Arrhythmia Service

Your GP may refer you to the Arrhythmia Service if you have a known arrhythmia that has stopped responding to treatment, or troublesome palpitations or blackouts.

Why would your GP refer you to the Arrhythmia Service?

Your GP may refer you to the Arrhythmia Service if you have a known arrhythmia that has stopped responding to treatment, or troublesome palpitations or blackouts. You may also be referred if you have close relative who has died suddenly and unexpectedly below the age of 35. You may be referred for screening to look for an inherited heart condition. Where the patient is known to have heart disease (such as a previous heart attack), urgent referral should be considered.

What tests will the GP do?

Your GP should send you for some diagnostic tests prior to referring you to the hospital based Arrhythmia Service.  Tests that they may do include:

  • 12 Lead ECG – copy should be sent with the referral
  • 24 Hour Holter Monitor or other such rhythm recording – copy should be sent with the referral
  • full blood count to exclude anaemia, electrolytes, liver function tests, glucose assessment, and thyroid function tests; and a cholesterol and lipid assessment for those over 35 years of age who have not had a recent cardiovascular risk assessment

It is important that your GP sends in ALL diagnostic test results that have been performed in primary care or other centres.  This will ensure that your referral is managed appropriately and in a timely manner.

Your referral may be rejected if the diagnostics tests are not present.

What will happen at the first appointment?

If this is your first appointment then you may be seen by the Consultant Cardiologist or he may have requested for you to be seen by the Arrhythmia Nurses.


At your appointment you will have a full examination including a history of your symptoms and may be asked to have another ECG.   Following the outpatient appointment you may be sent for more diagnostic tests which may include:

  • 24 hour Heart Monitoring
  • Exercise ECG
  • Echocardiogram  (ultrasound of the heart)
  • Cardiac MRI
  • Angiography

Electrophysiology Study – this maybe done here at the Royal Surrey or you may be referred St George’s Hospital in London

When will you get the results of your tests?

Your GP will be written to after you have had all of your diagnostic tests.  This means, if you were referred for one test then your GP will get a results letter after this investigation has been done and reported.  If you have been referred for more than one diagnostic test, then your GP will get a letter after all of your results have been reviewed.  This will help your GP understand what is happening with your care and treatment.

What happens next?

If your results indicate that your symptoms are not related to your heart then the Consultant may write with your results and discharge you back to your GP for your GP to refer you to another more appropriate service. If this occurs then you will not be brought back to an outpatient clinic.

If your results are negative but the Consultant or Arrhythmia Nurse would like to have a discussion with you, then you may be offered a telephone appointment.  This appointment allows you to stay at home or by your telephone rather than coming to the hospital site. It provides convenience for you and allows you to discuss any concerns that you still may have with a specialist member of the Cardiology Team.  

The other option is that you will be brought back to an outpatient clinic to discuss the results and any further treatment or monitoring that is required. 


There are a range of options depending on the heart problem that is diagnosed. The treatments range from:

  • Medications to help slow your heart rhythm down if it is too fast
  • DC Cardioversion to resynchronised the heart rhythm back into a normal pattern
  • Implantation of a cardiac pacemaker or defibrillator  
  • Ablation procedures

Where can I find more information?

Arrhythmia Alliance

Access the Arrhythmia Alliance website here.

Unit 6B, Essex House, Cromwell Business Park, Chipping Norton, OX7 5SR, UK
+44 (0) 1789 867 501 |


British Heart Foundation


Access the British Heart Foundation website here.


Heart Helpline for medical enquires 0300 330 3311


The Mayo Clinic – Patient Information

Read the Mayo Clinic patient information here.


Heart Rhythm Society – Patient Information

Access the Heart Rhythm Society website here.