Palpitations / Other Arrhythmias (incl SVT)

Availability

North South North West Statewide

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

  • U&Es, Creatinine
  • Liver function
  • Fasting lipids
  • Blood glucose
  • Thyroid function
  • ECG - particularly those demonstrating the arrhythmia

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 Tasmanian Health Pathways website.

Emergency

VT
Acute symptomatic SVT

Urgent / category 1

  • Supraventricular tachycardia without concerning features
  • Syncope
  • Severe dizziness
  • Ongoing chest pain
  • Increasing shortness of breath
  • Hypotension
  • Signs of cardiac failure
  • Ventricular rate >120

Semi-urgent / category 2

Documented evidence of pre-excitation on ECG with history of palpitations

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

Additional Information

RACGP Article - Initial Management of Cardiac Arrhythmias

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

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

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

Semi-urgent:

We will endeavour to see these patients within four weeks

Routine:

Next available appointment usually within eight weeks