OpenPalp — a low-risk palpitations pathway
Low-risk palpitations clinic in Hampstead
Free appointment and 12-lead ECG for suitable patients. One-week rhythm monitoring available for £70 if clinically appropriate.
Low-risk palpitations only · 12-lead ECG included · rhythm capture when needed · written summary to you and your GP
See if this is right for youLed by Dr Mahmood Ahmad — an NHS cardiology specialist doctor experienced in assessing palpitations, and trusted by local GPs who refer patients. GMC-registered · SF Studios, Hampstead · Tuesday mornings.
A 12-lead ECG is an important first test, but it only records your heart rhythm for a few seconds. If your palpitations come and go, a normal ECG may not capture the rhythm during symptoms. For suitable patients, OpenPalp offers one-week Kardia rhythm monitoring to help capture symptoms when they happen.
A low-risk pathway
Who this is for — and who it is not for
OpenPalp is only for low-risk palpitations. Every enquiry goes through a suitability check first — it is a genuine safety step, not a formality. If you are not suitable, we tell you clearly and point you to the right care.
Who this is for
- Intermittent palpitations (skips, flutters, brief racing)
- Clinically stable and generally well between episodes
- No current chest pain
- No fainting, collapse, or severe breathlessness
- Not acutely unwell
- Able to use a smartphone for Kardia rhythm capture
- Willing to receive a written summary and share it with your GP
Who this is not for — red flags
- Chest pain
- Fainting or collapse (syncope)
- Severe breathlessness
- Palpitations with collapse
- Known high-risk arrhythmia
- A very fast, ongoing heart rhythm right now
- New neurological symptoms
- Acutely unwell, or needing emergency assessment
- Needing a full cardiology consultation
The suitability check is step one of the pathway. Patients who are not suitable, or who have any red flag, are directed to the right NHS or emergency route — you will not be left without a plan. See the full suitability criteria.
You are not alone
Many palpitations are distressing but not dangerous
Palpitations are one of the most common reasons people visit a cardiologist. The sensation of your heart skipping a beat, fluttering in your chest, or suddenly racing can be alarming — but in the majority of people with no underlying heart disease, palpitations are a benign nuisance rather than a warning sign.
Most people find that their palpitations come and go unpredictably. This uncertainty is itself distressing. The OpenPalp programme is designed to give you answers: a clear record of what your heart is doing, an understanding of your personal triggers, and a structured plan to reduce the frequency and impact of symptoms.
Common triggers include:
- Caffeine
- Poor sleep
- Stress and anxiety
- Alcohol
- Dehydration
- Hormonal changes
You will find your personal triggers through this programme.
Every component of this programme is supported by published evidence, including a Cochrane review of 20 randomised trials (exercise), an NEJM randomised trial (alcohol reduction), and safety data from over 81,000 participants (omega-3 warning).
The attention loop
Why palpitations feel worse the more you notice them
The more you monitor your heartbeat, the more you find it — until you learn not to look.
The pathway
Four simple steps
A focused, low-risk palpitations pathway — rapid ECG assessment, rhythm capture when it is needed, and a clear written summary for you and your GP.
- Suitability check We confirm this is appropriate for low-risk palpitations. Red-flag symptoms are directed to the right NHS or urgent care instead.
- Appointment and 12-lead ECG A brief assessment and a 12-lead ECG at the clinic — free for suitable low-risk palpitations patients. Tuesday mornings at SF Studios, Hampstead.
- One-week Kardia monitoring if needed If your symptoms are intermittent and monitoring is clinically appropriate, one week of Kardia rhythm capture is offered for £70. There is no obligation to proceed.
- Summary to you and your GP A clear written summary and advice on next steps — shared with you and, with your consent, sent to your GP.
Pathway fit
Is this pathway the right fit?
For suitable low-risk patients, this pathway offers a focused local assessment. It is not a substitute for urgent care or comprehensive NHS cardiology.
