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Cardiac arrhythmia (irregular heartbeat)

A cardiac arrhythmia can lead to an abnormally slow or fast heart beat. We explain how arrhythmias can be treated.

Man holding his chest in discomfort needs cardiac arrhythmia treatment for his atrial fibrillation and palpitations
A cardiac arrhythmia is when your heartbeat is abnormal. This may mean it beats too fast, too slowly, or with an irregular rhythm. Cardiac arrhythmia may be harmless, serious, or even life-threatening.

Left untreated, some cardiac arrhythmias can lead to complications such as stroke, cardiomyopathy (damage to the heart muscle), and cardiac arrest.

There are several different types of cardiac arrhythmia including:

  • Sinus tachycardia - when your resting heart rate is faster than 100 beats per minute
  • Sinus bradycardia - when your resting heart rate is slower than 60 beats per minute
  • Atrial fibrillation (AF) - the most common type of arrhythmia where the heart rate is irregular and faster than normal
  • Supraventricular tachycardia (SVT) - a very fast resting heart rate
  • Atrial flutter - a fast heart rate where the two top chambers of the heart contract much faster than the two bottom chambers
  • Tachybrady syndrome (sick sinus syndrome) - causes periods of very fast or slow heartbeats
  • Heart block - a very slow heart rate due to a delay in the conduction system between the top and bottom chambers of the heart
  • Ventricular tachycardia - when the lower chambers of the heart beat too fast to pump effectively around the body

Call or book online today to arrange a consultation to discuss private cardiac arrhythmia treatment with a consultant of your choice at Circle Health Group.

This page explains what cardiac arrhythmia is, what are the symptoms and causes of cardiac arrhythmia and how the condition is treated.

The cost of this procedure depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

Sometimes, cardiac arrhythmia may not cause any symptoms, and you may be unaware that you have it. Your arrhythmia may be picked up during a routine checkup or an examination for a different problem.

If you do experience symptoms they may include:

  • Palpitations (a fluttering, pounding, or racing sensation in your chest)
  • Chest pain
  • Shortness of breath
  • Fast heartbeat
  • Slow heartbeat
  • Anxiety
  • Fatigue
  • Feeling lightheaded, faint, or dizzy
  • Fainting

Cardiac arrhythmias occur when the electrical signals that travel through your heart become disrupted. This can happen for several reasons, including:

  • Genetic factors
  • Smoking
  • Stress or anxiety
  • Obesity
  • Excessive alcohol or caffeine intake
  • Recreational drug use
  • Some medications such as cold medications and antihistamines
  • Heart attack
  • Buildup of scar tissue from a previous heart attack
  • Coronary artery disease
  • Cardiomyopathy (disease of the heart muscle)
  • Heart valve disorders
  • Diabetes
  • High blood pressure
  • Infections
  • Thyroid disorders
  • Electrolyte imbalances
  • Sleep apnoea

At your first consultation, you will be seen by a consultant cardiologist, a doctor specialising in conditions affecting the heart. Your consultant will ask you about your symptoms, general health, and medical history and perform a physical examination.

Your cardiologist will order some tests to check your heart. These may include:

  • Blood tests - to check for underlying health problems or electrolyte imbalances
  • Electrocardiogram (ECG) - a non-invasive procedure to measure the electrical activity of your heart, your heart rate and rhythm
  • Holter monitor (ambulatory ECG monitoring) - a portable ECG monitor that is worn for 24 hours or longer to give a longer-term picture of your heart's electrical activity
  • Cardiac event recorder - A portable ECG device that may be used to detect occasional arrhythmias by pressing a button when symptoms occur
  • Echocardiogram - an ultrasound of your heart that shows the structure of your heart and heart valves, and blood flow through your heart
  • Cardiac stress test - monitors your heart’s response to stress and exercise by attaching an ECG device while you perform exercise such as walking on a treadmill
  • Implantable loop recorder - an event recorder is implanted under your skin to continuously record your heart's electrical activity

How is a diagnosis made?

Your consultant will make a diagnosis based on your symptoms and test results.

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where your consultant will ask you about your symptoms, perform a physical examination, order any necessary tests, provide a diagnosis, and discuss possible treatments.

Your first consultation is also where we get to know you, discuss your expectations for treatment, and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please ask your consultant any questions you may have.

After making a diagnosis, your consultant will discuss possible treatments with you and decide on the best option based on your symptoms and diagnosis.

