FAQs

While every effort is made to ensure the information presented here it is only to be used as a guide. Please consult the DVLA website for a comprehensive guidance regarding driving at www.direct.gov.uk/motoring under “Driver Licensing” and “Medical Rules”.

All information provided is applicable to Group 1 drivers (cars and motorcycles), please consult the DVLA website for Group 2 entitlements.

When can I drive after my Angiogram?
The DVLA does not restrict drivers having had an angiogram but does advise that patients suffering from angina occurring at rest, with emotion or behind the wheel only recommence driving when satisfactory symptom control is achieved.

We recommend patients DO NOT drive home on the day of their angiogram and ask them to organise a friend or relative to bring and pick up from the hospital. They are welcome to wait in the cardiac day case unit while you have the angiogram.

You do not need to inform the DVLA you have had an angiogram.

When can I drive after my Angioplasty?
The DVLA restricts driving for 1 week following angioplasty (stents) as long as there are no other co-factors restricting your driving.

You do not need to inform the DVLA you have had stents.

When can I drive after having my Pacemaker?
The DVLA restricts driving for 1 week following a pacemaker insertion as long as there are no other co-factors restricting your driving.
This also applies to “box change” patients who have had another pacemaker following battery run down.

The DVLA must be informed of pacemaker implantation.

When can I drive after having an ICD?
The DVLA restricts driving for 6 months following an ICD implantation.
If a patient has a shock from the device or symptomatic pacing therapy driving is resitricted for a further 6 months.

“Box change” patients who have had another ICD following battery run down are restricted from driving for 1 week.

The DVLA must be informed of your ICD implantation.

When can I drive after having Biventricular Pacemaker?
If the device is a Biventricular pacemaker alone the advice is the same as pacemakers.

If the device is an ICD Biventricular device the advice is the same as ICDs.

Can I drive after my coronary artery bypass (CABG)?
The DVLA restricts driving after a CABG for 1 month as long as there are no other co-factors restricting your driving.

The DVLA do not need to be informed of your CABG.

Can I drive after my Valve surgery?
The DVLA does not restrict drivers suffering from valve disease or patient having had repair or replacement of valves surgically.

The DVLA do not need to be informed of your valve disease or valve surgery.

What do I need to bring to hospital?
Patients are advised to avoid bringing any valuable personal property such as jewellery into hospital with them. Make sure all your belongings all packed away into a locked cupboard if you have to leave your bedside for any period of time. If you do have any valuable items, ask a relative to take them home where possible or ask a member of staff to send them to the main hospital safe.

Suggestions of what you might want to bring to make your stay more comfortable:

• Several changes of underwear, a few changes of clothing and shoes.
• Nightwear, dressing gown and slippers
• Toiletries: toothpaste and brush, soap, body creams, comb, shower/bath gel, shampoo, deodorant, make-up, shaving things and aftershave, tissues, wet wipes
• Towels
• Diary, notebook, writing materials
• A non-valuable watch
• Telephone numbers, address book, mobile phone and charger (for use off the ward)
• Snack food,
• Books, magazines
• Mug and own supply of preferred tea or coffee, powdered milk
• Family photos
• Bedside clock/personal stereo/radio with headphones, batteries
• Ear plugs
• A small amount of money in case you want to purchase something from the trolley or from our snack shop.

When can I go home after surgery?
There are a numbers of factors that will help your consultant decide whether or not you are well enough to go home after surgery. Firstly there should be adequate support at home; you need to be physically stable, with a controlled heart rate and blood pressure, and without other complicating factors.

Patients should also be adequately mobile meaning you should be able to climb a couple of flights of stairs with reasonable ease. Your wounds need to be healing satisfactorily or should at least be able to be cared for by a district nurse on a daily basis in the rare case of a significant wound problem.

When can I drive after having my Pacemaker?
The DVLA restricts driving for 1 week following a pacemaker insertion as long as there are no other co-factors restricting your driving.

This also applies to “box change” patients who have had another pacemaker following battery run down.

The DVLA must be informed of pacemaker implantation.

When can I drive after having an ICD?
The DVLA restricts driving for 6 months following an ICD implantation.

If a patient has a shock from the device or symptomatic pacing therapy driving is restricted for a further 6 months.

“Box change” patients who have had another ICD following battery run down are restricted from driving for 1 week.

The DVLA must be informed of your ICD implantation.

When can I drive after having Biventricular Pacemaker?
If the device is a Biventricular pacemaker alone the advice is the same as pacemakers.

