Heart Rhythm Conditions We Treat in London

The Conditions Behind Pacemakers, Defibrillators and CRT

Understanding What Is Behind Your Symptoms

Blackouts, dizziness, breathlessness, palpitations, fatigue: heart rhythm symptoms are unsettling, and the uncertainty is often the hardest part. The reassuring truth is that almost all of these symptoms trace back to a handful of identifiable conditions, and once the cause is clear, the treatment usually follows naturally. This page explains the conditions we treat at London Pacemaker Centre, how they relate to one another, and how each is addressed.

Why Choose London Pacemaker Centre

Because we focus entirely on cardiac rhythm and devices, we can both identify exactly what is causing your symptoms and tell you honestly when treatment is, and is not, needed. We offer fast access to specialist assessment, often within days, the full range of diagnostics, and long-term care that does not stop once a device is in. Care is provided in London’s Harley Street medical district and at the internationally recognised Harefield Hospital in North West London.

Three Kinds of Problem

Most of the conditions we treat fall into one of three groups, which is a helpful way to understand them:

Hearts that beat too slowly, treated with a pacemaker. These include bradycardia, heart block and sick sinus syndrome

Hearts that can beat dangerously fast, treated with an implantable defibrillator. These include ventricular tachycardia and the risk of sudden cardiac death.

Hearts that pump inefficiently, where cardiac resynchronisation therapy can help. This is the role of devices in selected patients with heart failure.

It is worth knowing that some fast heart rhythms, such as many forms of atrial fibrillation, are not dangerous in the same way and follow a different treatment pathway altogether. Our focus is on the conditions managed with cardiac devices, and part of our role is making sure you are on the right path, whichever that is.

Heart Rhythm Conditions We Treat

From slow and irregular rhythms to heart failure, here are the conditions we assess and treat, and how each is cared for.

Bradycardia (Slow Heart Rate)

Bradycardia means the heart beats too slowly. A slow rate is not always a problem, very fit people often have one and feel perfectly well, but it becomes significant when it is too slow to meet your body’s needs and causes symptoms such as tiredness, dizziness, breathlessness on exertion, or blackouts. Where symptomatic bradycardia is confirmed, the established and highly effective treatment is a pacemaker. See our Pacemakers page for more.

Heart Block

Every heartbeat begins as an electrical signal that travels from the upper chambers to the lower, pumping chambers. In heart block, that signal is delayed or interrupted. A mild, first-degree block may cause no symptoms and need no treatment, while more significant block can cause the heart to slow or pause, leading to dizziness, tiredness, breathlessness or fainting. Complete heart block can be dangerous and usually needs treatment. Significant or symptomatic heart block is treated with a pacemaker, and for some patients conduction system pacing, which stimulates the heart’s own wiring directly, may be appropriate. See our Pacemakers page.

Sick Sinus Syndrome (Sinus Node Disease)

The sinus node is the heart’s own natural pacemaker, sitting high in the upper right chamber. In sick sinus syndrome it becomes unreliable, so the heart may run too slowly, pause, or fail to speed up when you become active. A telling sign is feeling fine at rest but unable to cope with activity. The treatment is a pacemaker, but the detail of the programming matters greatly here, because the rate-response function often needs careful, individual tuning so the device supports the life you actually lead. See our Pacemakers page and our guide to pacemaker checks and optimisation.

Blackouts and Fainting

Blackouts and fainting can come from a slow heart rhythm, but not always. Some are caused by a drop in blood pressure rather than a heart rhythm problem, in which case a pacemaker is not the right answer. Telling these apart is one of the most important judgements we make, because it determines whether a device will help or whether a different treatment is needed. Our dedicated guide explains this in full: see Do I Need a Pacemaker.

Ventricular Tachycardia and Sudden Cardiac Death Risk

Most fast heart rhythms, while unpleasant, are not life-threatening. A small but important group are. Ventricular tachycardia and ventricular fibrillation arise in the heart’s lower chambers and can stop the heart pumping effectively, leading to cardiac arrest. Risk is higher in people who have survived a cardiac arrest, who have significantly weakened heart function, who have had a previous heart attack, or who have an inherited heart condition. Where a significant risk is identified, the established protection is an implantable defibrillator, which monitors the heart continuously and acts immediately if a dangerous rhythm occurs. See our Implantable Defibrillators page.

Heart Failure

Heart failure sounds more alarming than it often is. It does not mean the heart is about to stop, but that it is not pumping as efficiently as it should, which can cause breathlessness, fatigue and reduced activity. In some patients the heart’s chambers also contract out of synchrony, and for this group cardiac resynchronisation therapy can pace both sides of the heart to beat in step, improving efficiency and, for suitable patients, easing symptoms and improving quality of life. Not everyone with heart failure needs a device, which is why assessment matters. See our Cardiac Resynchronisation Therapy page.

Frequently Asked Questions

Bradycardia

Not always. Many people, particularly fit individuals, have a slow heart rate and feel well. It becomes a concern when it causes symptoms such as dizziness, tiredness, breathlessness or blackouts.

No. Treatment depends on whether the slow rate causes symptoms and on the cause. Where symptomatic bradycardia is confirmed, a pacemaker is the established and highly effective treatment.

Heart Block

It depends on the type. A mild, first-degree block may need no treatment, while complete heart block can be dangerous and usually requires a pacemaker. Assessment determines the severity.

Significant or symptomatic heart block is treated with a pacemaker. For some patients, conduction system pacing may be an option. Mild block may simply be monitored.

Sick Sinus Syndrome

It is a condition where the heart’s natural pacemaker, the sinus node, becomes unreliable, causing the heart to beat too slowly, pause, or fail to speed up appropriately during activity.

With a pacemaker. With this condition in particular, careful programming of the rate-response function is important so the device matches your activity levels and lifestyle.

Blackouts and Fainting

No. Some blackouts are caused by a drop in blood pressure rather than a slow heart rhythm, in which case a pacemaker is not the right treatment. Accurate assessment tells the two apart.

Ventricular Tachycardia and Sudden Cardiac Death

It can be. Unlike many fast rhythms, ventricular tachycardia and ventricular fibrillation can stop the heart pumping effectively and lead to cardiac arrest, which is why assessment and, where appropriate, an ICD are so important.

Risk is higher in people who have survived a cardiac arrest, who have significantly weakened heart function, who have had a previous heart attack, or who have an inherited heart condition. Specialist assessment clarifies your individual risk.

Heart Failure

No. It means the heart is not pumping as efficiently as it should, not that it is about to stop. Many people live active lives with the right treatment and support.

In patients whose heart chambers contract out of synchrony, cardiac resynchronisation therapy paces both sides of the heart to beat in step, improving pumping efficiency and, for suitable patients, easing symptoms and improving quality of life.

Book an Appointment

Whatever your symptoms or diagnosis, the fastest route to certainty is a specialist assessment. Contact London Pacemaker Centre to arrange a consultation or make a referral, and our team will ensure you receive prompt, expert and personalised care.