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Oliver Segal, consultant cardiologist and electrophysiologist at The Harley Street Clinic, tells us why more people are being diagnosed with atrial fibrillation, the ease at which we can now monitor heart rhythms and how important it is that those with a heart concern come forward and see a medical professional immediately.  

What is electrophysiology?

Electrophysiology is the study of heart rhythm problems. The heart has an electrical system that sends impulses to make the muscles contract. When there are issues with the electrical signals in the heart, the result is an arrhythmia – an abnormal heart rhythm. These are the kinds of issues that I help patients with.  

The patients I see often present with either one or a number of the following symptoms:  

  • Palpitations and ectopic beats 
  • Blackouts   
  • Shortness of breath  
  • Very rapid heart rates and tachycardia 
  • Chest pain  
  • Blood pressure issues  

What has been one of the biggest recent developments in the diagnosis of heart rhythm problems?

One of the biggest new developments is wearable and implantable monitors. In the past, if we wanted to find out whether a patient had an irregular or fast heart rhythm (e.g. a rhythm called atrial fibrillation), we would ask patients to wear bulky monitors using lots of wires and sticky electrodes on their chest or even monitor patients within a hospital setting. The sticky electrodes often cause allergy, fall off and are uncomfortable to wear. We now provide patients with small waterproof patch monitors that stick to the front of the chest and record heart rate and rhythm for weeks at a time. There are no wires and patients can shower with them on.  

Another type of ECG monitor, the size of two matchsticks stuck together, can be inserted under the skin to monitor the heart for up to three years to look for very infrequent arrhythmia episodes, particularly in patients who have presented with a stroke.  

The other big recent development is wearable ECG technology. Many high-tech wearable devices can offer people a better understanding on heart rate and how their heart is performing, particularly those interested in sport. The latest Apple Watch and some other wearable solutions allow people to record ECG’s very quickly easily and whilst on the move, and the quality of the recording is excellent. This is revolutionising the way doctors, and now patients, can diagnose the cause of infrequent or rare palpitations. This has led to us being able to diagnose conditions like atrial fibrillation much more easily and then to provide the right treatments for patients earlier. 

How has the care you provide differed due to COVID-19?

Since the first peak in April, the majority of my clinics have become virtual and video consultations are now very popular. Patients have embraced this change in almost all cases, as it means that they don’t need to spend time travelling for an appointment, and often feel more comfortable talking about concerns in their own home. 

As doctors, we have of course had to get used to a new way of working. We now have to ensure patients follow isolation guidance before coming in for a procedure, all patients must have a COVID-19 test before admission, and we must follow guidance on using appropriate PPE during procedures, particularly those under general anaesthetic. As we’re now many months into this way of working, it has now become much more familiar. 

Why should someone choose The Harley Street Clinic if they have a heart complaint?

At The Harley Street Clinic, we’re proud to not only to be able to offer our patients the very best diagnostics and treatments options, but we’re proud that we remain able to offer rapid access to this outstanding level of healthcare, all in the safest of environments.   

I was able to see this from a patient’s perspective not that long ago when I had to attend an appointment as an outpatient at an HCA UK facility, and I had a great feeling of confidence, knowing that so much care and attention goes into keeping patients safe.   

It's so important that people know that during this second wave of the pandemic, our clinics will remain open to see and treat patients. Heart complaints can very quickly escalate, so it’s imperative you come forward if you have any symptoms or concerns.  

Book an appointment with Oliver Segal here
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