THE GOOD DOCTORS GUIDE

Exclusive: Britain’s best consultants – as chosen by their fellow doctors

WHAT are the hallmarks of a good doctor? Skill and technical expertise, of course. But also vital is someone who understands you and someone you trust.

In fact, research has proved that a good relationship with a doctor can actually improve your chances of a successful outcome. But how do you find a specialist who fits the bill?

That’s where this unique series of guides, which started in Saturday’s Mail and continues every day this week, can help you out.

We have identified the country’s top consultants — as judged by their peers. We’ve canvassed the views of more than 260 of them, across seven specialities, and asked them this very simple, but key, question: ‘If your own nearest and dearest were to need treatment in your field, to whom would you refer them — and why?’

The consultants who earned the most votes from their peers are the ones who made it into our guides.

Patients should bear in mind, though, that this is not a scientific study and there are many superb, highly skilled professionals nationwide who didn’t make it on to our list, but who are making a real difference to patients every day.

To help you make informed choices about your own care, or that of your loved ones, we’ve also talked to experts about the very latest thinking on various treatment options.

Today, we look at the best doctors for heart rhythm problems.

REVOLUTION IN TREATMENT

MORE than two million people in the UK have a faulty heartbeat, or arrhythmia. Unfortunately, up to half-a-million go undiagnosed and, as their condition hasn’t been spotted and, therefore, treated, their risk of stroke is significantly raised. The good news for those who

have been diagnosed is that there’s been a revolution in the treatment of heart rhythm disorders in recent years.

These disorders occur when the heart’s electrical circuits, responsible for keeping it pumping, become scrambled, sending faulty messages that override the heart’s natural pacemaker, a cluster of cells known as the sinus node.

This problem can be something you were born with or a consequence of coronary heart disease or ageing.

Arrhythmias can range from a slow heartbeat, where the organ can’t pump enough blood around the body, to the most dangerous form, ventricular fibrillation — the latter can be fatal without rapid emergency treatment.

Symptoms range from the mild to the alarming. Your heart may seem to flutter or skip beats. Or it can race like mad, even though you’re just quietly watching TV. Or you might find yourself suddenly exhausted, short of breath and prone to fainting.

The most common arrhythmia is atrial fibrillation, which causes a fast, chaotic heartbeat. This tends to occur mostly in people over the age of 60 and affects around a million Britons.

Here, random electrical charges cause the upper chambers of the heart (called the atria) to quiver, affecting the heart’s ability to pump blood efficiently.

The most serious consequence of untreated atrial fibrillation is stroke, because the heart’s feeble pumping action allows blood to pool, causing clots, which can break off and travel to the brain.

This is why one of the first steps in treating the condition is blood-thinning medication. Whatever the type of arrhythmia, medication can be used to try to control or prevent it.

Other options include giving a shock to the heart in order to restore a normal rhythm, or implanting a pacemaker or an ICD (implantable cardioverter defibrillator), which gives an electric shock if an abnormal heart rhythm is detected.

A minimally invasive alternative is catheter ablation.

This non-surgical procedure is becoming the gold standard way to resolve problems with heart rhythm, particularly atrial fibrillation, says Philippa Hobson, a senior cardiac nurse at the British Heart Foundation. It is performed by an expert cardiologist, known as an electrophysiologist, and takes between two and four hours. A thin wire with an electrode at its tip is threaded through the veins — usually starting in the thigh — to the heart to create scar tissue, either with heat or freezing, to destroy rogue tissue responsible for sending faulty signals, or effectively block abnormal electrical circuits in the heart.

However, as one leading cardiologist told us, it would be a dreadful shame ‘if the technological demands eclipsed the human side’.

Dr Edward Rowland, who is based at St Bartholomew’s Hospital in London, says that empathy and a caring attitude are important, too — particularly when patients are worried.

Successfully treating patients, he suggests, is not just about the ablation operation, but how the patient is treated in the run-up to it and their aftercare.

‘When your heart starts going crazy and you think you are going to die, it is not surprising that patients can become very anxious,’ says Dr Rowland.

‘Technical expertise is very important — but this has to be accompanied by other human factors to produce the best results possible.

‘There are some cardiologists who are excellent technically, but you would not necessarily send your closest family to them.’

So, how do you find an electrophysiologist equipped with not just the technological nous, but also the bedside manner that can help people conquer a distressing, and sometimes disabling, disease?

We asked 40 consultants across

the country who they believe are the top performers. Here, we reveal their choices — along with some of their reasons for selecting them.