We ask that all Holter Monitor referrals are submitted via the designated eRS services detailed below and not via email. The previous email address has now been closed. 

eRS service details: 

Speciality  Clinic Type Service Name  Location
Cardiology Arrhythmia  Cardiology - Epatch - CDC - RD7  Slough CDC 
Cardiology - Epatch - CDC - RDU Frimley 

The referral form on DXS has been updated to reflect these eRS changes and now includes collaboratively developed and agreed inclusion and exclusion criteria to support patients being managed in the most appropriate setting. Please see extract below, along with referral guidance for suspected POTS. If you need any advice prior to referring, please use the Advice and Guidance service available on eRS for General Cardiology.  

The updated form can be found in the following location on DXS: Frimley Health and Care / Cardiology / Frimley ICS Referral Forms / 5-day Holter ECG Patch referral form (FHC3720) or search words: holter, monitor, ecg, patch. This information has also been transferred to Ardens for South Bucks practices.

Indications for e-patch Referral – Palpitations 

  • Patients with suspected paroxysmal AF who experience symptoms less frequently than once / week would benefit from either AliveCor monitoring, medical review at the time of symptoms, or advice and guidance to the General Cardiology Service on eRS.  

Appropriate (Inclusion Criteria):

  • Symptoms that suggest a sustained arrhythmia, occurring at least once a week, without red flag features  
  • Documented ventricular ectopy on12 lead ECG causing symptoms obtrusive to daily life  

Inappropriate:  

  • Patients with thumping, missed or skipped beats.  
  • Patients with red flag features – they need direct referral to cardiology via eRS e.g. history of MI, personal or family history of cardiomyopathy or channelopathy  
  • Suspected POTS – ambulatory monitoring not needed for diagnosis: The 10 minute stand test can be done in primary care, or even at home by the patient. 10 minute stand test video.
  • Incidental ECG abnormality – advice and guidance to the general cardiology service instead  

Indications for e-patch Referral – Syncope and Presyncope

  • Genuine cardiac syncope should be referred to General Cardiology via eRS – organising an e-patch first introduces an unnecessary delay.  
  • If genuine cardiac pre-syncope is suspected i.e. due to aortic stenosis or paroxysmalarrhythmia/intermittent heart block, then refer to General Cardiology via eRS  

Appropriate:

  • None (see above)

Inappropriate:

  • Orthostatic features  
  • Vasovagal features  
  • Vestibular features  
  • Epileptiform features  
  • Situational syncope e.g. cough, micturition, defecation 
  • Unsteadiness on the feet  

For admin enquiries relating to a referral which has already been sent, please contact the relevant clinical admin team who will be able to investigate and respond:

Site  

 Service   Email address
FPH Cardiology fhft.cardiologysecretaries@nhs.net 
HWPH Cardiology fhft.cardiologymedsecshwph@nhs.net 

Nb. All our admin enquiry details can be found on the FHFT GP Centre- referrals and key contacts page