Heart rhythm management means finding out which rhythm problem you have and then treating it. The heart may beat too fast, too slowly or out of step. Options include medicines, an electrical reset, a pacemaker or referral for ablation. Dr Navin Chandra, a consultant cardiologist who fits pacemakers, sees patients at four hospitals across East Berkshire and South Buckinghamshire.
| Question | Answer |
|---|---|
| Who is it for? | Adults with a known or suspected rhythm problem, such as AF, SVT or a slow pulse |
| What is checked? | Your heart rhythm, on an ECG and a recorder worn for one day to two weeks |
| What is treated? | A rate that is too fast or too slow, an unsteady rhythm and stroke risk in AF |
| Which treatments? | Medicines, cardioversion, a pacemaker or referral for ablation |
| Does it affect driving? | Sometimes, so check the DVLA rules |
| How do I book? | Call 020 7099 9685 or book online |
What Is Heart Rhythm Management?
An arrhythmia is a fault in the electrical system that sets the pace of each heartbeat. Some of these faults are harmless. Others raise the risk of a stroke or heart failure, so they are treated. The NHS guide to heart rhythm problems notes that many people need no treatment at all, or only regular check-ups.
Heart rhythm management with Dr Navin Chandra starts by catching the rhythm on a recording. He then explains what it shows and agrees a plan with you. He is a consultant cardiologist at Frimley Health NHS Foundation Trust and implants permanent pacemakers himself.
A Racing Heart With Chest Pain or Fainting: When to Get Emergency Help
Some rhythm problems need help straight away, before any clinic visit.
| Your symptom | Why it matters | What to do |
|---|---|---|
| A fast or irregular heartbeat now, with chest pain, shortness of breath, sweating or feeling sick | The rhythm may be straining the heart | Call 999 |
| A fast or irregular heartbeat with fainting, feeling dizzy or falling over | It needs checking at once | Call 999 |
| A fast or irregular heartbeat with a severe headache, one-sided weakness or numbness, blurred vision or confusion | AF raises the risk of stroke | Call 999 |
| Diagnosed SVT, and an episode lasting longer than usual | Hospital treatment may be needed | Call 999 |
| Any of these symptoms that have now stopped | They still need prompt review | Urgent GP appointment or NHS 111 |
Let a friend or an ambulance crew get you to hospital rather than driving there. Take your tablets with you. The NHS page on atrial fibrillation lists every warning sign.
Rhythm Conditions Dr Chandra Diagnoses and Treats
- Atrial fibrillation (AF) and atrial flutter: an unsteady rhythm from the upper chambers, which may come and go or stay.
- Supraventricular tachycardia (SVT): sudden bursts of a much faster heartbeat that stop just as abruptly.
- Ectopic beats: early or extra beats. How they feel is covered on the palpitations page.
- Ventricular tachycardia: assessed by Dr Chandra, with onward referral for specialist treatment.
- Heart block and sick sinus syndrome: slow rhythms that can cause tiredness or fainting and blackouts.
- Wolff-Parkinson-White syndrome: spells of a very fast heartbeat, usually starting between the ages of 30 and 50.
A rhythm problem that shows up during sport is assessed through sports cardiology.
Treatment Options: Medicines, Cardioversion, Pacemakers and Ablation
Treatment depends on the type of rhythm problem and its cause, such as an overactive thyroid.
Medicines to Control Rate or Rhythm
Tablets can slow a racing heart or help hold a steady rhythm. For most people with AF, NICE advises controlling the rate first. Your symptoms, other conditions and wishes guide the choice.
Blood Thinners for AF
Anticoagulants lower the risk of clots and stroke in AF. How that choice is made is set out below.
DC Cardioversion
A controlled electrical shock resets the heart into a normal rhythm. It may suit AF or flutter that has not settled. NICE prefers this electrical reset once AF has lasted longer than 48 hours. The rhythm can slip back afterwards.
Pacemaker
A small device under the skin of the chest sends signals that keep the heartbeat steady. It mainly suits heart block and other slow rhythms. Fitting usually takes about an hour under local anaesthetic, often with one night in hospital. An infection afterwards is sometimes possible. Read more about when a pacemaker is given.
Catheter Ablation Referral
Thin tubes reach the heart through a blood vessel, and heat or freezing treats the area causing the faulty rhythm. It may suit SVT, flutter, or AF when tablets have failed or are not tolerated. For AF, it does not always work. Dr Chandra refers suitable patients to a specialist electrophysiology centre.
Why Patients Choose Dr Chandra for Heart Rhythm Care
- An NHS consultant: cardiologist at Frimley Health NHS Foundation Trust, and honorary consultant at Royal Brompton and Harefield.
- Pacemakers fitted by him: a slow rhythm can be treated by the doctor who found it.
- Monitoring arranged: Holter and event recorders, loop recorders and ablation referral run through his clinic.
- Research: published work on inherited cardiac conditions and sports cardiology.
- Qualifications: MRCP (UK), MD (Res) and Fellow of the Royal College of Physicians.
From a 12-Lead ECG to a Loop Recorder: Catching a Rhythm That Comes and Goes
A rhythm problem is easiest to treat once it is caught on a recording. The test is matched to how often symptoms happen.
- 12-lead ECG: patches on the arms, legs and chest record your rhythm for a few minutes.
- Holter monitor: a recorder on a belt, usually worn for 24 to 48 hours. You cannot bath or shower in it.
- Event recorder: worn for 7 days, or 14 if needed, for episodes every few days.
