Consultant Cardiologist & ElectrophysiologistExperience of more than 1,500 catheter ablation procedures.
When direct electrophysiology input may help
Referrals are welcome when symptoms, an ECG or the rhythm-treatment pathway are unclear. Referral does not need to wait until every investigation has been completed: the consultation can help decide what should happen next.
The focus is a practical specialist arrhythmia opinion and a clear plan — whether that is targeted investigation, medication, catheter ablation, reassurance or ongoing local care.
Patients you can refer directly
- Recurrent palpitations or intermittent racing heart with documented or suspected arrhythmia, even where the resting ECG is normal.
- New symptomatic AF, or AF where symptoms continue despite rate control.
- A patient with AF who would like to understand rhythm-control options, including whether AF ablation could be appropriate. The AF ablation decision guide may be useful to share with them.
- Recurrent SVT or atrial flutter, especially where episodes are leading to urgent-care attendance.
- An abnormal ECG, suspected pre-excitation, or an uncertain wearable or single-lead rhythm tracing.
- Troublesome ectopic beats, particularly when symptoms remain disruptive or there is concern about burden.
- Syncope or near-syncope where an arrhythmic cause is possible.
- An established rhythm problem where medication is ineffective, poorly tolerated or not preferred.
What the patient can expect
The review can clarify the likely rhythm, interpret available ECGs or monitoring, and explain whether further investigation, medication, cardioversion, catheter ablation or reassurance is most appropriate. Recommendations are shared clearly with you and the patient so that ongoing care can remain local where appropriate.
Opinion letters and residual questions
I will usually send an electronic letter setting out my opinion and recommendations on the same day as the consultation. I am happy to be contacted about residual questions and will usually respond promptly, so that the agreed plan can be taken forward without unnecessary delay.
Making the referral
Please include a concise clinical question, symptoms, ECGs or rhythm recordings, medication and relevant test results where available. For a difficult ECG or a concise arrhythmia question before referral, remote ECG and arrhythmia advice is available.
For an emergency or an acutely unwell patient, please use the appropriate urgent or emergency pathway.