Cardiology  |  Palpitations Pathway - Suspected Significant Cardiac Arrhythmia


Palpitations Pathway - Suspected Significant Cardiac Arrhythmia

Referral to Cardiology OPD

The following will assist with grading of referral and the information is requisite to the referral being accepted.


Description of palpitations:

  • estimate of rate, rhythm, and duration - ask patient to tap out on desk

Associated features:

  • dizziness, shortness of breath, chest pain

Frequency - may facilitate direct referral for Holter monitoring:

  • multiple episodes per day
  • daily
  • several times per week
  • weekly
  • less than one weekly
  • single episode only

Important Co-morbidities

The following indicate high risk of cardiac arrhythmia:

Patient history of heart disease:

  • heart failure
  • coronary arterial disease
  • known arrhythmia
  • valvular heart disease

Family history of premature sudden death:

  • sudden cardiac death
  • arrythmogenic¬† right ventricular cardiomyopathy
  • hypertrophic obstructive cardiomyopathy


Note on Family History:

  • Cardiovascular assessment my be warranted of all first degree relatives where there is:
    • unexplained sudden death >30
    • all sudden death <30


List current medications

Other Medical History

Detail any relevant medical history


Detail all relevant findings - include specifically BP/ heart sounds / pulse and character


Advise any important social implications:

  • It is mandatory for a medical practitioner to advise patient of legal driving restrictions.
  • "NZTA regulations"
  • Indicate if driving essential to employment.
  • Indicate if at risk in present living arrangements.

Last updated : Thursday, September 10, 2015
Next review date : Friday, September 09,2016

Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.