Reference 2018-753

REF:           2018-753

Subject:       Cardiac rhythm monitoring



  1. Any care pathways for the investigation and management of patients with symptomatic palpitations and/or syncope referred to cardiac services in your trust by GPs. Of particular interest is the role and positioning of diagnostic investigations such as cardiac rhythm monitoring, cardiac imaging and cardiovascular performance assessment.
  2. Details of both national and locally negotiated tariff arrangements applied to this service
  3. Does the GP have direct access to the cardiac monitoring service?
  4. Is the patient seen by a cardiologist before having the monitor attached?
  5. If not, who undertakes the process (e.g. technician, nurse etc)
  6. What is the first pass monitoring technology (e.g. 24hr, 48hr, 7-day event triggered etc)
  7. What happens after the first pass monitoring – are all seen by a cardiologist or is there a pre-appointment triage process?
  8. What other tests are ordered (e.g. 12-lead ECG, Echo etc), at which stage in the pathway and for which patients?
  9. What determines who is selected for 2nd pass monitoring and what technology is used for this?
  10. What determines who is discharged back to the GP?
  11. What is the current tariff for 24 hr, 48 hr, 7-day Holter Monitoring
  12. What is the tariff for referral to community cardiology investigation clinics
  13. What is the tariff for direct referrals for GPs for 24hr, 48 hr and 7-day Holter Monitoring




Please find information attached.

2018-753 – FOI Request – Cardiac rhythm monitoring [113 kb] PDF