Palpitations / Other Arrhythmias (incl SVT)

This condition is treated in the Cardiology clinic.

Pre-referral work-up

History

All referrals should comply to the referral standards and must include:

• Cardiac risk factor assessment

For supraventricular tachycardia:

• Rate and pattern of pulse
• Constant or intermittent
• TIA's/stroke - past or present
• Associated symptoms - angina, SOB
• Current and past medications

NB: Ventricular Tachycardia is an emergency and needs immediate referral to ED via ambulance.

For palpitations:

• History of episodes is essential
• Impact on functioning
• Medications trialled and results of trial

Tests

Pathology:

• FBC
• UEC
• CMP (Ca. Mg, PO4)
• LFT
• TSH

Imaging:

• Nil

Investigations:

• Any relevant ECGs (during episodes if possible)
• Holter monitor report - if available

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

Additional information which may be useful for triage:

• Relevant previous medical history and co-morbidities
• Caffeine intake, alcohol intake and drug use (including recreational drugs)
• Echocardiogram report
• Stress test report
• CXR report

Interim management advice can be found on the HealthPathways website.

For more information please see the HealthPathways Tasmania website.

Additional Information

RACGP Article - Initial Management of Cardiac Arrhythmias

Clinic appointments

🚩 Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

🚩 Palpitations with any of the following concerning features:

• chest pain
• shortness of breath
• loss of consciousness
• syncope / pre-syncope
• persisting tachyarrhythmia on ECG

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

🚩 Palpitations without emergency referral concerning features (Select to display above) however includes any of the following (select applicable):

🚩 Other cardiac symptoms

🚩 Haemodynamic disturbance

🚩 Abnormal resting 12 lead ECG

🚩 Palpitations in a patient with known structural heart disease or family history of sudden cardiac death

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.

We will endeavour to see these patients within one week, or sooner if clinically indicated.

Semi-urgent (Category 2)

Significant burden of ventricular ectopy i.e., Symptomatic or Associated with impaired cardiac function

Routine (Category 3)

Palpitations - Patient's symptoms / presentation has not yet been addressed in any above criteria

Next available appointment usually within eight weeks

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Mersey Community Hospital
Phone: 1800 636 455
Fax: 6441 5928

South

Wellington Clinics

General cardiology clinic enquiries and appointments:
Phone: 03 6166 0061
Fax: 03 6231 0101

Pacemaker and cardiac device enquiries and clinic appointments:
Phone: 03 6166 0064

Royal Hobart Hospital
Level 2 (D Block) - Cardiology and Echo Department

General cardiology clinic enquiries and appointments:
Phone: 03 6166 8620 or 03 6166 8860
Fax: 03 6234 3982

Nurse Practitioner: Chronic Cardiac Care/Heart Failure
Phone: 03 6166 7398

Pulmonary Hypertension Services
Phone: 03 6166 8034