Your clinician
Dr Mahmood Ahmad
NHS cardiology specialist doctor · experienced in palpitations · trusted by local GPs · MRCP(UK) · GMC 6071047
All care within the OpenPalp pathway is delivered by Dr Ahmad, an NHS cardiology specialist doctor who works in senior cardiology roles in NHS teaching hospitals in London. He is experienced in assessing palpitations, and local GPs refer patients to him. He is fully GMC-registered with a licence to practise, holds MRCP(UK), and is insured for independent private practice.
About Dr Ahmad’s role
Dr Ahmad practises as a specialist doctor in cardiology within the NHS. He is not a CCT-holding Consultant on the GMC Specialist Register; his NHS specialist experience, GMC registration, and right to practise independently do not depend on that particular training route. You can verify his GMC registration at any time at gmc-uk.org.
Pricing
Simple, transparent pricing
No hidden fees. No online payment. Rhythm monitoring is only offered if it is clinically appropriate.
| Suitability screen Short screening form, reviewed by Dr Ahmad |
Free |
| Appointment and 12-lead ECG For suitable low-risk palpitations patients |
Free |
| One-week Kardia rhythm monitoring pathway If clinically appropriate |
£70 |
There is no obligation to proceed with rhythm monitoring. It will only be offered if clinically appropriate.
How to start
Free screening — no online booking
The clinic does not take direct bookings. Instead, complete this short screening form. Dr Ahmad reviews it personally before any appointment is offered.
To book, email Dr Ahmad
- Step 1. Complete the free 2-minute screening form below.
- Step 2. Dr Ahmad reviews your form and may call you.
- Step 3. If suitable, an appointment and 12-lead ECG are offered — free for low-risk palpitations patients (Tuesday mornings, SF Studios, Hampstead).
- Step 4. If your symptoms are intermittent and rhythm monitoring is clinically appropriate, one-week Kardia monitoring is offered for £70 — optional, no obligation.
OpenPalp — The Programme
THE SELF-GUIDED BOOKLET
A self-guided one-week journey
Six daily focuses across one week. Each builds on the one before. Your home monitoring, if you choose it, runs for the week; the booklet is yours to keep.
Every component is supported by published evidence — including three high-quality landmark trials (Cochrane, NEJM, Circulation).
Listen
If you have the home monitor, start your Kardia and begin your diary. Simply observe. Every entry is a clue. Home monitoring runs for one week. Structured self-monitoring is supported by moderate-quality evidence from an umbrella review of 39 systematic reviews.
Breathe
Five minutes of slow breathing, twice a day. 4 seconds in, 6 seconds out. In a meta-analysis of 31 studies, this changed heart rhythm within the same session — not after weeks. Within minutes.
Discover
Look back at your diary. Find your two personal triggers. In studies of people with palpitations, 71% found stress, 62% caffeine, 58% sleep disruption. You are part of a very human pattern. Today, experiment with caffeine — and consider your alcohol intake. A landmark NEJM trial found that reducing alcohol cut AF recurrence by 45%.
Change
Act on your top trigger. One change. The same heart responds differently to a different life. This is where you test it. Sleep quality matters — the UK Biobank study of 403,000 people found insomnia increases AF risk by 30%. And if weight is relevant, the LEGACY trial (Pathak et al., 2015) showed 88% AF freedom with 10% or more weight loss.
Move
Set your step baseline and add 500 today. Exercise has the strongest lifestyle evidence of all — a Cochrane review of 20 randomised trials found a 30% reduction in AF recurrence (RR 0.70). Movement is medicine.
Understand
The final day. Review your progress, practise vagal techniques (the REVERT trial showed the modified Valsalva achieves 43% SVT reversion vs 17% standard), and consolidate everything you have learned. Fill in your progress tracker and write your letter. When your week ends, return the Kardia by post (a freepost envelope is provided) — this booklet is self-guided, with no follow-up appointment.
When you feel palpitations
Most episodes pass within a few minutes. Here is what to do — in order.
If you feel faint, develop chest pain, or experience a sustained fast heart rate that does not settle after 15–20 minutes, stop and call 999 immediately. Do not attempt the steps below.
