UNTIL just two years ago, patients needing heart investigations had to travel to Blackpool.
But now, in just one morning at the Royal Blackburn Hospital, the cardiology team can perform two exploratory operations, and fit a life-saving pacemaker.
The heart catheter laboratory (cath lab) opened when Queen’s Park Hospital and the Blackburn Royal Infirmary merged in 2006.
Since then, specialist medics have been able to add performing angiograms - procedures to show detailed pictures of the heart - and fitting pacemakers to their list of services.
And a second cath lab planned for the hospital will mean angioplasty – fitting supports to weak coronary arteries – will also be available in Blackburn.
Consultant cardiologist Dr Ravi Singh, 38, came to East Lancashire a year ago as part of a three-strong new team to develop services for heart patients.
In the cath lab, he opens an artery in either a patient’s groin or wrist, and feeds a thin tube through major arteries and into the heart. The patient is awake and under a local anaesthetic.
During the angiogram, wires threaded down the tubes can monitor pressure inside the heart, and inject dye into blood vessels and heart chambers, which allows a mobile X-ray unit to show clear images highlighting problems.
Before the technique was developed, the only way to get a clear view of heart problems was major surgery.
The cath lab is also used for fitting pacemakers. In this procedure, a small opening is made in the shoulder, but wires are again threaded through major arteries and into the heart. This time, though, the wire is corkscrewed into the heart wall, monitoring electrical impulses.
At the shoulder, it is threaded out of the blood vessel and joins the tiny pacemaker – a disc of about 2in diameter – which is stitched under the skin at the shoulder. It monitors the heartbeat, kickstarting it by sending down an electrical impulse whenever it senses that the patient’s pulse is dangerously low.
Dr Singh said: “Just 20 years ago, fitting a pacemaker was a very big thing. People would have to wait months, and go to one of the big city hospitals in London or Manchester. We would have to fit temporary external devices in the mean time.
“Now, people can arrive at the emergency department with a problem, have a pacemaker fitted the next morning, and go home that afternoon. And when we get the new lab, we’ll be able to do even more.
“But the exploratory work is just as important. Before these techniques were widely used, people would have irregular heartbeats show up, and doctors would literally have to make an informed guess on how bad things were, or go for full open-heart surgery.
“If a patient is told they might have something wrong with their heart, they want to know straight away what the problem is and what effect it’s going to have on their life.
“A heart concern can force people to give up work, and the worry alone can make them even more ill. By taking a look straight away, we can tell them, and being able to tell someone that the problem is not as bad as we thought is just as important as identifying someone who needs a major operation.
“Since the merger with Burnley, we have been able to be even more efficient, because now we run as one unit over the two sites. That means all the consultants can work together to make sure every patient sees someone very senior very quickly.
“People used to stay four or five days, but by working together and ensuring every patient gets everything done at once, most are staying less than three days, and that means a better service for everyone.
“We simply couldn’t work at that rate before the merger.”
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