Dr Nuta's Postgraduate training was all completed in the UK, mostly in the South West. Further Specialist Registrar training in Cardiology in Exeter and Plymouth (Derriford Cardiothoracic Centre) with 2 years sub-specialty training in cardiac devices for heart failure and arrhythmia management. Dr Nuta was appointed in Gloucestershire in May 2008 to develop the specialist cardiac devices service in the county. Cardiac devices (bi-ventricular pacemakers for cardiac resynchronization of the failing heart and implantable cardioverter defibrillators for treatment of dangerous heart rhythm disturbances) are now implanted in Cheltenham without the neeed for patients to travel to Bristol or Oxford for the procedure or follow-ups. We have now repatriated the majority of devices patients previously implanted out of county. Heart failure is a common condition resulting in severe breathlessness, fatigue and exercise limitation. The most common causes are either related to heart attacks or simply dilatation and impairment of cardiac muscle's ability to contract efficiently. Some patients suffering from heart failure may develop a tendency to dangerous life threatening arrhythmia and rarely cardiac arrest. Traditionally heart failure has been treated with medication, but many other surgical treatment options have now become standard when medication either reaches a ceiling or fails altogether. Identification and treatment of suitable patients with cardiac devices is essential in order to improve the outcome of these patients. Dr Nuta has a specialist interest related to pacing in heart failure (Biventricular pacing), implantation and programming of internal cardiac defibrillators (ICD) to treat dangerous ventricular arrhythmia, as well as the assessment of palpitations, arrhythmia and risk of sudden cardiac death and family screening for arrhythmia. Referrals are welcome from patients (via GP referral letter), GPs and Consultant colleagues. Research: Research in arrhythmic risk stratification after myocardial infarction undertaken in Taunton and resulted in many specialist publications and presentations at national and international meetings.