Dr. Nicholas Pegge : Cardiologist

• DR PEGGE: RESUME
• APPOINTMENTS
• CONTACT

• Symptoms
  • Chest pain: is it angina?
  • Breathlessness
  • Palpitations, arrhythmias and blackout
  • Heart Murmur
• Conditions
  • Coronary artery disease: angina and heart attack
  • Heart Failure and Cardiomyopathy
  • Heart Valvular Disease
  • Arrhythmias
  • Hypertension
  • Cholesterol and other risk factor management
• Investigations
  • ECG and heart rhythm monitoring
  • Echocardiography
  • Exercise treadmill testing
  • Cardiac MRI, CT and other scans of the heart
  • Cardiac catheterisation: coronary angiography
  • Electrophysiology investigations
• Treatments
  • Drug treatment for heart disease
  • Percutaneous coronary intervention: angioplasty and stents
  • Coronary artery bypass grafting
  • Valve replacement
  • Pacemakers, Defibrillators
  • Cardioversion and Ablation

The electrocardiogram or ECG provides at rest a snapshot of the electrical activity of the heart muscle at a moment in time. We derive considerable information from this. This test takes a couple of minutes to perform, and is performed routinely during the outpatient appointment.

Patients with palpitations, giddy spells, blackout or syncope; or those with intermittent breathlessness, or structural heart disease, may need to have more prolonged ECG monitoring. This is performed generally by a simple 24 hour tape, with a small electronic device worn for a day. Other ‘worn’ devices are used for monitoring heart rhythm for up to a week.

Some patients with rarer but disabling symptoms which may be caused by intermittent heart rhythm disturbance require longer term monitoring, and this can be achieved by a small electronic gadget, rather like a ‘USB flash-drive’, inserted under the skin at the front of the chest.
Dr Pegge implants these subcutaneous continuous loop recorders of the ECG – commonly known as ‘Reveal’ devices – under a local anaesthetic, in the cardiac catheter laboratories at Worthing hospital. Patients having this procedure are generally at the hospital for a couple of hours only. The battery in the device lasts long enough to monitor the heart rhythm for between two and three years.
The ECG data stored in this loop recorder can be read non-invasively, by a small device held by a Cardiac Physiologist over the chest wall where the monitor has been implanted. The readings can happen through clothing.