If the device is an ICD Biventricular device the advice is the same as ICDs.

Can I go back to work after Surgery?
Most younger patients should be fit to return to work after surgery, and older patients should gain more enjoyment from their activities during retirement. In general terms, patients with a sedentary occupation are ready to return to work by about 6 weeks, those with a more strenuous activity will take up to 3 months.

What activities can I do after Surgery?
Physical activities such as walking are encouraged from the time of discharge. You can begin cycling, yoga etc. approximately four weeks after discharge, so long as you find it relaxing rather than strenuous and build it up slowly, steadily and gradually. You should be able to undertake most light household and gardening activities by about the third or fourth week post discharge. Ask at your 6 week post op check if you can start swimming.

Patients are also encouraged to return to normal patterns of sleeping as soon as possible.

Sexual activity may also continue when both the patient and partner are comfortable with the idea.

Why do I need coronary artery bypass grafts?
When performing an angiogram your cardiologist has seen narrowings in the coronary arteries which are causing your symptoms of angina or breathlessness.
Your cardiologist has decided that these narrows are not suitable for medical treatment alone or angioplasty (stents). This is usually because there are several narrowings in several arteries.

During surgery your cardiac surgeon will attach veins (usually taken from your legs) to the aorta (main blood vessel leaving the heart) or an artery (from your chest wall) to the artery with the disease after the narrowings. This allows blood flow to your heart muscle bypassing the diseased section of the artery.

How long do my bypass grafts last?
A coronary bypass will last a long time, although exacts times vary by patient.
If an artery is used as a bypass it will usually last longer than a vein bypass graft. Typically bypass operations last 10 years, with some patients requiring more than one bypass or may even require angioplasty (stents) as well.

Why do I need valve surgery?
Valves work to ensure blood only flows one way through your heart but can sometimes be damaged by inflammation, infection, degreneration. This means blood may leak into another chamber or have difficulty getting past a valve that is narrow. Surgery works to either repair the valve or replace it altogether, ensure normal blood flow can be resumed.

How long will my valve last?
If a pig valve (porcine valve) is used it will typically last 10 – 15 years.
If a mechanical valve is used it should be for life.

What should I bring with me?
As the majority of our procedures are day case procedures you do not need to bring many items with you. Night clothes, toiletries and a change of clothes in case you stay over night are recommended.
Please bring all your medications with you, you will be able to take them on the ward unless specifically asked not to.

Should I take my medication on the day?
All patient cases are different. Please follow any medication advice given in your letter or the nurse at the pre-admission clinic.

When can I go home?
The majority of patients go home the same day of their procedure.
Exceptions are pacemakers, ICDs and biventricular pacemakers which will need to stay the night to have an X-ray and pacemaker check the next day.
Rarely angiogram and angioplasty patients may need to stay over night if the case is complicated, so we recommend you bring night clothes and fresh clothes for the next day.

Why do I need a coronary angiogram?
An angiogram is used to directly see the arteries which supply your heart with blood, oxygen and nutrients.

Other tests can indicate problems with the blood flow to your heart (such as exercise stress testing and myocardial perfusion scans) but an angiogram is the best way to see how bad the narrowings are and if these narrowings are causing your chest pain and shortness of breath.

What are the risks of having an angiogram?
Risks included: Bleeding / bruising at the access site (where the catheters go in to reach your heart), injury to artery (dissection), stroke, heart attack and death. The overall risk of major complication is about 1 in 1000 patients, but may differ slightly depending on operator.

Can I choose if they go in my wrist or groin artery?
Patient choice is very important to us at the Lancashire Cardiac Centre and if you have a preference where the doctor uses to gain access for your angiogram let them know. Your doctor will consider your medical history, along with the type of procedure you are having (and might be having) and will access your pulses at the wrist and groin. If they feel your preference is not advisable they will explain why and offer the alternatives.

What are the other options to having an angiogram?
Most other methods only indicate if blood flow is causing your angina or shortness of breath. Cardiac computer topography (CT) can visualise the coronary arties but you may still require angioplasty to fix the narrowings, which is the same as an angiogram but more invasive.

Who will perform my angiogram?
Either your consultant cardiologists or one of their registrars with excellent experience of performing angiograms will perform your angiogram. The registrar will still have the consultant present and watching at all times.

Why do I have narrowings in my coronary arteries?
The heart is a muscle which needs it’s own specialised network of blood vessels. Angina is caused by narrowings which limit blood reaching your heart muscle. These tightenings are caused by thickening of the walls of the artery, known as atherosclerosis. This process of thickening happens over time and can just be the result of aging but is speeded up by high cholesterol, smoking, being overweight, diabetes, poor diet and lack of exercise.

