Borders Ref Help Toolkit
Direct Access Ambulatory ECG
NHS Borders provides a service for the assessment of patients with new symptoms suggestive of cardiac arrhythmia. This allows direct access to 24-hour ambulatory ECG monitoring for frequent symptoms and cardio memo for patients with intermittent symptoms. These are for low-risk patients with normal sinus rhythm ECG and no previous history of cardiac disease or sudden cardiac death in family. Patients with an established arrhythmia and a recurrence of previous symptoms and significant cardiac history should be referred to their previous cardiologist.
For patients referred for direct access ambulatory ECG monitoring, reports will be sent directly back to the referring doctor. Further clinical advice is available on request through SCIgateway, attaching the ambulatory monitor report.
Who to refer for Direct Access Ambulatory ECG:
- Palpitations characterised by a sensation of an abnormally rapid, forceful or irregular heartbeat
- Frequent symptoms (i.e. symptoms > twice/week) with no high-risk features
- Patient can comply with monitoring period (confused patients may remove the monitor or electrodes and are likely to produce unclear recording).
- These patients should be referred via SCI gateway
Who not to refer for Direct Access Ambulatory ECG:
- Patients with recent syncope or high-risk features (see below)
- Patients already known to Cardiology – please refer to existing Consultant.
Who to refer to General Cardiology clinic:
- Recent syncope or high-risk features above (urgent)
- Patients with a history of acute coronary syndrome, cardiac surgery, percutaneous coronary intervention or a pacemaker / device implant within the last two months
- Known history of ventricular tachycardia or ventricular fibrillation
- Already known to a consultant or has increasing or changing low risk symptoms of a previously identified arrhythmia.