani | Special Interests

    Arrhythmia What is an arrhythmia? Arrhythmias are abnormalities of the heart rhythm. These may cause symptoms such as palpitations, chest pain, blackouts (syncope), shortness of breath and dizzy spells. What is a palpitation? A palpitation is an unpleasant awareness of your heart rhythm. The causes of these symptoms vary from very benign conditions, right through to more serious heart conditions. How do I know if a heart palpitation is serious? It can be difficult to assess whether a palpitation is due to a serious underlying condition or not. However if you experience blackouts, shortness of breath or chest pain associated with your palpitation then you should seek urgent medical advice. Other palpitations may also need further investigation and you should start by seeking advice from your family doctor. What tests are done to investigate palpitations? Patients with palpitations often need a number of different test, these include ECGs, ECHO scans and holter monitors. Further tests may be needed, depending on the results of the basic tests. What is an ECG? A 12-lead ECG involves electrodes attached to the chest and limbs and records the electrical activity of the heart. What is a holter? A holter monitor is attached to the patient and they can then continue with their normal activities, a 3 lead ECG is recorded and can help diagnose abnormal heart rhythms. What is an echo? An echo scan is an ultrasound scan of the heart, it involves a technician who places a probe on the chest and records images of the heart structure and flow across the heart valves. It is a very useful first line test to assess the structure and function of the heart, including the pumping chambers and valves. Ectopics Ectopic beats are a common cause of palpitations. They often cause a sensation of a skipped beat or an extra beat. If they originate from the top chambers of the heart they are called atrial ectopics, or if they arise from the lower chambers of the heart they are called “ventricular ectopics.” Atrial Fibrillation (AF) AF is a common heart arrhythmia. It results in an irregular heart rhythm, which is often felt as a heart palpitation. It is associated with rapid heart rates, which need controlling with medication. It is also associated with clots forming in the heart which can be thrown off to the brain. If this happens then the patient can suffer a disabling stroke. To try and prevent this, patients with AF are commonly treated with blood thinners, called anticoagulants. How is AF diagnosed? AF can be diagnosed with a 12-lead ECG, especially if it is persistent. In some cases AF comes and goes and can only be diagnosed with other tests, such as holter monitors. There are a number of other treatments available for patients with AF and these include: pacemaker implant, ablation, cardioversion and LAAO devices.These are highly specialised treatments and for further information about these treatments, please discuss these with your cardiologist. Useful websites The following websites can provide useful further information about palpitations and their causes and treatments: British Heart Foundation Arrhythmia Alliance AFIB Matters VIEW MORE CONDITIONS

  • Shortness of Breath | Dr. Raj Khiani | Special Interests

    Shortness of breath What are the causes of shortness of breath There are a large number of causes to shortness of breath including: anxiety (hyperventilation), lack of physical fitness, being overweight, high blood pressure, anaemia. If these causes have been excluded heart or lung disease commonly cause shortness of breath. The list below is not exhaustive but includes some of the common causes. Please do not try and self-diagnose and seek professional medial advise from your GP if you are concerned about shortness of breath. Heart causes: Heart attack Atypical angina Heart failure Arrhythmias such as atrial fibrillation Valvular heart disease Lung causes: COVID-19 Asthma COPD Clot on the lungs (pulmonary embolism) Pneumonia Scarring of the lungs (fibrosis) Lung cancer Pleural effusion(fluids accumulation around the lungs) Pulmonary hypertension Pneumothorax (collapsed lung) When can I experience shortness of breath Cardiac causes of shortness of breath commonly occur during walking or other exertion such as climbing stairs or walking up hills. It can also occur at rest particularly at night when lying flat. What tests are used to investigate the causes of breathlessness Patients with breathlessness will need a full history and examination and may require a variety of tests. These might include some or all of the following: blood tests, chest x-ray, lung function tests, an ECG, echocardiogram or a stress test. Other tests such as a CT scan may also be required depending on the clinical assessment. What should I do if I develop shortness of breath If your shortness of breath is of sudden onset or associated with chest tightness or a heavy feeling in your chest, or if you have pain which spreads to your arms or back you should call 999 and seek urgent medical care in hospital. You might be suffering from a heart attack of other serious heart or lung problem. ​ If your shortness of breath is persistent, especially if associated with a cough, exertion, is worse when lying flat or associated with swelling of your ankles you should contact your GP as you might need further tests and review by a heart or lung specialist. VIEW MORE CONDITIONS