How long will my angiogram take?
Angiograms usually only take about 30 minutes but it depends on the patient anatomy and how easy it is to find your coronary arteries.

It is important to remember that while you may be asked to attend hospital early, your procedure could take place any time on that day, depending on the number of cases and emergency cases that day. Try to remain patient and staff will keep you informed as they find out more information.

Why do I need angioplasty?
When performing an angiogram (or sometimes a cardiac CT) your cardiologist has seen narrowings in the coronary arteries which are causing your symptoms of angina or breathlessness.

During angioplasty your cardiologist will insert stents at the narrowings which will hold the artery open and allow normal blood flow to your heart muscle.

What are the risks of having angioplasty?
Risks include: Bleeding / bruising at the access site (where the catheters go in to reach your heart), injury to artery (dissection), stroke, heart attack and death. Complications vary by a patient-to-patient basis, some cases may be higher risk than others, but the overall risk is around 1 in 200 patients having a major complication.

Can I choose if they go in my wrist or groin artery?
Patient choice is very important to us at the Lancashire Cardiac Centre and if you have a preference where the doctor uses to gain access for your angiogram let them know. Your doctor will consider your medical history, along with the type of procedure you are having and will access your pulses at the wrist and groin. If they feel your preference is not advisable they will explain why and offer the alternatives.

What are the other options to having angioplasty?
There are 3 possible outcomes following an angiogram that shows disease in your arteries; medical treatment (tablets), angioplasty or coronary artery bypass grafts.

Your doctor will discuss with you following your angiogram what they feel are the best options for you. Small amounts of narrowings may only require medication, narrowings which are limiting blood flow may require stents (angioplasty) and multiple narrowings in multiple arteries may require coronary artery bypass grafts (surgery).

Please discuss any questions or worries regarding your options with the cardiology doctors (and surgeons if you are referred to them).

Who will perform my angioplasty?
Your angiogram will be performed by your consultant cardiologists along with either a cardiology registrars or cardiology nurse to help in the procedure.

How long will my angioplasty take?
Angioplasty times vary depending on how much disease is in the arteries and how many arteries are involved.

Typically 1 hour is quoted but don’t worry if it is longer or shorter, it doesn’t mean there is a problem. Your cardiologist will explain if it is taking longer than expected and why. If you are uncomfortable tell the doctor and a nurse may be able to give sedation or pain relief to relax you.

How long will the stents last?
Stents are only a recent entry to cardiology compared to coronary artery bypass grafts, but they have been seen to last at least as long as bypass grafts (typically 10 years).

To help them last as long as possible it is important you keep taking the medication prescribed by your cardiology doctor, smokers should quit and diet and activity should be looked at (the cardiac rehabilitation team should be able to help you here).

Why do I need a pacemaker?
To function normally the heart has an electrical nerve system which tells the heart when to beat. If this system is weakened through age or heart disease the heart may not beat every time it is required. This can cause dizziness or faints/blackouts.

The pacemaker helps to regulate the heart rhythm, working the heart when the heart should beat but doesn’t, and should stop the faints / dizziness.

What are the risks of having a pacemaker?
Risks include: Haematoma 1-2% (a collection of blood under the skin), Pneumothorax 0.5% (air trapped next to the lung), infection1%, lead dislodgment 1%.

Can I choose which side it goes on?
Usually pacemakers are inserted on the left side of the chest below the collar bone as most people are right handed. If you are left handed inform the doctor or staff in the pacemaker laboratory.

Some patients may have pacemakers fitted alongside having heart surgery, in this case the pacemaker is implanted in the abdominal region and the leads attached on the outside of the heart.

What are the other options to having a pacemaker?
For any symptom which has been shown to be caused by low heart rates or pauses in heart rates a pacemaker is the only option.

Who will perform my angioplasty?
Your angiogram will be performed by your consultant cardiologists along with either a cardiology registrars or cardiology nurse to help in the procedure.

Who will implant my pacemaker?
Either your cardiology consultant or their cardiology registrar with excellent experience of inserted pacemakers may insert your pacemaker. If the registrar inserts the pacemaker their consultant will be present at all times.

How long will my pacemaker implant take?
Typically pacemaker implants take around 1 hour but individual anatomy can make it more difficult sometimes to feed the lead(s) to your heart. Your doctor will let you know if it is taking longer than expect to keep you at ease. If you are uncomfortable inform the doctor or pacemaker team and sedation and pain relief may be able to be given.