Stay calm
Anxiety amplifies palpitations. Take one slow breath and remind yourself: most palpitations are not dangerous. You are not in danger.
Sit or lie down
Reduce demand on your heart. Do not continue strenuous activity until the episode has fully passed.
Breathe slowly
4 seconds in. 6 seconds out. Repeat five times. This activates your vagus nerve and can slow or settle the heart.
Try a vagal technique
If you feel safe to do so: bear down gently as if straining (Valsalva), or splash cold water on your face. Only if you feel well enough.
Record on Kardia
As quickly as possible. Even if symptoms are settling — record anyway. A trace during or just after an episode is highly informative.
Write in your diary
Time, duration, severity, what you were doing, what helped. The pattern across your monitoring period is where the answers live.
Important note on vagal techniques
Not suitable if you have known eye disease or significant heart valve problems. Do not press on your neck (carotid massage). If symptoms worsen during any technique, stop immediately. If you feel very unwell or develop chest pain, do not attempt them — call 999. Always sit or lie down first.
Your daily practice
Small consistent actions change the nervous system more than anything else. You do not need to be perfect. You need to be regular.
Every morning
- Check your HRV if your watch tracks it — note the number in your diary
- Take one resting Kardia recording — before getting up
- Five minutes of 4-6 breathing. In for 4, out for 6.
- Fill in your diary for yesterday
Every evening
- Five minutes of 4-6 breathing
- Note one thing that helped your heart today
- Rate your heart anxiety today (1–10) in your diary
- Note your steps for the day
If anything concerns you during the programme, email [email protected] — Dr Ahmad typically responds within 4 hours during working days.
If your symptoms change during the programme
If your palpitations become more frequent, more severe, or different from usual, or if you develop new symptoms such as fainting, chest pain, or breathlessness, contact the clinic by email or call your GP. If urgent, call 111 or 999.
Understanding HRV — your nervous system score
Heart rate variability (HRV) is the variation between heartbeats. A higher number means your nervous system is calm and adaptable. A lower number means it is under strain.
You do not need to analyse it. Just watch the trend. Most people see their HRV rise with regular practice as their nervous system settles.
Your two lifestyle experiments
Experiment 1 — The caffeine test (day 3)
From day 3, replace your first coffee with hot water and lemon for the rest of the week. Note your palpitations in the diary each day, and compare with your first two days. If palpitations drop, caffeine is likely your trigger.
Experiment 2 — The sleep anchor (day 4)
From day 4, set one fixed wake time and keep it for the rest of the week — even at the weekend. Stop caffeine after 2pm. Note sleep quality in your diary each morning. This single change often reduces palpitations within days.
OpenPalp — Your Device
YOUR DEVICE
Your device
Kardia — your handheld ECG (one week)
The Kardia is yours to use whenever you feel something. Think of it as your heart’s voice recorder — activated by you, at the moment that matters.
Setting up
- Download the free Kardia app (App Store or Google Play)
- Open app, tap ‘Add a device’, follow pairing steps
- No paid subscription needed — free tier stores all ECGs
How to record
- Place each thumb on one electrode pad
- Hold still, breathe gently, stay for 30 seconds
- App saves and analyses recording automatically
When to record
Record whenever you feel symptoms — as quickly as you can. Also take one morning resting recording each day, before getting up. This builds a baseline picture. Note the time of each recording in your diary.
Open the Kardia app and show Dr Ahmad your full recording history. You review them together.
If the app says ‘Unclassified’ — that means the AI could not read it. Your clinician will review the trace directly.
What if your Kardia shows a concerning result?
If the app displays “Possible Atrial Fibrillation” or another concerning result, do not panic. Record the ECG and note the time in your diary. Email [email protected] with the date and time of the recording — Dr Ahmad will review it promptly. If you also feel unwell, faint, or have chest pain, call 999.
Device loan
The KardiaMobile is loaned for one week (£70, when clinically appropriate). You return it by post (a freepost envelope is provided).
If the Kardia is lost or damaged beyond reasonable wear, we may charge for a replacement device.
