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Dr Ali Khavandi

Dr Ali Khavandi

Consultant Interventional Cardiologist

Specialises in complex angioplasty and advanced rhythm device implantation, General cardiology, Interventional cardiology, Ischaemic heart disease, Heart failure, Hypertension, Arrythmia, Atrial fibrillation, Valve disease, Complex angioplasty, Heart rhythm disorders and complex pacing, Dietary treatment of cardiovascular risk factors and exercise rehabilitation

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Advanced Palpitation Pathway

Advanced palpitation and loss of consciousness pathway – bespoke diagnosis and treatment

Many people who experience heart palpitations find them quite alarming, and this is one of the most common reasons people come to see me in clinic.

At Sulis Hospital Bath, we are able to provide an advanced palpitations pathway via the Bath Arrhythmia and Atrial Fibrillation Clinic. Designed from the ground up to be as convenient for you as possible, we use modern diagnostic rhythm and imaging technology to accurately assess the cause of your palpitations and then use this data to provide a robust diagnosis and effective (holistic) treatment plan for you.

Personalised evidence-based treatments, not rigid ‘tick-box’ protocols

I firmly believe, and my experience clearly shows, that one size does not fit all, especially when it comes to managing and treating heart palpitations. Treatment guidelines and protocols of course have their uses and should always be used as a starting point. Through the Bath Arrhythmia and Atrial Fibrillation Clinic, we are often able to improve significantly upon these baseline protocols, providing you with a superior service in which everything is tailored to your specific needs. This is a truly ‘holistic’ service, and I use that term to reflect consideration of all aspects of rhythm symptoms and treatment. We consider the whole patient rather than simply escalating to “treatment by numbers”.

By way of example, the traditional medical approach for somebody with palpitations is to monitor their heart for 24 hours. While this may appear to be a sensible approach, more often than not the person won’t experience any palpitations again within that 24-hour period, making the monitoring completely redundant. It does not lead to useful, robust data from which treatment can then be planned. This is why at Sulis Hospital Bath, the minimum period that we normally provide this type of monitoring to people is seven days, and we can go up to two weeks if needed. It’s not just a case of monitoring for a set period of time, it’s about monitoring specifically to obtain useful data.

Unlike the traditional, old-fashioned equipment often used for this monitoring, which has multiple leads on the chest and wires in a box that you need to carry around, we have access to modern, small, light, discreet and convenient equipment. You don’t need to take it off and you’re able to shower with it. You can even return it by posting it to us, rather than having to make an inconvenient trip to us to drop it off*.

*For insured patients monitoring equipment options may be defined

Implantable loop recorders

There is a group of patients I see who have been either having palpitations for a long time or intermittent episodes of loss of consciousness, without a firm diagnosis. Some will have had basic tests which were “reassuring” or speculative diagnoses. Others feel that their symptoms were dismissed or that they weren’t happy with the answers they were given, and these issues then hang over them without closure. Sometimes this will affect work or driving via the DVLA.

When they come to see me, we are able to use a tiny device called an implantable loop recorder to help see exactly what is going on in their heart to cause the palpitations or ‘blackouts’. This device is roughly half the size of a modern USB stick, and is inserted just under the skin on the chest wall through a minimally invasive procedure under local anaesthetic.

This implantable loop recorder records your heart rhythm ECG continually for up to three years. The data it captures is uploaded wirelessly through a home monitoring modem we give you, so if there is any unusual heart activity the system will pick it up and notify our team. It really is an incredibly helpful diagnostic and monitoring tool and will provide a clear diagnosis.

I have found this has been extremely helpful for people who have suffered symptoms for many years without explanation, as you’ll read in the patient story below. Through this technology, we are often able to find a definitive answer and then provide an effective solution for what was previously put down as ‘unknown causes’.

The Bath Arrhythmia and Atrial Fibrillation Clinic

Should you be worried about palpitations or atrial fibrillation, please contact my PA, ‘Tash’ (Natasha Jones), on 01761 422287 today to schedule a consultation with me. You will be able to select a time that is convenient to you including evening clinics. When we meet, I will discuss and arrange any diagnostic tests needed to determine exactly what is causing your palpitations. If an implantable loop recorder is needed for this, we will arrange a time to put this in. With our advanced diagnostic equipment, pacing technologies and surgical techniques, we are able to provide you with a convenient, effective and efficient pathway to get your palpitations successfully controlled.

Patient stories

Simon Newton

I didn’t realise anything was wrong with my heart. For a number of years prior to the fall, I had been experiencing a few funny turns where I felt like I was going to pass out. It was a strange feeling, and very hard to explain to anyone. Even though I tried to ignore it as much as possible, I was aware that these episodes seemed to be becoming more frequent and lasting for longer.

When I fainted in London I was taken to hospital, but they couldn’t work out what had caused me to faint. After running a number of tests, they told me that my heart was ‘odd’ and that I should get it looked at. This was slightly concerning, so I contacted my private healthcare provider who booked me a consultation with Ali at Sulis Hospital Bath.

Talking with Ali, again it was difficult to explain precisely what these funny turns felt like. Eventually, I ended up saying to Ali, ‘It’s a bit like a déjà vu feeling.’ As soon as I said those words, Ali told me he knew exactly what was going on – syncope.

Syncope, as I was to learn, was used to describe fainting due to a lack of blood to the brain. To effectively treat and manage the problem, Ali would need to see data from my heart during an episode of syncope; he needed to ‘catch it’ when it was happening. To get this data, he put an implantable loop recorder in my chest to measure and record all the electrical signals in the heart. I was able to upload the data from this recorder wirelessly and send it to Ali and his team remotely, which was really convenient.

Ironically, I didn’t have another funny turn for about 3 months (my heart decided to wait until I was on a plane to Italy!). When I returned home, I had a phone call from Ali asking where I was and telling me I needed to come to Sulis Hospital Bath straight away. The monitoring system had alerted him to the syncope – in fact it showed him that my heart had stopped beating for 27 seconds during my flight to Italy.

It was the data from the loop recorder that showed Ali very clearly that I needed a pacemaker to correct the problem. Since the pacemaker went in, I’m glad to say that I haven’t passed out again. When I last saw Ali, he was able to see that the pacemaker had kicked in 276 times over the last 12 months, so it is clearly needed and doing its job well. Without the implantable loop recorder to show exactly what the problem was, it is highly likely that I would still be suffering from my weird turns to this very day.

I am now back to normal health and have run a number of marathons since the pacemaker went in. Ali really knows his stuff and I highly recommend him. (I can also personally attest to the usefulness of an implantable loop recorder.)

Dr Ali Khavandi

Dr Ali Khavandi

Consultant Interventional Cardiologist

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