Evolution of a nurse-facilitated suspected arrhythmia clinic

Abstract

Objective: The purpose of this audit was to describe and compare the referred population to a nurse-facilitated suspected arrhythmia clinic for the period July 2007 to July 2008 with the previous year’s audit data as reported by Lapper and Smallwood (2008); assessing the impact on service provision and use of resources. Method: Retrospective data were collected from all new referrals to a nurse-facilitated suspected arrhythmia clinic from July 2007 to July 2008. Results: 302 patients were referred to the nurse-facilitated suspected arrhythmia clinic. Referrals were predominantly female, aged between 17–92 years and mostly Caucasian. The most common symptom prompting referral was palpitations (60%), with ‘stress’ being the most common self-reported precipitating factor (20%). Cardiac monitoring was instituted in 73% of patients. Following investigation atrial fibrillation was identified in 31% of referred patients, paroxysmal supra-ventricular tachycardia 9%, atrial ectopy 7%, ventricular ectopy 13%, sinus rhythm with pauses (1%), with no arrhythmias identified in 38% of the cohort. Findings were not recorded in 1% of patients. Conclusions: The most striking feature of this review is the 57% increase in new patients referred suggesting that this clinic has become embedded in the cardiology appointments system and shows a willingness of referrers to use this avenue of referral. An impact on resources and practitioner role was noted. Despite the increase in referrals the number of arrhythmias detected was noted to be similar to the previous audit period. The need to evaluate clinic effectiveness is highlighted.