How your cardiac arrhythmia is treated depends on the type and severity of the arrhythmia you have. Sometimes, if your cardiac arrhythmia is mild and not causing any symptoms, you may not need any treatment.

Treatments for arrhythmia include lifestyle changes, medication, therapies, and surgery.

Lifestyle changes

Your consultant may advise you to make some changes to your lifestyle to help control your cardiac arrhythmia. These may include:

  • Stop smoking
  • Lose weight if you need to and maintain a healthy weight
  • Take regular exercise (at least 30 minutes a day five days a week)
  • Follow a diet that's low in salt and saturated fat
  • Limit or avoid caffeine and alcohol
  • Control high blood pressure, high cholesterol, and blood sugar levels
  • Reduce stress
  • Get plenty of sleep


Medication to treat cardiac arrhythmias may include:

  • Antiarrhythmic drugs - such as beta-blockers and calcium channel blockers
  • Anticoagulants (blood thinners) - prevent blood clots from forming with arrhythmias like atrial fibrillation


If lifestyle changes and medication alone haven't worked, your consultant may recommend further treatments including:

  • Vagal manoeuvres - are manoeuvres that stimulate the vagus nerve and slow your heart rate. They include coughing, pushing as if having a bowel movement, and applying an ice pack to your face. Vagal manoeuvres may be used to treat arrhythmias such as supraventricular tachycardia (SVT).
  • Cardioversion - An electric shock applied through paddles on your chest is used to help reset your heart rhythm


If other treatments haven't worked, your consultant may recommend surgery such as a pacemaker, internal defibrillator, catheter ablation, or maze procedure to correct your cardiac arrhythmia. These procedures are discussed in more detail below.

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

You may not be able to eat or drink anything from midnight on the day of your operation, check with your healthcare team about when you can eat or drink before your procedure.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

  • Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
  • If you smoke, try to stop at least eight weeks before your surgery
  • Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
  • Take regular exercise

There are several types of surgical procedures to treat cardiac arrhythmias including:

Catheter ablation

Catheter ablation is a type of keyhole surgery where small tubes called catheters are inserted into the blood vessels in your heart through a vein or artery in your groin or neck. Once the arrhythmia trigger site is identified, sensors at the catheter tips use either heat (radiofrequency ablation) or cold (cryoablation) to destroy the cells and create tiny scars in your heart. This scar tissue prevents arrhythmias from occurring by blocking irregular electrical signals.

Catheter ablation is normally performed under local anaesthetic with sedation, but if your procedure is prolonged or complicated, you may be given a general anaesthetic. How long catheter ablation takes varies according to the number of areas that need to be treated and can last from 30 minutes to four hours.


A pacemaker is a small device that's inserted under the skin in your chest to help control your heartbeat. Pacemaker insertion is normally performed under local anaesthetic with sedation and the procedure usually takes around an hour but in some cases may be longer.

During pacemaker insertion, your consultant will make a small (5-6cm) incision just below your collarbone, usually on the left side.

The pacemaker wires are inserted into a vein and guided to the correct part of your heart using X-rays.

The other ends of the wires are connected to the pacemaker, which is inserted between the skin of your upper chest and your chest muscle.

You'll usually need to stay in hospital overnight and have a day's rest after the procedure.

Implantable cardioverter-defibrillator (ICD)

This device is inserted under the skin and continuously monitors your heart rhythm. If an arrhythmia occurs, it sends out low- or high-energy shocks to reset your heart's rhythm.

ICDs are usually fitted through a vein in a similar way to pacemakers, but in some cases may be implanted under the skin (subcutaneously).

The procedure may be performed under local anaesthetic and sedation or general anaesthetic. It normally takes between one and three hours.

You will be monitored for the first 24 hours after your procedure and will need to spend one night in hospital.

Maze procedure

During this procedure, your consultant makes tiny incisions (cuts) in the upper half of your heart to create a maze-like pattern of scar tissue. This scar tissue blocks the abnormal electrical signals that trigger cardiac arrhythmias. Maze procedure is performed under general anaesthetic.

During your maze procedure, your consultant will make an incision along the middle of your chest. Your sternum (breastbone) is then separated to allow your consultant to access your heart. During the procedure, you will be connected to a heart-lung (cardiopulmonary bypass) machine which will take over the work of your heart and lungs during the procedure.

Your consultant will create scars in your left and right atria (the top chambers of your heart) using either a scalpel and stitches or a technique called cryoablation that uses intense cold to destroy abnormal areas of tissue. Your consultant may also cut off or close your left atrial appendage which is a common source of blood clots and strokes in people with atrial fibrillation. Closing or removing your left atrial appendage reduces your risk of stroke.

