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.