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Cardiac Rhythm Analysis

Checked: 17-06-2025 by Rob Adams Next Review: 17-06-2027

Specialist Advice

Local cardiologist, Ed Duncan advises:

'We still get a lot of requests from GPs and physicians for 24hr tapes when symptoms occur very infrequently. This results in a low yield and lots of work/expense. If symptoms are infrequent and unlikely to be captured by standard ambulatory monitoring, then we would suggest the patient attends the practice or A+E during an episode for an ECG.'

Referral

Bristol Heart Institute - use the BHI Cardiac Rhythm Analysis form (word doc) (available as a template in EMIS) which should be sent via eRS requesting cardiology monitoring (no longer available via ICE).

NBT - use the NBT Cardiology Monitoring request form (Word doc) (available as a template in EMIS) which should be sent via eRS requesting cardiology monitoring.

WGH - use the direct access cardiac investigation form (EMIS template) and send via email: wnt-tr.ecgtestreferrals@nhs.net. Please note that Clevedon hospital ecg service has been suspended.

Interpreting Results

Reports from monitoring do not routinely come with interpretation or advice from a cardiologist and should be interpreted in correlation with patient symptoms and the symptom diary that was completed during the monitoring period.

Please see the Arrhythmia page for advice on next steps and when to refer is an arrhythmia is found on monitoring .

If you require more specific advice about interpretation of results then please consider using Advice & Guidance . Please note: The cardiologists kindly request that advice requests regarding monitoring should be sent to the hospital trust where the monitor was fitted. Advice and guidance should also include clinical details of presenting symptoms, cardiovascular examination (e.g. BP, heart sounds) and results of other investigations (such as bloods, 12 lead ecg, echo) if these are available.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.