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GPs will be under pressure to improve their skills in reading ECGs after the Government set out new guidance for referral to heart specialists.

The Department of Health published a new chapter of the national service framework on CHD, focusing on arrhythmias and sudden cardiac death.

GPs should refer patients who suffer recurrent unexplained falls and first-degree relatives of under-40s who are victims of sudden cardiac death, the eighth chapter of the NSF states.

It also sets out signs and symptoms that warrant urgent referral to a specialist.

Dr Strat Liddiard, clinical lead for the CHD Collaborative and a GP in Poole, said: 'It does put some pressure on GPs to be better at reading ECGs. There are certain conditions where you must refer urgently, but that means you need to recognise [the signs].'

But Dr Gerald Partridge, medical CHD lead at Airedale PCT and a GP in Keighley, west Yorkshire, said primary care had been excluded from the care pathway, despite the fact that many GPs could use ambulatory ECG kits.

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