Specialist Pacemaker Service

A pacemaker is a small electrical device that sends electrical pulses to your heart to keep it beating regularly. Should you have an irregularity in your heart or a conduction problem, a pacemaker can make a real difference to the quality of your life; indeed, in many cases it is lifesaving.

Medical intervention through use of a pacemaker is known as pacing. I currently provide the only private pacing service in Bath, which means that if you live in or around Bath and have a pacemaker requirement (or think that your consultation is going to be regarding pacing), it is highly likely you will be referred to see me at Sulis Hospital Bath.

Why me?

While pacing has been around for a number of years, there have been significant advances in both technology and surgical approaches. I have kept abreast of all of these and indeed am an opinion leader in many of them.

In 2010, I was one of the founders of the surgical skills course for cardiologists in the UK. As cardiology was becoming an increasingly procedural specialty, our focus with this course was to help refine the surgical skills of cardiologists in order to potentially improve outcomes for patients. This surgical skills course provides specialist training, ranging from how to reduce surgical site complications through to the study of surgical techniques to prevent infection and bleeding.

We also started working very closely with plastic surgeons to help improve the appearance of the scar post-surgery. It is easy for cardiologists to focus on the technicalities of the pacemaker, but it is hugely important that we always remember that you want the scar to be as small as possible so that it is hardly noticeable on the outside.

Complex advanced pacing

As well as providing ‘standard’ two-lead pacing, I also specialise in complex advanced pacing often requiring a third lead. This really encompasses three things:

Implantable cardioverter devices (ICDs): These are defibrillators for patients with a risk of potentially dangerous heart rhythm disturbances that can cause fatal cardiac arrest. As well as monitoring heart rate, an ICD is able to deliver a shock (defibrillation) in order to restore its normal rhythm. I was responsible for starting the new ‘leadless’ subcutaneous ICD service in Bath and implanted the first device in Swindon.

Cardiac re-synchronisation therapy / bi-ventricular pacemakers (CRT-P or CRT-D): These are specialist pacemakers that we use in patients who have heart muscle impairment or ‘heart failure’. They help re-coordinate the contraction of the heart, improving its efficiency and reducing common symptoms like breathlessness and ankle swelling.

His bundle pacing (HBP): Traditional pacing puts the lead for the pacemaker into the apex of the right ventricle. While this is a good treatment, it’s not actually the natural way to activate the heart electrically. Increasingly, there has been interest and attention focused on putting the lead precisely in the area where the electrical impulse naturally travels down into the ventricles (this area is known as the ‘His’). We are seeing some very exciting results with this type of physiological pacing and have some of the most experience in the UK between Bath and Swindon.

Not all pacemakers are the same

While standard pacemakers can certainly be effective, in many ways they provide us with a baseline for treatment. There are opportunities now for us to provide you with a pacemaker that provides physiological stimulation in exactly the right place for you. More precise positioning and programming means more effective measurement (and correction when needed) of your heart rhythms.

It can be easy to think that all pacemakers are the same, but this is no longer the case. ‘One size fits all’ is not appropriate for this area of medical intervention. Advances in pacing technology and surgical techniques now provide us with the ability to tailor a pacemaker to your exact requirements. Working closely with you, we will help ensure your pacing is the best it can be for you. We also then monitor everything over time to ensure you continue to receive the best support possible.

No unsightly scars

Many people come to see me when they have had a pacemaker put in elsewhere and are now unhappy with an unsightly or uncomfortable scar / pacing site. Sometimes the wound itself is problematic. To help with these problems, we provide a service where we can revise scars, or correct where the pacemaker is to make it more comfortable.

To reduce the risk of this happening in the first place, when I put a pacemaker in, I always keep the incision as small as possible and use minimally invasive techniques. These advanced techniques, extrapolated from our experience of working closely with plastic surgeons and using the latest electrocautery equipment, means there is minimal trauma to the surrounding tissues, which reduces the risk of an unsightly or painful scar in the future, bleeding or swelling. Combined with good analgesia and sedation where needed, any pain or discomfort is kept to an absolute minimum.

Specialist pacing service in Bath

Should you need a pacemaker, please do contact my PA, ‘Tash’ (Natasha Jones), on 01761 422287 today to schedule a consultation with me at Sulis Hospital Bath. You will be able to select a time that is convenient to you. When we meet, we will talk through your options to determine what would be best for you. With advanced diagnostic equipment, pacing technologies and surgical techniques, we will ensure you receive the optimal pacing service for your particular needs.