OpenPalp — Suitability
Suitability
Is this pathway right for you?
This service is designed for selected low-risk patients. Please review the criteria below carefully.
Most people with palpitations will not have these features. If you are unsure about any item below, do not book directly. Complete the screening form and Dr Ahmad will review whether this clinic is suitable.
This pathway is designed for you if
- You are aged 18 or over
- You have intermittent palpitations — an awareness of your heartbeat
- Episodes are brief, lasting seconds to minutes
- You feel generally well between episodes
- You have no known significant heart disease
- Symptoms include missed beats, skipped beats, or occasional rapid episodes that settle on their own
- Symptoms are associated with caffeine, stress, poor sleep, or anxiety
This pathway is not suitable if
- You have fainted or nearly fainted
- You have chest pain that may be cardiac in origin
- You have severe or unexplained breathlessness
- Your heart races for more than 20–30 minutes without settling
- You have known structural heart disease or heart failure
- You have a known significant arrhythmia requiring management
- You have had cardiac surgery or complex congenital heart disease
- Your symptoms are clearly triggered by exertion
- You have a strong family history of sudden cardiac death
- You have an abnormal baseline ECG that needs investigation
- You have a pacemaker or ICD in situ
Borderline — clinical judgement required
- More frequent or prolonged episodes
- Mild exertional symptoms without other red flags
- Unclear history
- Previous investigations but persistent symptoms
These patients may enter the pathway after clinician review, or be referred onward directly.
What if I attend and turn out not to be suitable?
If Dr Ahmad determines during your appointment that you need a different pathway, you will be advised clearly on the day. You will still receive a clinical opinion and a written summary for your GP. You will not be left without a plan.
What if monitoring finds something significant?
If monitoring reveals atrial fibrillation, SVT, significant pauses, or a high ectopy burden, you will be referred promptly to NHS cardiology. You will not be left without a plan.
If examination findings suggest structural heart disease — such as a murmur, abnormal ECG, or signs of ventricular hypertrophy — you will be referred for echocardiography and specialist assessment. Echocardiography is not performed at this clinic, but referral is arranged promptly when indicated.
If your thyroid function has not been checked recently, Dr Ahmad may recommend a blood test through your GP — thyroid disorders are a common and treatable cause of palpitations.
Supplement safety check
At your appointment, we will review any supplements you are taking — including omega-3 fish oil, which recent high-quality evidence (7 RCTs, 81,210 participants) suggests may increase arrhythmia risk by 25%. If you take fish oil supplements, please mention this to Dr Ahmad.
OpenPalp — The Evidence
The Evidence
These are not theories
They are findings from real studies involving real people — people whose hearts changed when they changed how they lived.
View Interactive Evidence Dashboard →Exercise — the strongest lifestyle evidence
(Buckley et al., Cochrane 2024 — 20 RCTs)
A Cochrane systematic review — the gold standard of evidence synthesis — found that exercise-based cardiac rehabilitation reduces AF recurrence by 30% (RR 0.70, 95% CI 0.56–0.88). This is the strongest lifestyle evidence in the entire programme. Separately, a meta-analysis of 1.46 million people confirmed that guideline-level physical activity protects against AF onset.
Regular moderate exercise is not just good for the heart. It is one of the most effective interventions in all of cardiology for reducing arrhythmia burden.
Buckley BJR, et al. Cochrane Database Syst Rev. 2024. • Mishima RS, et al. Heart Rhythm. 2021;18(7):1203-1213.
Alcohol reduction — the only lifestyle RCT in the NEJM
(Voskoboinik et al., New England Journal of Medicine, 2020 — RCT, n=140)
In the first randomised trial of alcohol abstinence for AF, patients who stopped drinking reduced their AF recurrence by 45% (HR 0.55, 95% CI 0.36–0.84). AF burden fell from 1.2% to 0.5% of total time. Even moderate regular drinking (10+ drinks per week) has measurable cardiac effects.
This was not an observational study. This was a controlled trial, published in the most prestigious medical journal in the world, showing that one lifestyle change — reducing alcohol — cut AF recurrence nearly in half.
