Expert Diagnosis and Management of Heart Rhythm Disorders and Cardiac Electrical Disease
What Are Heart Rhythm Disorders?
The heart’s electrical system generates and conducts impulses that regulate the sequence and rate of cardiac chamber contractions. Degeneration of conduction tissue, structural cardiac disease, autonomic imbalance, or systemic illness can disrupt this system and cause an abnormal heart rhythm, known as cardiac arrhythmia.
Arrhythmias can produce a wide spectrum of symptoms, including palpitations, dizziness, pre-syncope, syncope, breathlessness, fatigue, and chest discomfort. Some patients have entirely asymptomatic rhythm disturbances that investigations detect incidentally. In others, symptoms occur intermittently and unpredictably. This can complicate diagnosis, as the electrical abnormality may be absent during testing.
Managing heart rhythm disorders requires careful consideration of this variability. Symptoms alone do not reliably indicate the nature or severity of the underlying electrical abnormality. Accurate diagnosis requires recording the heart rhythm during a symptomatic episode to determine whether abnormal electrical activity explains the patient’s symptoms. Patients with infrequent episodes may require extended monitoring or an implantable monitoring device to capture this information.
Other Services
Conditions Treated
Bradycardia
An abnormally slow heart rate causing fatigue, reduced exercise tolerance, dizziness, or fainting. May arise from sinus node dysfunction, atrioventricular conduction block, or medication effects.
Syncope
Sudden transient loss of consciousness caused by a temporary reduction in blood flow to the brain. Cardiac causes require electrocardiographic correlation to diagnose and include both bradycardic and tachycardic arrhythmias.
Cardiac Conduction Disease
Disorders of the heart's specialised conduction tissue including sick sinus syndrome, bundle branch block, and atrioventricular nodal disease, typically presenting with bradycardic symptoms or reduced exercise capacity.
Device-Related Conditions
Patients with existing pacemakers or implantable loop recorders require specialist review of device functions, stored electrogram analysis, reprogramming, or assessment in the context of new symptoms.
Heart Block
A conduction disorder in which electrical signals are delayed or blocked within the heart's conduction system. Complete heart block is a serious condition requiring prompt pacemaker implantation.
Palpitations
The subjective awareness of the heartbeat as rapid, irregular, or forceful. Characterisation requires correlation between symptoms and a simultaneous electrocardiographic recording.
Unexplained Dizziness or Episodes of Collapse
Recurrent unexplained dizziness, near-syncope, or collapse requires systematic exclusion of cardiac rhythm cause. Implantable loop recorder monitoring is the most reliable investigative strategy when standard monitoring has not captured the abnormality.
Advanced Diagnostic Assessment
Holter Monitoring
Continuous ambulatory electrocardiographic recording over 24 to 48 hours, used to detect arrhythmias that occur with daily activity but are absent at rest.
Extended Rhythm Monitoring
For patients with less frequent symptoms, external monitoring devices record heart activity over several days or weeks, increasing the likelihood of detecting an arrhythmia during a symptomatic episode.
Implantable Loop Recorder (Reveal Device)
This miniaturized subcutaneous device provides continuous ECG monitoring for up to three years. It is particularly useful for patients with infrequent syncope, unexplained palpitations, or suspected paroxysmal arrhythmias that standard monitoring has not detected. Clinical experience includes more than 30 loop recorder implantations at Level 3 independent competence.
Device Interrogation and Analysis
Specialist review of stored electrograms, sensing and pacing thresholds, lead integrity, and device counters in patients with existing pacemakers or implantable loop recorders.
12-Lead Electrocardiography
The foundational assessment tool in cardiac rhythm evaluation, identifying baseline conduction abnormalities, bundle branch block, atrioventricular block, pre-excitation, and prior myocardial infarction.
Cardiac Device and Rhythm Procedures
Permanent Pacemaker Implantation
A minimally invasive procedure performed under local anaesthesia in which a pulse generator is implanted under the skin of the upper chest and connected to the heart via one or two leads. The pacemaker continuously monitors heart rate and delivers electrical stimulation when the intrinsic rate falls below the programmed minimum. Over 100 permanent pacemakers have been implanted at Level 3 independent competence.
Temporary Cardiac Pacing
Short-term transvenous pacing is used in emergencies including complete heart block complicating acute myocardial infarction, hemodynamically significant bradycardia, and as a bridge to permanent pacemaker implantation. More than 100+ temporary pacing procedures have been performed at Level 3 independent competence.
Implantable Loop Recorder Insertion
A brief procedure under local anaesthetic in which the loop recorder is inserted through a small incision in the upper chest wall. The procedure takes approximately 15 to 20 minutes, and the patient is discharged the same day with remote monitoring established.
Pacemaker Follow-Up and Optimisation
Ongoing clinical review and device interrogation to confirm appropriate sensing and pacing function, review battery status, assess lead integrity, and optimise programmed parameters for each patient's individual needs.
Electrophysiology Assessment and Rhythm Management
Specialist evaluation of cardiac rhythm disorders using advanced ECG monitoring and targeted electrophysiological assessment to diagnose and guide management of bradyarrhythmias, tachyarrhythmias, and unexplained syncope.
International Expertise. Precision Cardiovascular Care.
100+ Permanent Pacemaker Procedures
100+ Temporary Pacing Procedures
30+ Implantable Loop Recorders
Specialist Device Follow-Up