- Implantable loop recorder: a small device just beneath the skin, for symptoms that come only every few weeks or months.
NICE guidance on blackouts uses the same logic. Episodes several times a week suit a Holter monitor. Episodes every 1 to 2 weeks suit an external recorder, and rarer ones suit an implanted recorder. Note the time and what you feel during each episode.
Atrial Fibrillation and Stroke Risk: Why Blood Thinners Are Discussed
AF raises the risk of blood clots and stroke. Anticoagulants lower that risk but add a chance of bleeding. NICE asks doctors to weigh both with two separate scores.
For most people, NICE says the benefit outweighs the bleeding risk. Age or a risk of falls alone should not rule a blood thinner out. Dr Chandra goes through both scores with you before any decision.
What Happens When You First See Dr Chandra About Your Heart Rhythm
- Book: by phone or online, face to face or by video.
- Bring: your medicines list, earlier ECGs or results, and insurance details.
- Consultation: up to 30 minutes covering how each episode starts, how long it runs and anything that seems to trigger it.
- Tests: an ECG and, if needed, a monitor. An echo may check the heart’s structure through cardiac imaging.
- Plan: at follow-up he explains the recording, with the benefits and risks of each next step.
Driving and the DVLA With a Heart Rhythm Condition
Not every rhythm problem affects your licence. Car and motorcycle drivers must tell the DVLA if their arrhythmia causes distracting or disabling symptoms, or could stop them safely controlling the vehicle. Form H1 or the online service is used. If you drive a bus, coach or lorry, every arrhythmia must be declared, using form VOCH1. See the gov.uk page on arrhythmia and driving.
Once a pacemaker is fitted, the NHS advises telling both the DVLA and your insurer. Avoid driving for at least the first week.
Where to See Dr Chandra for Heart Rhythm Care
| Clinic | Address |
|---|---|
| The Parkside Suite, Heatherwood Hospital | Brook Ave, Ascot SL5 7GB |
| The Parkside Suite, Wexham Park Hospital | Wexham, Slough, Berkshire SL2 4HL |
| BMI Princess Margaret Hospital | Osborne Road, Windsor, Berkshire SL4 3SJ |
| Spire Thames Valley Hospital | Wexham Street, Wexham, Buckinghamshire SL3 6NH |
Ring 020 7099 9685 or write to enquiries@navinchandra.co.uk for clinic days at each site. The practice also confirms where a pacemaker would be fitted. Outside clinic times, ring NHS 111 about anything urgent. Dial 999 for an emergency.
Heart Rhythm Management Fees and Insurance
| Item | Fee or cover |
|---|---|
| First consultation | Quoted when you book |
| Heart rhythm monitoring | Quoted when you book |
| Cardioversion or pacemaker | Quoted after assessment |
| Insurers | AXA Health, Aviva, Bupa, Cigna, Healix, Vitality and WPA |
Nothing is priced online. The practice confirms each 2026 fee before any test is booked. Self-pay patients are welcome. Insured patients should ask their provider about cover and authorisation beforehand.
FAQs About Heart Rhythm Management
My symptoms come and go. Can a rhythm problem still be found?
Yes. The longer a recording runs, the more likely it is to catch an episode. Dr Chandra can arrange a 7-day event recorder, or a loop recorder under the skin for rare symptoms.
What is atrial fibrillation and how is it treated?
AF is a rhythm problem where the heartbeat is not steady. Treatment often starts with tablets to control the rate and rhythm, plus a blood thinner if stroke risk is raised.
Do all arrhythmias need treatment?
No. Many people need only regular check-ups. Treatment is offered when a rhythm causes troublesome symptoms or raises the risk of stroke or heart failure.
Can an arrhythmia go away on its own?
Some do. AF can start and stop by itself, and an SVT episode usually lasts a few minutes. A rhythm that keeps returning still needs checking.
Will I need a pacemaker?
It depends on the rhythm. A pacemaker mainly treats a heartbeat that is too slow, such as heart block. It is also used for some people with heart failure or AF. Dr Chandra can fit one if needed.
How long does it take to recover from a pacemaker?
Expect tiredness and a sore chest for a few days. Full recovery can take weeks or months. Avoid heavy lifting and raising that elbow above the shoulder for 4 to 6 weeks.
Can AF come back after cardioversion?
Yes, it can. NICE asks for prompt referral, within 4 weeks, when AF returns after cardioversion. Medicines may help hold the normal rhythm for a time.
Is catheter ablation right for me?
It depends on your rhythm, heart health and wishes. For AF, NICE notes that it does not always work and symptoms can return. Dr Chandra refers suitable patients to a specialist centre.
Do I have to tell the DVLA about an irregular heartbeat?
Car drivers must if it causes distracting or disabling symptoms, or affects safe control. Bus, coach and lorry drivers must always report it. Ask Dr Chandra if you are unsure.
Can I have AF and a pacemaker?
Yes. The NHS lists a pacemaker among AF treatments. NICE also describes pacing plus ablation of the link between the upper and lower chambers for some people with a persistently fast rate.
Book a Heart Rhythm Consultation with Dr Navin Chandra
- Phone: 020 7099 9685
- Email: enquiries@navinchandra.co.uk
- Online: the appointment form, or the contact form for questions
Chest pain, breathlessness or fainting with a racing heart means calling 999 rather than waiting. Once they have settled, an urgent GP slot or a call to NHS 111 is the next step. You can also browse all treatments and services.