Voskoboinik A, et al. N Engl J Med. 2020;382:20-28.
Omega-3 fish oil supplements — increased AF risk
(Gencer et al., Circulation, 2021 — 7 RCTs, n=81,210)
Counter-intuitively, omega-3 fish oil supplements increase the risk of atrial fibrillation by 25% (HR 1.25). At doses above 1g per day, the risk rises to 49% (HR 1.49). This is a large, high-quality meta-analysis of randomised controlled trials with a clear dose-response relationship. Eating fish as part of your diet does not carry this risk.
If you are taking omega-3 supplements to help your heart, the evidence suggests they may be making your rhythm worse, not better. Mention all supplements at your appointment.
Gencer B, et al. Circulation. 2021;144:1981-1990.
The breathing story
(Springer Nature, 2024 — meta-analysis of 31 studies, n=1,133)
Researchers gathered 31 studies involving 1,133 people. Some were anxious. Some had high blood pressure. Some had palpitations. All of them were asked to do one thing: slow their breathing to fewer than 10 breaths per minute for five minutes.
In every group, heart rate variability improved. Not after weeks of practice. Within the same session. Within minutes. The vagus nerve — the body’s main brake on the heart — responded to the exhale. Longer out than in. The heart slowed. The anxiety eased.
Five minutes, twice a day — morning and evening. Build this into your routine and your nervous system will change over weeks.
Laborde S, et al. Sci Rep. 2024;14:2881. doi:10.1038/s41598-024-53389-8
The sleep story
Miner et al., SLEEP, 2016 (conference abstract) — an observational analysis of hospital alarm noise suggested that on quieter nights, PVCs were lower by approximately 33% and remained lower the following day.
A 2021 study in JACC followed 403,187 UK Biobank participants and found a 29% lower risk of atrial fibrillation in those with healthy sleep patterns.
Your sleep is not separate from your heart rhythm. It is part of it.
Kwon Y, et al. J Am Coll Cardiol. 2021;78(21):2029-2041.
Miner SEJ, et al. SLEEP. 2016;39(Suppl):A297 (conference abstract).
Weight, movement, and the heart
(PubMed, 2015 — 22,516 adults, 14-year follow-up)
Over 14 years, researchers followed 22,516 apparently healthy men and women attending health screenings. They measured weight, activity, and heart rhythm. Obese patients were 33% more likely to have ectopic ventricular beats. Every additional unit of BMI added 4% more risk.
In absolute terms, these risks are small for most people. These figures describe population trends, not individual predictions.
Separately, large observational studies have found that regular moderate physical activity is associated with a significantly lower risk of atrial fibrillation.
Not because of a disease — because of how they were living. The heart that moves less, fires irregularly more.
Ataklte F, et al. BMC Cardiovasc Disord. 2015;15:176.
The most important story in modern cardiology
This story has a reassuring ending — and it changed how we think about the heart forever.
In 1989, doctors ran a trial. They had a drug that successfully suppressed extra heartbeats after heart attack. The logic seemed obvious: fewer extra beats, less risk of sudden death. The trial was stopped early. Patients taking the drug were dying at three times the rate of those who took nothing.
(CAST Trial, 1989)
The lesson was profound and it changed cardiology permanently: extra heartbeats are a signal, not always the problem. Silencing them without understanding them can be worse than leaving them alone. Understanding them — as you are doing — is often more important than trying to suppress every extra beat.
The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. N Engl J Med. 1989;321:406-412.
Lifestyle factors: alcohol and weight
A 2020 randomised trial published in the New England Journal of Medicine found that alcohol abstinence reduced AF recurrence by 45% compared to continued moderate drinking. The effect was dose-dependent: even light drinking was associated with increased recurrence.
The LEGACY trial (Pathak et al., 2015) demonstrated that sustained weight loss has a profound impact on AF burden. Patients who lost 10% or more of their body weight achieved an 88% rate of AF freedom — compared to just 26% in those who lost less than 3%.
