From diagnosis to treatment, explained clearly
We offer the full range of tests and treatments for heart rhythm problems — from simple diagnostic recordings to complex ablation procedures. Below, we’ve grouped them so you can find what’s relevant to you. Every procedure is explained in the same everyday language we’d use with you in clinic.
Ablation Procedures
What is ablation?
Ablation is a keyhole procedure that modifies the small area of heart muscle responsible for an abnormal rhythm — usually by heating it (radiofrequency), freezing it (cryoablation), or applying high-energy electrical pulses (pulsed field ablation) via a catheter, so it can no longer conduct the faulty electrical signal. All our ablations are carried out under heavy sedation and strong pain relief.
For complex cases, we believe the best results come from two of our consultants working together.
Atrial Fibrillation Ablation
This procedure aims to stop AF completely, or make it infrequent enough that medication works better. Using 2–3 small punctures at the top of the leg, we ablate around the four veins that feed into the heart’s top-left chamber — disconnecting them electrically, since these veins are usually where AF signals originate. It typically takes about 2 hours, occasionally longer, and most patients need to be on blood-thinning medication before, during and after.
Atrial Flutter Ablation
A more straightforward procedure than AF ablation, this targets the small area in the right atrium responsible for flutter, using two or three catheters passed through the vein at the top of the leg. Some patients need to be on warfarin beforehand.
Supraventricular Tachycardia Ablation
The most commonly performed ablation, usually carried out straight after an electrophysiological study identifies the abnormal circuit. Once located, the area is treated with radiofrequency energy so it can no longer conduct the abnormal signal — performed under sedation, so it’s painless.
Cryoablation
Rather than heat, cryoablation uses freezing to modify heart tissue. We tend to use it where there’s a higher risk of damaging the heart’s normal electrical wiring, since it’s gentler on surrounding tissue and virtually painless — though recurrence rates can be slightly higher and procedures can take longer. We’ll discuss with you whether it’s the right choice for your procedure.
Pulsed Field Ablation
Pulsed field ablation (PFA) is the newest of our ablation techniques. Rather than heat or freezing, it uses very short, high-energy electrical pulses delivered through a specially designed catheter to disable the heart tissue causing the abnormal rhythm — a process called electroporation. Because it targets heart muscle specifically and largely spares surrounding structures such as the oesophagus and the nerves that control the diaphragm, it can reduce the risk of certain rare complications seen with heat- or freezing-based ablation, and procedures are often quicker. We’ll let you know if PFA is a suitable option for your particular procedure.
Devices
Pacemakers
A pacemaker is fitted when the heart rate is too slow. It’s a small device, about the size of a cigarette lighter, implanted under the skin near the collarbone, with wires connecting it to the heart muscle to deliver a small stimulus that keeps the heart beating steadily. Modern pacemakers are smart — they’re programmed to let your natural rhythm take over wherever possible, only stepping in when needed, which helps the battery last longer. Fitted under local anaesthetic and sedation, the procedure takes about an hour.
Implantable Cardiac Defibrillator (ICD)
An ICD works like a pacemaker but with an added safety net: it can detect dangerous heart rhythms and correct them, either by pacing the heart rapidly or, if needed, delivering a short, high-energy shock to reset it. Fitted the same way as a pacemaker, under local anaesthetic and sedation.
Cardiac Resynchronisation Therapy (CRT)
CRT is used where the heart’s pumping function is significantly reduced and heart failure is present. An additional wire helps retime the heart’s contraction so it pumps more efficiently — often combined with a defibrillator (ICD) in one device. Fitted under local anaesthetic and sedation, in the same way as a standard pacemaker.
Diagnostics
Electrophysiological Study
An invasive test to pinpoint the cause of an abnormal heart rhythm. Catheters are passed into the heart via the vein (and occasionally the artery) at the top of the leg to measure the heart’s electrical activity and, where needed, deliberately trigger the abnormal rhythm to help us diagnose it precisely. In most cases, we’re able to treat the cause with ablation in the same sitting.
Cardiac Catheterisation
A diagnostic procedure that images the coronary arteries, measures how well the heart’s left ventricle is pumping, and checks pressures throughout the heart and major blood vessels — using a dye visible on X-ray, delivered via catheters passed through the leg. Local anaesthetic makes it virtually painless, and most patients don’t need sedation.
Heart Rhythm Monitoring
Small, comfortable adhesive patches record your heart rhythm continuously for anywhere from 24 hours to two weeks, while you carry on with normal daily life. You can mark the exact time any symptoms occur using a button on the device, and keep a diary alongside it — we then correlate the two to reach a diagnosis. The device is returned by post afterwards, in packaging we provide.
Implantable Loop Recorder
For symptoms too infrequent for even two weeks of monitoring to catch, a loop recorder — about the size of a pen cap — can be implanted just under the skin through a small incision, lasting up to three years. It records continuously in a loop, saving a recording whenever you (or it, automatically) flags an event, which can then be downloaded without removing the device. Fitted and removed under local anaesthetic in around 15 minutes.
Stroke Prevention
Left Atrial Appendage Occlusion (LAAO)
In patients with AF, most stroke-causing clots form in a small pouch of the heart called the left atrial appendage. LAAO is a keyhole procedure that seals this pouch off using a small device, so no blood — and therefore no clots — can collect there. Taking 1–2 hours under general anaesthetic, research shows it’s as effective as warfarin at reducing stroke risk, without the bleeding risk, daily tablets or regular blood tests that come with anticoagulant medication. It’s a good option for patients who can’t tolerate long-term blood-thinning tablets.
Other Procedures
Direct Current Cardioversion
Sometimes an abnormal rhythm can be stopped simply by resetting the heart’s electrical system — a bit like restarting a computer. Under heavy sedation, a short electrical shock is delivered across the chest via large electrode pads, usually resetting the heart to a normal rhythm, with medication used afterwards to help maintain it. Most commonly used for AF and atrial flutter.