Coronavirus: cardiology service update
We know that this is a concerning time for lots of people. Even through the coronavirus situation, we remain committed to providing you and your family the best, and safest, care possible.
We are changing how we work in the cardiovascular team, so that we can continue providing the best care possible for current and new patients, both in and out of our hospital. These changes are designed to help keep everyone as safe as we can during this challenging time.
Frequently asked questions
Visit our frequently asked questions (FAQs) page for answers to further queries we have been receiving.
To reduce the risk to our patients, whilst still ensuring they get the care they need, our team of consultants and nurses are carefully reviewing every single patient's medical history and test results. Following these detailed reviews, they can find which patients need to be seen in person, which patients could have a 'virtual' review, and which patients could safely have their appointment postponed.
We are currently working to contact every patient regarding any changes. We understand that you may have waited some time for an appointment, and we apologise that your appointment may be changed.
After our detailed review, one of the following may happen:
- in some cases, we are changing appointments to a telephone consultation, and in certain circumstances, a video appointment. This prevents you from having to travel to the Trust.
- some patients may be discharged back to their GP and we will write to you if this is the case. If you have been discharged back to your GP, it is because it is safe to do so. If your situation as changed, please let us know.
- some appointments may be deferred without a future date being arranged at this stage. If we defer your appointment, this is because we believe it is safe to do so. You will remain on our waiting list and we will contact you in due course. If your symptoms have changed and you think you should be seen, please contact your team so we can give you the help and treatment you need.
We understand that this is a concerning time, and we apologise that we have had to change your appointment. If you have not heard from us within three days of your scheduled appointment please contact us by email email@example.com.
Clinical help and advice
If you have symptoms that could be a medical emergency (such as a heart attack or stroke), dial 999.
It is possible that you are seen in more than one service. If your query is specifically about your heart failure condition, you should direct that query as outlined below.
The cardiology team consists of the following consultants. If you are under their care, then you are a patient of the cardiology team.
- Harith Alam
- Rachel Bastiaenen
- Una Buckley
- Gerry Carr-White
- John Chambers
- Natali Chung
- Brian Clapp
- Michael Cooklin
- James Coutts
- Hannah Douglas
- Andrew DSilva
- Benjamin Dyer
- Yaso Emmanuel
- Gherardo Finocchiaro
- Alessandra Frigiola
- Jaswinder Gill
- Jane Hancock
- Cathy Head
- Tevfik Ismail
- Matthew Jones
- Stam Kapetanakis
- Michael Marber
- Lawrence Nunn
- Mark ONeill
- Nikolaos Papamichail
- Antonis Pavlidis
- Divaka Perera
- Bernard Prendergast
- Ronak Rajani
- Simon Redwood
- Aldo Rinaldi
- Nabeel Sheikh
- Anoop Shetty
- Jessica Webb
- Matt Wright
Contact us by email if you are an existing patient who has previously been seen in our service and need advice from the clinical team, email us on firstname.lastname@example.org and we will try to email back as soon as we can. You are likely to receive the quickest response by using an email query.
Contact us by telephone on 020 7188 1026 if you are worried about your health or feel that you are getting worse, or you are unable to email so that we can give you the help and treatment you need. Our phone lines are very busy and there may be a wait for your call to be answered.
Please note that many of our clinical staff are assisting with the unprecedented situation of the coronavirus situation. This may mean a slightly longer response time than usual. However, we assure you that we will contact you as soon as we can.
Contact us by email for:
- queries regarding your appointment or the contact details we have for you
- if you have recently discovered you are pregnant and need specific advice and guidance
- if you are self-isolating for a confirmed or suspected COVID-19 infection.
Contact us by telephone if:
- you need to urgently discuss your clinical condition, or are concerned about new symptoms
- you do not have access to email or our website.
Advice and guidance
We are doing everything we can to support GPs and your patients during the COVID-19 pandemic. Therefore, prior to any referral, we would strongly advise that GPs to seek advice and guidance via e-RS or Consultant Connect (if it is available in your area). Please note that all of our services available on e-RS are set up for advice requests.
This will enable the clinical team to review your request and provide an interim treatment plan for ongoing management of a patient. They can also advise/provide clarification regarding a patients test results.
The GP can attach documents to the e-RS advice request, which may include diagnostic results or scanned images (eg ECGs). Providers can also respond with attachments.
If you feel that a referral is absolutely necessary, please refer via e-RS and use the 'defer to provider' functionality for urgent/2WW referrals. Please attach the referral letter at the point of referral/within 24 hours. For 2WW referrals, please ensure that the patient meets the criteria ahead of referring. Please do not refer urgent patients under 2ww as this will overwhelm the service.