Important: Omega-3 fish oil supplements may increase the risk of atrial fibrillation. A meta-analysis of 81,210 participants found a 25% increased AF risk, with higher doses (above 1g/day) carrying a 49% increased risk. If you take omega-3 supplements, mention this at your appointment.
Voskoboinik A, et al. N Engl J Med. 2020;382:20-28. • Pathak RK, et al. J Am Coll Cardiol. 2015;65(21):2159-2169. • Gencer B, et al. Circulation. 2021;144:1981-1990.
OpenPalp — Frequently Asked Questions
Questions
Frequently asked questions
You will be seen in a private consultation room for a specialist palpitations assessment lasting 20 minutes. Dr Ahmad takes a full history and performs a clinical examination, then provides a clear management plan on the day and a letter to your GP (sent within 5 working days, with your consent). A 12-lead ECG is performed on the same visit for suitable low-risk patients, at no charge. The clinic is at SF Studios, Hampstead.
The KardiaMobile is a small handheld device that records a medical-grade single-lead ECG in 30 seconds. You use it whenever you feel symptoms, and once each morning at rest. If rhythm monitoring is clinically appropriate, it is loaned for one week for £70. You review the Kardia recordings yourself during that time. There is no follow-up appointment; email [email protected] with any concerns.
No. The appointment and a 12-lead ECG are free for suitable low-risk patients. If your symptoms are intermittent and monitoring is clinically appropriate, one week of Kardia rhythm monitoring is offered for £70. It is optional — there is no obligation and no pressure.
A normal resting ECG is reassuring, but it only captures a few seconds of your heart rhythm. Many palpitations are intermittent, which is why optional home monitoring over one week can help catch what a single ECG often misses.
If monitoring identifies a significant rhythm abnormality — such as SVT, atrial fibrillation, significant pauses, or high ectopy burden — you will be referred to an appropriate NHS specialist. We provide documented findings and a clear summary to the receiving clinician.
If monitoring does not capture an abnormal rhythm, that itself is useful information. Combined with a normal clinical assessment, it provides meaningful reassurance. The self-guided booklet can still help reduce symptom frequency. If clinical concern persists, you will be referred onward.
The KardiaMobile is loaned for one week. You return it by post (a freepost envelope is provided). There is no deposit or pre-authorisation. If the device is lost or damaged beyond reasonable wear, we may charge for a replacement device.
No. Fainting (syncope) associated with palpitations is a red flag that requires urgent or specialist assessment. This pathway is for low-risk patients without syncope.
SF Studios, Hampstead. Approximately a short walk from Hampstead. Appointments are available on Tuesday mornings, 9:00–12:00.
Because most low-risk palpitations are influenced by modifiable factors — caffeine, stress, sleep quality, activity levels, and how you respond to symptoms. Monitoring alone tells you what your heart is doing. The self-guided booklet aims to help you influence what it does next.
Yes. This pathway does not prevent or replace referral to a cardiologist. If significant findings emerge, or if symptoms persist beyond the pathway, referral is arranged. Patients may also choose to see a private cardiologist independently at any time.
While eating fish is part of a healthy diet, omega-3 fish oil supplements may actually increase the risk of atrial fibrillation. A meta-analysis of 81,210 people found a 25% increased risk with supplements, particularly at doses above 1g per day. If you currently take fish oil supplements, mention this at your appointment.
OpenPalp — Patient Feedback
Patient Feedback
What patients say
What the self-guided booklet looks like in practice.
Early on
“Recording my first Kardia trace felt empowering. For the first time, I could see what my heart was actually doing instead of just worrying about it.”
Partway through
“The caffeine experiment was a revelation. I had no idea my afternoon coffee was the trigger. Five days without it and the skipped beats almost stopped.”
By the end
“My heart anxiety score dropped from 8 to 3. The breathing technique and understanding the attention loop changed everything.”
Illustrative examples based on typical programme outcomes. Individual results vary.
Completed the programme? We would love to hear about your experience.
