Dear Dr Thomson,

Thank you for referring your patient, Mr Longman, to me.
I conducted a thorough cardiovascular investigation including 24-hour Holter monitoring.
The monitoring showed several episodes of AV block and bradycardia at 25 beats per minute.
As your patient is in good general health, I propose to proceed with the implantation of a dual chamber pacemaker.        I have explained this procedure to Mr Longman, and arranged for it to take place at Sheffield Royal Infirmary on the 25th of February 2016.

Thank you again for your referral. If you have any questions, please conatct me.

Yours sincerely,

Dr Smith, MD