Drafting Referrals to Electrophysiology and Cardiac Surgery

The problem

Referrals from general cardiology to subspecialty services — electrophysiology, cardiac surgery, advanced imaging, inherited cardiac conditions — need to be specific and well-structured. The receiving team needs to understand the patient's clinical situation quickly, what question you are asking, and what investigations have already been performed.

A vague or poorly structured referral delays the patient's journey and generates unnecessary back-and-forth. A well-structured one means the receiving clinician arrives at the appointment prepared and can focus on the clinical question rather than reconstructing the history.

Writing a clear, complete referral at the end of a busy clinic is not always easy.

How AI helps

An AI tool can take a bullet-point summary of the clinical situation and produce a structured, professional referral letter. You provide the clinical facts and the specific question for the receiving service. The tool produces the structure, headings, and prose. You check the clinical accuracy and add anything missing.

The tool is particularly useful for ensuring that all the standard elements of a subspecialty referral are present — indications, relevant investigation results, medications, the specific clinical question, and urgency. When you are writing in a hurry, it is easy to miss one of these. The tool's framework acts as a prompt.

A real example

Dr Helena is a general cardiologist referring a 52-year-old woman for electrophysiology assessment. The patient has symptomatic paroxysmal AF that has not responded to two antiarrhythmic agents. She is well, haemodynamically stable, and asking about catheter ablation.

Dr Helena opens an AI tool and types:

Draft a referral letter from a general cardiologist to an 
electrophysiology service.

Use these headings: Reason for Referral, Clinical Background, 
Investigations, Current Medications, Request.

Clinical details:
- Woman, 52, symptomatic paroxysmal atrial fibrillation (AF)
- Symptoms: palpitations, fatigue, occasional presyncope with longer episodes
- Duration of AF: 3 years
- Antiarrhythmic agents tried: two agents at therapeutic doses 
  (without naming specific drugs), both ineffective at maintaining sinus rhythm
- Echocardiogram: normal LV function, no structural disease, LA mildly dilated
- 24-hour Holter: documented paroxysmal AF, maximum ventricular rate 148 bpm 
  during episode
- Anticoagulation: on appropriate anticoagulation
- Request: assessment for catheter ablation
- Urgency: routine

Tone: professional and concise.

The tool produces a structured letter. Dr Helena reads it. She adds the specific medication names and confirms the echo date. She adjusts the urgency assessment — the patient's presyncope episodes make this slightly more than routine in her clinical view, so she amends the language. The letter is ready in six minutes.

Try it yourself

Things to watch for

Specific medication names must be verified. If you mention specific medications in your prompt, the tool will include them. If you ask the tool to infer medications from clinical context, it may hallucinate plausible but incorrect drug names. Always specify medications clearly or add them yourself after drafting.

The specific clinical question matters. A referral that asks "please see and advise" is less useful than one that asks a specific question: "Is this patient a candidate for catheter ablation given her symptom burden and failure of two antiarrhythmic agents?" The more specific your request in the prompt, the more specific the letter.

Urgency categories vary between services. What "soon" or "urgent" means to your local electrophysiology service may differ from general usage. Check your local referral pathway for the correct urgency language before finalising.

Investigation dates and values must come from you. The tool cannot generate accurate echocardiogram measurements, Holter findings, or blood results. Any specific values in the letter come from your prompt. Anything the tool adds that you did not provide should be reviewed with particular care.

Remember: AI is a helpful assistant, not a clinician. You make the call.