The Trust will vet the referral and either book into a virtual appointment or add the patient to the waiting list if they need a face to face appointment.
Please do not defer to provider routine referrals. Send the appointment request to the patient so they can do this when they are ready to book.
Please consider this before making any referral as our capacity to see new patients is very limited.
For any training issues/ technical assistance with e-RS/Smartcards, please contact your local CSU facilitators or Registration Authority Helpdesk.
For south-east London GPs, your Clinical Commissioning Group (CCG) has commissioned the Consultant Connect service so you can also use this to seek advice. We are in the process of expanding our Consultant Connect lines – these will be available Monday-Friday, 9am-5pm. The communication will come via your local CCG bulletins so please share this information within your practice.
Frequently asked questions
Visit our frequently asked questions (FAQs) page for answers to further queries we have been receiving.
Our cardiology department provides a full range of services for inpatients and outpatients. We pride ourselves on the quality of these services, and we are recognised as a world leader in the development and application of innovative treatments for heart conditions.
The services we offer are delivered by expert cardiologists using state of the art facilities.
Find out more about the services we offer:
Further information for healthcare professionals
The interventional cardiology group includes specialist interventional consultants in addition to a highly skilled team of physiologists, radiographers and specialist nurses. A 24 hours 7 day week primary angioplasty service ensures all patients presenting with heart attacks receive gold standard treatment irrespective of day or time of admission. Our team has published a number of academic publications in high impact journals, and our consultants participate in international conferences.
Electrophysiology and rhythm management devices
Five specialist cardiologists (including three professors) lead a team of highly specialised physiologists, radiographers and nurses. The unit is one of the largest volume operators for ablation and device implantation in London. Close working with the cardiology imaging unit has resulted in ground breaking approaches in radio frequency ablation for rhythm management. The unit has a very strong international presence. A 24 hours 7 day service, led by the specialist electrophysiologist consultants in addition to the specialist electrophysiologist clinical scientists, operates to provide definitive gold standard treatments (device implantation, rhythm management) to all patients irrespective of day or time of admission. The unit has particular expertise in the laser assisted extraction of devices, being one of two high volume departments in this field.
Structural and valvular heart disease
In close conjunction with the cardiac surgical unit, and the paediatric cardiologists, the cardiology department has developed multiple multidisciplinary teams including a transcatheter aortic valve replacement (TAVR) team, a mitral team and an adult congenital heart team. The structural heart disease team is internationally recognised and coordinates the largest transcatheter valve meeting in the world. We have pioneered many new technologies in this field and were the first centre in the world to perform transcatheter mitral valve replacements and to offer parachute device implantations to patients with heart failure.
Cardiac imaging is a major strength of the department and provides a comprehensive portfolio including echocardiography, cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI). The department hosts the largest number of clinical imaging cardiologists in the United Kingdom with a strong academic presence both nationally and internationally. We are amongst the five largest volume centres in the United Kingdom for cardiac CT, echocardiography and cardiac MRI. Many of our imaging cardiologists are invited speakers both nationally and internationally at major scientific conferences, and we have published a number of academic publications in high impact journals.
The department provides a complete range of non-invasive services for inpatients and outpatients, within the Trust and the local community. This supports directorates throughout the Trust.
Heart failure and inherited cardiac conditions
Our heart failure service is one of the largest in the United Kingdom and is made up of three heart failure consultants and a dedicated team of heart failure specialist nurses. We offer a rapid assessment of patients presenting to hospital with shortness of breath and integrate our service with our community based services and GPs to ensure continuing care and optimal treatment. Notably, we have specific expertise in dealing with patients who have sustained damage to their hearts as a result of treatments to cancer (cardio-oncology) and in the investigation of novel treatments for heart failure. We have a philosophy of developing innovative technologies to deliver our heart failure services. For example, we offer video virtual clinics and work with IT companies to deliver "telehealth".
The inherited cardiac conditions service is the fastest growing within the directorate, and works in conjunction with other specialties (including genetics, neurology and respiratory medicine) to deliver an innovative specialised service. The inherited cardiac conditions service provides a comprehensive service for patients with inherited heart muscle disorders, inherited heart rhythm disorders, inherited cholesterol disorders and diseases of the aorta.
Adult congenital heart disease
A great deal of recent investment has taken place in this service. The department is the fastest growing ACHD unit in the UK.
Find out how imaging is transforming care for cardiac patients
At Guy's and St Thomas’ cardiologists are working to improve the way they use imaging to diagnose and treat patients with cardiac disorders.
