My colleagues and I aim to offer a comprehensive range of services in adult cardiac
medicine at the
Royal Devon & Exeter Hospital, Barrack Road, Exeter EX2 5DW
Telephone & Fax: 01392 402273
E-mail: [email protected]
a. In-patient services based on Taw & Avon wards and the Coronary Care Unit (CCU).
b. Out-patient consultation services
c. Chest pain clinic
d. Non-invasive cardiac investigations including
- Electrocardiography (ECG) and signal averaged ECG
- Echocardiography (including transoesophageal and stress echo)
- Exercise ECG
- Ambulatory ECG monitoring (24 hour ECG and Cardiocall)
- Tilt table testing
- Cardiac magnetic resonance (CMR) scanning
- Cardiac (including coronary) CT scanning
e. Cardiac catheterisation & angiography
f. Coronary balloon angioplasty and stenting
g. Pacemaker and defibrillator implantation (including biventricular systems) and follow-up
h. Electrophysiological studies and radiofrequency ablation.
i. DC cardioversion
j. Cardiac rehabilitation
Access to all these facilities is via a General Practitioner in the first instance.
Appointments for out-patient services are allocated after I receive a letter from the General Practitioner. Unfortunately current waiting times are quite long:
Urgent 4-6 weeks
Routine 8-12 weeks
Chest pain clinic 7 weeks
I appreciate that these waiting times are unsatisfactory, but I see as many patients as I can with safety in a week (I personally saw over 700 new patients last year). I very much hope that the appointment of new consultant cardiologists this year will result in lower waiting times for out-patient clinics in the future.
At present, I run 1-2 outpatient clinics per week. On both days there are concurrent pacemaker clinics run by the cardiac technicians.
I see 24-28 new and follow-up patients with my Registar and Senior House Officer.
Consultant only clinics
I see 12-14 (mostly new) patients.
I occasionally have one of my secretaries (Karen) with me in the clinic. They help me with the administration of the clinic (e.g., finding test results) and will provide patients with a typed letter for their general practitioner before they leave. Female patients will always have a nurse to chaperone them in the examination room if they wish. If you are a new patient and are seen by a doctor below the grade of Registrar, I will see you myself after discussing your case with the SHO.
I often arrange for tests, such as ECG and echocardiography, to be carried out on the same day as the clinic appointment to save patients travelling more than once from long distances. However, this is not possible for all investigations, so some tests may be carried out prior to the clinic appointment
These are arranged by the consultants in the cardiac department. After I receive a letter from a General Practitioner about a patient, I often arrange for these tests without seeing the patient myself in the outpatient department. Once I have seen the results, I write to the General Practioner, it may not be necessary for the patient to come to the clinic. Once again the waiting times for some investigations are long.
Echocardiography 6 weeks
Exercise Testing 2-4 weeks
24 hour ECG tapes 2-6 weeks
Long-term ECG monitoring 2-6 weeks
Tilt table testing 8-12 weeks
I personally carry out implantation of permanent pacemakers and cardioverter-defibrillators (including biventricular systems). I stopped doing
cardiac catheterisation and angiography, coronary balloon angioplasty, diagnostic electophysiology studies (EPS) and ablation in October 2016 when I started part time working.
Waiting times are approximately as follows
Coronary angiography 12-28 weeks
Coronary angioplasty 39 weeks
Pacemaker insertion 2-40 weeks
EPS & ablation 18-52 weeks