Helen Eftekhari

University Hospitals Coventry and Warwickshire NHS Trust · Department of Cardiology

In this month's BANCC column, Helen Eftekhari takes a look at the ethics that guide cardiac nurses in clinical practice and research.

Background The PULSE (PostUraL tachycardia Syndrome Exercise) study is a randomised controlled trial assessing the feasibility of conducting a multicentre RCT testing supervised exercise rehabilitation with behavioural and motivational support, compared to best-practice usual care, for people with Postural Tachycardia Syndrome (PoTS). The original...

This literature review examines recommendations regarding good decision making for the deactivation of implantable cardioverter defibrillators in individuals who are nearing the end of life. Implantable cardioverter defibrillators are considered the first line of treatment in individuals presenting with life-threatening arrhythmias. However, there...

As we mark Global Atrial Fibrillation Awareness Week from 16-22 November 2021, BANCC president elect Helen Eftekhari reflects on the current evidence and the tremendous impact that cardiovascular nurses can have on care outcomes

Background Implantable loop recorders (ILRs) are effective in achieving symptom-rhythm correlation. Data on their diagnostic yield, on nurse-led syncope clinics and nurse-led ILR implants are limited. Objectives We evaluated the safety and efficacy of our nurse-led syncope clinic and nurse-led ILR-implants. Methods Retrospective study of all cons...

This article will review pacing in the context of acute care, with a focus on temporary pacing. Beginning with an overview of the heart's intrinsic electrical conduction system and its function, the discussion moves on to pacing, acute clinical presentations and indications for pacing. This includes an overview of temporary pacing, with the differe...

The article provides an overview of the principles in anti-arrhythmic drug prescribing. The cardiac action potential is explained, followed by general principles involved in treating arrhythmias and prescribing decisions. An overview of the five classifications of anti-arrhythmic drugs is given, with examples of the main drugs in the classification...

POTS is under diagnosed with an estimated prevalence of 0.2%. North American and Australian researchers, as well as patient groups have called for more research into POTS. However, there has been no comprehensive appraisal of the current POTS evidence base. Aim To map the POTS evidence base. Methods Two reviewers systematically searched 12 databa...

The lifestyle management of PoTS is the cornerstone of current treatment. It is important for health care professionals to understand the issues which are specific to people with PoTS and need to be addressed. The evidence base, as with all management in PoTS, is limited and recommendations are framed around the available research and rationale pra...

The article aims to give an overview of the principles in anti-arrhythmic drug prescribing. Practitioners assessing cardiac patients are highly likely to review anti-arrhythmic drug therapies and need an understanding of the principles of therapy. The cardiac action potential is explained, followed by general principles involved in treating arrhyth...

The Year of the Nurse has not only coincided with the global COVID-19 pandemic, but also the growing momentum of the Black Lives Matter movement. BANCC president-elect Helen Eftekhari highlights the legacy of British-Jamaican nurse Mary Seacole to modern nursing and the vital contributions made to the profession by black, Asian and minority ethnic...

Background Postural orthostatic tachycardia syndrome (POTS) is an autonomic nervous system disorder causing an abnormal cardiovascular response to upright posture. It affects around 0.2% of the population, most commonly women aged 13 to 50 years. POTS can be debilitating; prolonged episodes of pre-syncope and fatigue can severely affect activities...

The focus of this chapter is on the important role that nurses play in the delivery of care for people with PoTS within nurse ledNurse led clinics, in a cardiologyCardiology setting. We have used the 2018 Department of Health, Social Services and Public Safety UK National Advanced Nursing Practice FrameworkAdvanced Nursing Practice Framework. The f...

Background Syncope is a leading cause of hospital admission and is associated with significant morbidity and mortality. Our Syncope Clinic commenced in 2014 and we sought to evaluate its impact on outcomes (1‐yr mortality and syncope re‐hospitalization) in patients discharged following syncope admission. Methods A single‐center study of all consec...

This month, Helen Eftekhari, BANCC Secretary, looks at the current COVID-19 crisis and its impact on cardiovascular care.

Postural orthostatic tachycardia syndrome is a debilitating and underdiagnosed condition, affecting five times as many women of childbearing age as it does men. The true prevalence is difficult to estimate, with charities reporting up to potentially 3 million people with the condition in the United States. There is a lack of awareness and knowledge...

Background and aims Syncope guidelines recommend Implantable loop recorders (ILR) to aid symptom-rhythm correlation. Arrhythmia Nurse Specialists (ANS) are important in assessment of these patients. Their effectiveness at risk stratification is unknown. ESC 2018 Syncope guidelines recommend more research. Our aim was to evaluate the diagnostic yiel...

This article summarises the history of cardiac pacing, from major early scientific developments to implantable pacing systems. Advances in batteries, leads, electromagnetics and programming in pacing are traced, and there is an up-to-date appraisal of innovations. There is a review of cardiac devices developed from pacing technology, including bive...

With the current strapped financial climate, specialist nursing posts are often difficult to secure funding for. Improvements in the quality of patient care and reductions in financial costs, either directly or indirectly, are often missed. This article draws on one centre's experience of achieving a second specialist nursing post, explaining how t...

Case study of a Brugada syndrome patient who presented twice as an ST-elevation myocardial infarction for a primary percutaneous myocardial intervention. Brugada syndrome was first described by the one of the famous cardiac electrophysiology Brugada brothers in 1992. The differential diagnosis, underlying pathphysiology, diagnostic criteria and man...

This case study follows the management of a patient with Mesothelioma who is subsequently diagnosed with heart failure and atrial flutter. The article illustrates how the appropriate management of atrial flutter with radiofrequency ablation can impact on the disease management; both heart failure and mesothelioma, improving patient care in this cas...

This article aims to examine quality of life issues for the implantable cardioverter defibrillator (ICD) patient, increase our understanding of the psychosocial issues for ICD patients, and identify their educational and counselling needs. It also explains how to recognise the psychological issues specific to those living with an ICD. It examines t...

This article reviews the definition and treatment of Wolf-Parkinson White Syndrome (WPWS), the risk of pre-excited atrial fibrillation (AF) in WPWS, the importance of recognizing pre-excited AF in WPWS and emergency treatment. It discusses the importance of cardiac imagining in WPWS to assess cardiac structure, as mild Ebstein’s anomaly, a rare con...