Share Your FeedbackOpenPalp — For Clinicians
For Clinicians & Referrers
OpenPalp Pathway
Patients self-refer by email. This page is for clinicians who wish to understand the pathway or discuss patient suitability.
Pathway focus
OpenPalp is a rapid low-risk palpitations pathway for patients who do not need urgent cardiology referral but may benefit from ECG and short-term rhythm capture. It is designed for adults with low-risk palpitations who are otherwise well and have no high-risk features.
In practice this means: a free patient appointment and 12-lead ECG for suitable patients; one-week Kardia rhythm monitoring only if clinically appropriate; a clear written summary sent back to the GP; red-flag patients excluded. OpenPalp is not a chest pain, syncope, emergency, or full cardiology service.
Inclusion criteria
- Intermittent palpitations (awareness of heartbeat)
- Brief episodes (seconds to minutes), settling spontaneously
- No loss of consciousness
- No known significant structural heart disease
- No prior high-risk arrhythmia diagnosis
- Generally well between episodes
Exclusion criteria
- Syncope or pre-syncope
- Chest pain suggestive of cardiac origin
- Severe or unexplained breathlessness
- Sustained tachycardia (>20–30 minutes)
- Known structural heart disease, heart failure, or significant arrhythmia
- Exertion-triggered symptoms
- Strong family history of sudden cardiac death
- Abnormal baseline ECG requiring investigation
- Pacemaker or ICD in situ
Monitoring protocol
- KardiaMobile — one week of patient-activated single-lead event recording
Escalation thresholds
- SVT or significant supraventricular tachycardia
- Atrial fibrillation or flutter
- Significant pauses (>3 seconds)
- High ectopy burden (>10% of recorded beats)
- Symptoms remaining unexplained after completion of the pathway
- Persistent clinical concern
Self-guided lifestyle booklet
- Day 1 — Listen
- Day 2 — Breathe
- Day 3 — Discover
- Day 4 — Change
- Day 5 — Move
- Day 6 — Understand
Governance
- This service is for selected low-risk patients only. Not a substitute for comprehensive cardiology care.
- Every patient assessed at initial appointment to confirm suitability.
- Clear referral thresholds defined. Significant findings are escalated.
- Not an emergency service. Does not replace urgent or hospital care.
- Monitoring recordings reviewed within clinic pathway. Complex findings escalated.
- Improvement programme is supportive and behavioural. Does not replace medical treatment.
- Unexplained symptoms after pathway completion are escalated.
Service delivery
All care is delivered by Dr Mahmood Ahmad, an NHS cardiology specialist doctor (MRCP(UK), GMC 6071047) who works in senior cardiology roles in NHS teaching hospitals in London and is experienced in assessing palpitations. He is fully GMC-registered with a licence to practise and insured for independent private practice.
For clarity: Dr Ahmad practises as a specialist doctor in cardiology within the NHS; he is not a CCT-holding Consultant on the GMC Specialist Register. His NHS specialist experience and right to practise independently do not depend on that particular training route.
Communication
With patient consent, a written summary of findings, ECG results, and management plan is sent to the referring or registered GP within 5 working days. Red-flag ECG recordings are reviewed by Dr Ahmad within 24 hours and the patient is contacted directly.
Load on your practice
Most suitable low-risk patients will not require further GP action. Where I recommend blood tests, monitoring, echo or referral, I will state the specific clinical reason. I will not ask practices to arrange investigations routinely.
Referral
Patients may self-refer. If you would like to refer a patient or discuss suitability, please contact [email protected].
For GPs: signposting a patient
We are happy for GPs to signpost suitable low-risk palpitations patients to OpenPalp. Patients self-refer and choose whether to proceed with private rhythm monitoring if it is clinically appropriate.
No formal referral is required. If you would like to refer directly or discuss a patient's suitability, please email [email protected] with a brief clinical summary.
After the appointment, a written summary of findings is sent to the patient's GP (with consent), including any Kardia recordings of clinical significance.
Dr Mahmood Ahmad — NHS cardiology specialist doctor, MRCP(UK), GMC 6071047. Senior cardiology roles in NHS teaching hospitals in London.