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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. (Image courtesy of iRhythm Technologies Ltd) Back To New Technology

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

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 Blood pressure is a common term for hypertension. A normal blood pressure reading is classified as an average home BP monitoring result less than 135/85. ​ 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

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