How imaging is transforming care for cardiac patients – video transcript
Prof Mark O’Neill: One of the challenges facing us today is applying a new paradigm to the management of our patients with cardiovascular disease. With our diagnostic capabilities we can personalise our investigation of a patient and subsequently personalise the treatment of that patient.
Prof Reza Razavi: By not only looking at the patient's history and their ECGs but actually by looking at the substrate at what's going on inside the heart we can have a some idea of which patients are likely to respond and which might not.
Prof Aldo Rinaldi: We can use data that's been derived from magnetic resonance imaging or even CT scanning imaging now and this can give us an idea of the patient's anatomy by using computer modelling we can test whether a patient will respond to therapy so we're moving much more towards the sort of precision or targeted approach in individual patients try to improve response.
Prof Mark O’Neill: Guy's and St Thomas' is one of the largest teaching hospitals, university hospitals, in the United Kingdom based in the centre of London there has in fact been a St Thomas' Hospital based on the Southbank of the Thames since the 12th century. The clinical and intellectual atmosphere here is unique together with my colleagues in bioengineering and advanced cardiovascular imaging including MR physics we have the ability to answer very quickly questions which we ask. All under one roof. We're seeking to expand the boundaries of how diagnostic imaging can inform therapeutic intervention in patients with heart rhythm disturbances, to understand why a particular patient on a particular day suffers a rhythm disturbance which could potentially be fatal. In the United Kingdom at least 1.5 to 2 percent of our population suffers with atrial fibrillation therefore it's very important for us to find better ways to manage this condition in a more cost-effective way. The current interventions we use seek to ablate or destroy in a controlled way clearly defined cardiac tissue. Advanced cardiac imaging allows us to assess atrial structure. It's important for us to understand which parts of the atrium are the sites that we should target and also how safely can we target them. Sitting here within the XMR environment, we have the ability to take a patient on the morning of their procedure, perform a scan to assess their atrial structure and function, and then to tailor our procedure according to that individual patient's anatomy and depending on where we see sites with scar or abnormal tissue or sites with thick or thin atrial tissue.
Prof Aldo Rinaldi: Cardiac resynchronisation therapy is an extremely powerful treatment. But approximately a third of patients don't respond to this treatment. By looking for areas of scar, by looking for areas of late electrical or mechanical activation and by using that data and taking it into the catheter lab to actually guide the procedure at the time, we hope to be able to then make a bespoke treatment for the patient to guide the lead to the optimal position in that patient's heart to improve the response to therapy. We were also able to develop in conjunction with our biomedical engineers here, biophysical models derived from MRI and electrical input. We can actually test in silicone what the response to a patient's treatment will be before we actually give it to the patient. There are several studies and programmes we're undertaking in conjunction with other centres in the UK and Europe actually to validate these models. Also we want to make the models more sophisticated and require less invasive data. We want them to be quicker as well so we hope to be able to now create this in hours to minutes in the future.
Prof Reza Razavi: When we are looking at patients with ventricular tachycardia, cardiac MR allows us to image the shape and size of the ventricle in its function but particularly it allows us to image the scar and the areas around the scar, the border zone, or the grey zone, but getting that information into the cardiac catheterisation laboratory is difficult. That is why we're pursuing doing these procedures inside the MR scanner where we can both observe the substrate accurately but also accurately to target it by tracking our device to do the ablation, the catheter into the right part of the substrate. We can ablate arrhythmias in patients inside an MR scanner for atrial flutter but doing this for ventricular tachycardia is much harder. We have developed the technologies working with Siemens Healthcare and Imricor to be able to do this in an animal model and a next step over the coming year or two for us is to translate that into studies in patients.
Prof Mark O’Neill: Almost every patient we see is interested in understanding better why they have suffered the problem they have suffered. Therefore every patient who comes into hospital contact with a doctor or a nurse is offered the opportunity, if appropriate, to participate in a research study.
Dr Ronak Rajani: The UK's National Health Service indicates that all patients should have access to clinical research should they wish to be involved in research. We do screening of patients as they attend their clinics and patients are identified if they have specific pathological conditions or clinical disease states and if these conditions match up to current research studies they are approached for inclusion into these research studies. The transition of clinical data acquisition will ultimately be dependent on the publication and dissemination of our research findings but we are already starting to see that patients are benefitting from some of the work that's being conducted on our site.
Prof Mark O’Neill: With the support of the infrastructure provided by the NHS, King's College London and our in-house services in bioengineering medical physics, cardiovascular imaging and interventional cardiac electrophysiology we hope that our work using imaging technology to assess arrhythmia substrate in patients will lead to earlier identification of patients for whom intervention is appropriate and better interventions in those patients.