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Cardiology

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Cardiology

Cardiology is the medical specialty that diagnoses and treats disorders and diseases of the heart including congenital heart defects, coronary artery disease, heart valve problems and heart failure.

Cardiology is a large multidisciplinary unit which provides both secondary and tertiary outpatient and inpatient services for the Waikato and the wider the Midland region.

The department includes 12 cardiologists, plus registrars and house officers, cardiac technicians, MRTs and echosonographers, specialist nursing and allied health staff, and clerical support. 

Cardiology is part of the Cardiology, Cardiothoracic and Vascular Surgery (CCTVS) service.

The main areas within Cardiology at Waikato Hospital are:

Our 50 bed Cardiac Care Unit (CCU) (which includes an 8 bed coronary care unit), provides world-class care for those with cardiac conditions in the Waikato and the greater Midlands Region. In future, with further collaboration and integration of services with the associated DHBs in the Midlands Region, there will be an even more streamlined and efficient process for getting patients from regional referral centres prompt access to the care they require. This process is well underway with the opening of the new Cardiac Regional Unit within CCU which is currently comprised of 6 beds for regional patients with a plan to expand the capacity of this unit in future.

There are fifteen cardiologists with a variety of subspecialty skills and interests to provide comprehensive care of our patients across all the subspecialty disciplines of cardiology.

Percutaneous coronary intervention (PCI) has been a mainstay in the contemporary management of acute coronary syndromes (heart attacks) and coronary artery disease since the 1990s. It is an ever-developing technology whereby atherosclerotic plaques in coronary (heart) arteries which are responsible for acute coronary syndromes and coronary artery disease can be treated in a Cardiac Catheterisation Laboratory (Cath Lab) with minimally-invasive approaches through either the wrist or groin blood vessels.

Waikato has four Cath Labs which provide a 24/7 service for emergency treatment of acute coronary syndromes for over one million New Zealanders who call the Midlands Region (Waikato, Taranaki, Bay of Plenty, Lakes and Tairawhiti DHBs) home and is run by a team of well-organised and highly-trained nursing staff, radiographers, clinical physiologists and interventional cardiologists.

The Cath Labs in Waikato routinely utilise the most contemporary adjunctive technologies, including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and rotablation, and furthermore, remains on the frontier of the latest advancements in cardiology, being frequently involved in both local and international clinical trials.

Read more about Cardiology department 


Coronary Angiography

The Waikato Structural Programme is a leader in offering innovative percutaneous treatment options for structural cardiac pathologies and it was the first hospital in New Zealand to perform transcatheter aortic valve implantation in 2008. It was also the first hospital to lead and develop a transcatheter aortic valve intervention programme in New Zealand.

The services offered include, but are not limited to, percutaneous aortic valve intervention, percutaneous atrial septal defect, ventricular septal defect and patent foramen ovale closure, percutaneous balloon aortic and mitral valvuloplasty, aortic pseudoaneursym intervention and aortic coarctation stenting.

The programme performs percutaneous aortic valve interventions on a weekly basis, working closely in a highly multi-skilled heart team which includes interventional cardiologists, cardiac surgeons, intensivists, geriticians, cardiac anaesthetists, cardiologists,  senior nurses, senior physiologist and radiographers.

In addition to standard cardiac imaging technologies, the department is also capable in performing 4D tranesopheageal echocardiography and 4D Cardiac CT with latest integrated imaging platforms such as the Philips HeartNavigator and EchoNavigator.

The department also works closely with the industry by participating in clinical trials and devices that would pioneer new therapies and improve current ones. The department is involved in first in-man clinical trials for percutaneous aortic, mitral and tricuspid valves intervention.

The department provides in-house post-graduate training for structural intervention via the structural fellowship programme and can accommodate one structural fellow a year

The Waikato Electrophysiology Department is the regional centre for Cardiac Electrophysiology for Midland. Interventional procedures such as the implantation of pacemakers, ICDs, loop recorders and cardiac resynchronisation therapy are carried out in timely manner. Electrophysiology studies are performed for a full range of arrhythmias including the capacity for 3D mapping and ablation (by both cryo and radiofrequency) of complex atrial and ventricular tachyarrhythmias. Arrhythmia advice is provided on inpatients across the region.

In addition to our inpatient services, the Waikato Electrophysiology Department reviews patients in the clinic, supports the Cardiac Inherited Disease Registry and conducts pacemaker and ICD clinics within the Waikato DHB and, until recently, across the Midland region.

As Waikato is an accredited site for RACP Cardiology Training, we provide in-house training in electrophysiology for advanced trainee registrars in cardiology. There is an Electrophysiology Fellow who is undergoing post-specialist training to gain a super-speciality in cardiac electrophysiology. Many of the electrophysiologists currently practising in New Zealand trained here. Waikato Hospital is the centre for proctoring left ventricular lead implantation using the Worley sheath implantation technique for Australasia. Previously, Waikato Electrophysiologists have proctored the implantation of subcutaneous ICDs across Asia and Australia. Alongside their clinical duties, the Waikato Electrophysiology Department has academic affiliations with the University of Auckland, the University of Adelaide and the University of Otago for both basic and clinical research. The Department also participates in multi-centre clinical trials of medications and devices that are hoped to provide future improvements in cardiac electrophysiological treatments.

Echocardiography
Waikato has a large echocardiography department, employing 8 cardiac sonographers and 2 trainees who perform over 9000 scans a year. Echocardiography services include transthoracic and transoesophageal echocardiography, as well as exercise and dobutamine stress echocardiograms.

CT
Cardiac CT services at Waikato DHB include CT coronary angiography, calcium scoring as well as cardiac CT.

MRI
Cardiac MRI is routinely performed at Waikato hospital, with combined cardiology and radiology reporting to provide a comprehensive diagnostic service.

Our nursing group is led by an experienced senior nursing group. There is a wide range of nursing experience from the new entrant nurse to the more experienced cardiology nurse, with a wide range of nationalities which supports an excellent team environment.  

Nurses have opportunities to manage the acute cardiology patient through to the more complex, high-needs patient. Nurses also play an integral part in supporting the palliative aspects of cardiology.

Nurses work within a multidisciplinary team supporting both patient and family/whanau to provide optimal care and a safe discharge.

Nursing students and new staff are supported by a Nurse Educator and an experienced preceptor to develop their skills and knowledge of cardiology nursing

The breadth of cardiac nursing experience and knowledge in Waikato Hospital is second-to-none.

In addition to the community heart failure and secondary prevention nurses, the cardiology service is supported by a number of Clinical Nurse Specialists (CNS) - from the Cardiology Patient Flow CNS (who plays an integral part in managing patient flow with an aim to provide equity for cardiology patients across the Midland Region) to Electrophysiology to Cardiac Inherited Diseases to Structural Heart Disease. Each play a key role in the day-to-day functioning of the service and care of both inpatients and outpatients in the Waikato and greater Midlands Region. 

Location

Waikato Hospital, Waiora Waikato Hospital Campus, Pembroke Street, Hamilton

  • Cardiac Care wards (CCU1, CCU2, CCU3), Level 1, Menzies Building
  • Cardiology Clinics (Meade Clinical Centre)
  • Waikato Integrated Heart Failure service (based at Waikato Hospital but provide inpatient and community services)
  • Cardiac Secondary Prevention service (education and rehabilitation service based at Waikato Hospital but provide inpatient and community services)

Contact

Phone 07 839 8899 for all hospital departments and services

Referrals are by general practitioners (GPs) or other health specialists.

Non-acute (non-urgent) referrals will initially be seen at a clinic appointment.