How long will the pacemaker last?
Pacemakers last around 5 -8 years depending on what settings are on the pacemaker and how much you use it.

When the battery is found to be low you will be listed for a new pacemaker which is done in a similar way to your first pacemaker but uses the existing leads in your heart.

Why do I need a biventricular pacemaker?
Sometimes patients who have long standing heart disease or a family history of particular types of heart disease can have a weak heart which doesn’t pump blood efficiently. Some of these patients may benefit from a biventricular pacemaker, which works to resynchronise the heart making it work more effectively.

However not all patients have all their symptoms (shortness of breath, fatigue, ankle swelling) removed by these devices – everyone reacts differently to the treatment and this is something you should discuss with your cardiology doctor.

What are the risks of having a biventricular pacemaker?
Risks include: Haematoma 1-2% (a collection of blood under the skin), Pneumothorax 0.5% (air trapped next to the lung), infection1%, lead dislodgment 5%.

Can I choose if which side it goes on?
Usually pacemakers and biventricular pacemakers are inserted on the left side of the chest below the collar bone as most people are right handed. If you are left handed inform the doctor or staff in the pacemaker laboratory.

Some patients may have pacemakers fitted alongside having heart surgery, in this case the pacemaker is implanted in the abdominal region and the leads attached on the outside of the heart.

What are the other options to having a biventricular pacemaker?
While medications play a vital role in controlling the symptoms and progression of the disease some patients require a biventricular pacemaker to make the heart beat much more effectively.

Who will implant my biventricular pacemaker?
Your pacemaker may be inserted by your cardiology consultant and their cardiology registrar with excellent experience of inserted pacemakers.

Who will implant my biventricular pacemaker?
Either your cardiology consultant or their cardiology registrar with excellent experience of inserted pacemakers may insert your pacemaker. If the registrar inserts the pacemaker their consultant will be present at all times.

How long will my biventricular pacemaker implant take?
Typically pacemaker implants take around 1 hour but individual anatomy can make it more difficult sometimes to feed the lead(s) to your heart. Your doctor will let you know if it is taking longer than expect to keep you at ease. If you are uncomfortable inform the doctor or pacemaker team and sedation and pain relief may be able to be given.

How long will the biventricular pacemaker last?
Pacemakers last around 5 -8 years depending on what settings are on the pacemaker and how much you use it.

When the battery is found to be low you will be listed for a new pacemaker which is done in a similar way to your first pacemaker but uses the existing leads in your heart.

Why do I need a Internal Cardio-defibrillator (ICD)?
ICDs are implanted in patients that have had, or may be at high risk of having cardiac arrests (irregular and dangerous heart rhythms). An ICD works by stopping the irregular rhythm through either a fast pacemaker or a shock to the heart to restore normal activity.

What are the risks of having a pacemaker?
Risks include: Haematoma 1-2% (a collection of blood under the skin), Pneumothorax 0.5% (air trapped next to the lung), infection1%, lead dislodgment 1%.

Can I choose if which side it goes on?
Usually pacemakers and ICDs are inserted on the left side of the chest below the collar bone as most people are right handed. If you are left handed inform the doctor or staff in the pacemaker laboratory.

Some patients may have pacemakers fitted alongside having heart surgery, in this case the pacemaker is implanted in the abdominal region and the leads attached on the outside of the heart.

What are the other options to having an ICD?
While medications play a vital role in controlling many of the irregular rhythms some patients will still need an ICD to treat the few rhythms that medications can’t.

Some patients may not like the idea of having a shock and it is something you and your family need to think about first. Discussing it with the cardiology doctor may help and a cardiac arrhythmia nurse is available to discuss the implications the ICD may have.

Who will implant my ICD?
Your cardiology consultant and their cardiology registrar with excellent experience of inserted pacemakers will insert your pacemaker.

How long will my ICD implant take?
Typically ICD implants take around 1 hour and a half but individual anatomy can make it more difficult sometimes to feed the lead(s) to your heart. Your doctor will let you know if it is taking longer than expect to keep you at ease. If you are uncomfortable inform the doctor or pacemaker team and sedation and pain relief may be able to be given.

How long will the ICD last?
ICDs last around 3 – 5 years depending on what settings are on the ICD and how much you use it.

When the battery is found to be low you will be listed for a new ICD which is done in a similar way to your first ICD but uses the existing leads in your heart.