When the procedure is complete, your consultant will remove you from the heart-lung machine, join your breastbone back together, and close your incision with stitches or staples.

Maze procedure normally takes between two and four hours.

Recovery from any type of surgery is different for everyone and depends on the type of procedure you had, as well as factors such as your age, general health, and medical history.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

How many nights will I need to stay in hospital?

You will normally spend one night in hospital after insertion of a pacemaker, or ICD. After catheter ablation, you may be able to go home the same day or need to stay overnight in hospital.

After a maze procedure, you will spend one night in intensive care for close monitoring, followed by between five and eight days recovering on the ward.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your cardiac arrhythmia surgery. Please make arrangements for someone to collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your surgery depends on the type of procedure you had and the job you do.

If your job is sedentary, you may be well enough to go back to work within a week or two of pacemaker or ICD insertion. You should take at least two days off work after cardiac ablation, longer if you have a manual or strenuous job.

After maze procedure, you can expect to return to a sedentary or office job within around four to six weeks. This may be up to 12 weeks for a more physically demanding job.

Talk to your consultant about when you can expect to go back to work after your cardiac arrhythmia surgery.

How soon can I drive?

After having a pacemaker fitted, you can normally drive a week after your procedure as long as you do not have symptoms such as fainting or dizziness or have not had a recent heart attack or heart surgery.

If you had an ICD implanted because you had a cardiac arrest, you won't be able to drive for six months. If it was inserted as a precaution, you won't be able to drive for one month, and only if your ICD hasn't delivered any shocks.

You'll need to inform the DVLA and your insurance company that you have a pacemaker or ICD.

After catheter ablation, the DVLA does not permit you to drive for two days after the procedure, but we recommend that you wait a week before driving again.

Driving after your maze procedure depends on your recovery, and you'll need to get the all-clear from your consultant before you drive. This is normally around four to six weeks after your maze procedure.

When will I be back to normal?

Recovery from any type of surgery is a gradual process that is different for everyone. It’s important that you recover at your own pace and listen to your body during your recovery. Call the hospital if you have any questions or concerns.

Most people are recovered from catheter ablation after about a week.

Following pacemaker or ICD implantation, you should be able to get back to most normal activities within a week or two. Avoid strenuous exercise for around 3 to 4 weeks after having your pacemaker or ICD fitted.

It can take up to six months to fully recover from a maze procedure.

As with all types of surgery, cardiac arrhythmia surgery carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision.

Possible complications of any surgery include:

  • Bleeding
  • Infection
  • Blood clots
  • Adverse reactions to the anaesthetic

Possible complications specific to pacemaker/ICD implantation include:

  • Infection around the device
  • Swelling, bruising, or bleeding (especially if you take blood thinners)
  • Blood clots near where the device is placed
  • Damage to the surrounding blood vessels or nerves
  • Pneumothorax (collapsed lung)
  • Haemothorax (blood in the space between the lung and the chest wall)
  • The device or leads may move
  • Device malfunction

Possible complications specific to catheter ablation include:

  • Blood clots
  • Damage to the vein from the catheter
  • Damage to the surrounding heart tissue or valves
  • Infection
  • Bleeding
  • Stroke
  • The need for a permanent pacemaker
  • The procedure may be unsuccessful

Possible complications specific to maze procedure include:

  • Bleeding
  • Blood clots
  • Infection
  • Stroke
  • Heart attack
  • The need for a permanent pacemaker
  • The procedure may be unsuccessful
  • Kidney failure
  • Further arrhythmias

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

  • Flexible appointment times and locations that are convenient for you
  • The freedom to choose which hospital and consultant suit your needs
  • Personalised, consultant-led treatment plans tailored to your individual needs
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams
  • Private ensuite rooms as standard
  • A range of delicious healthy meals
  • Affordable, fixed-price packages with aftercare included
  • Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about cardiac arrhythmia treatment, book your appointment online today or call a member of our team directly on 0808 189 5499.


Content reviewed by Circle in-house team in July 2024. Next review due July 2027.

Catheter ablation British Heart Foundation

What Is an Arrhythmia? National Heart, Lung, and Blood Institute

Arrhythmia NHS

Overview. Pacemaker implantation NHS

Implantable Cardioverter Defibrillator (ICD) Insertion Johns Hopkins Medicine

AFib Surgery and Maze Procedure Johns Hopkins Medicine

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