Skip to main content
If you have chest pain, fainting, severe breathlessness, or feel acutely unwell, call 999 immediately. This is not an emergency service.

OpenPalp — Your Personal Heart Rhythm Programme

If your heart has been worrying you, you are not alone — and you do not have to keep wondering.

Dr Mahmood Ahmad — MRCP(UK), GMC verified — SF Studios, Hampstead

Specialist (SAS) grade — different career pathway from the NHS consultant training route. Not a CCT-holder; not on the GMC Specialist Register. Full GMC registration; fully insured for independent private practice.

Understand what your heart is doing.

A free clinic assessment with Dr Ahmad, an optional 12-lead ECG, and optional KardiaMobile home rhythm monitoring for one week. Tuesday mornings in Hampstead — no time off work.

Complete screening form

Free clinic · optional 12-lead ECG £49 · optional Kardia monitor £70 · no referral needed

See if this is right for you

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

finds more beats  →
Heartbeat
noticed or felt
awareness increases
Attention
focuses on heart
anxiety rises
←  notices even more
This programme breaks the loop
By understanding your triggers, breathing slowly, and reducing the fear around symptoms, the loop gradually weakens.

The more you monitor your heartbeat, the more you find it — until you learn not to look.

What's available

Three clear options

Start with the free clinic. Add the optional ECG or home monitor only if you want to — there is no obligation.

Free clinic appointment
Free

Face-to-face assessment with Dr Ahmad — symptoms, triggers, risk, and a clear plan.

12-lead ECG
£49

Optional standalone 12-lead resting ECG on the same visit, interpreted by Dr Ahmad.

Home rhythm monitor
£70

Optional KardiaMobile loaned for one week, with the OpenPalp self-guided booklet.

How it works

Four simple steps

  1. Email [email protected] to book your free clinic appointment
  2. Attend your Tuesday morning specialist palpitations assessment (20 minutes) — Dr Ahmad takes a full history, examines you, and provides a management plan and a letter to your GP. Add an optional 12-lead ECG on the day (£49) if you wish.
  3. If suitable and you wish to, take home a KardiaMobile and the OpenPalp booklet on the same visit — £70 for one week
  4. Record whenever you feel symptoms and follow the self-guided booklet — email Dr Ahmad any time with concerns

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

Specialist in Cardiology (SAS grade — a senior NHS specialist role) · MRCP(UK) · GMC 6071047

Dr Mahmood Ahmad receiving an award

All care within the OpenPalp pathway is delivered by Dr Ahmad. He works independently in senior cardiology roles in NHS teaching hospitals in London, and brings extensive experience in managing common cardiac conditions in private practice. He is fully GMC-registered and fully insured for independent private practice.

Transparency

Dr Ahmad works independently in senior cardiology roles in NHS teaching hospitals in London. He is fully GMC-registered (with licence to practise), holds MRCP(UK), and is fully insured for independent private practice. His career pathway to Specialist grade was different from the traditional NHS consultant training programme — he does not hold a CCT, a credential specific to that training route. His clinical role and right to independent practice are not dependent on holding a CCT.

Pricing

Free clinic. Two optional add-ons.

Three clear options. No hidden fees. No online payment.

Screening & Clinic Appointment

If suitable. Email screening form, reviewed by Dr Ahmad; appointment offered Tuesday morning at SF Studios, Hampstead if appropriate.

FREE

no charge

  • Face-to-face assessment
  • Symptom and trigger review
  • Risk factor assessment
  • Suitability confirmation
  • Clear explanation and next steps

12-Lead ECG

Optional standalone 12-lead resting ECG, performed on the same visit and interpreted by Dr Ahmad.

£49

optional add-on

  • Standard 12-lead resting ECG
  • Interpreted by Dr Ahmad
  • Result and explanation on the day
  • Written GP summary (with consent)
  • No follow-up required

Home Rhythm Monitor (KardiaMobile)

Optional single-lead KardiaMobile loaned for one week, with the OpenPalp self-guided booklet.

£70

one week

  • KardiaMobile loaned for one week
  • Record whenever you feel symptoms
  • OpenPalp printed booklet & digital booklet
  • Email Dr Ahmad with any concerns
  • Returned by post — no follow-up required

If the KardiaMobile is lost or damaged beyond reasonable wear: replacement cost £70. The clinic appointment is free and standalone — the ECG and the home monitor are optional, and there is no obligation to take either.

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.

  1. Step 1. Complete the free 2-minute screening form below.
  2. Step 2. Dr Ahmad reviews your form and may call you.
  3. Step 3. If suitable, an appointment is offered (Tuesday mornings, SF Studios, Hampstead).
  4. Step 4. Add an optional 12-lead ECG (£49) or a one-week home rhythm monitor (£70) if you wish — both optional.

Screening form

Age band
Trigger you've noticed
Red-flag checklist — tick any that apply

If any of these apply, this pathway is not suitable. Do not submit the form — see the safety message that will appear below.

If your email client doesn’t open automatically, please email the same information to [email protected].

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).

Day 1

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.

Day 2

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.

Day 3

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%.

Day 4

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.

Day 5

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.

Day 6

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.

1

Stay calm

Anxiety amplifies palpitations. Take one slow breath and remind yourself: most palpitations are not dangerous. You are not in danger.

2

Sit or lie down

Reduce demand on your heart. Do not continue strenuous activity until the episode has fully passed.

3

Breathe slowly

4 seconds in. 6 seconds out. Repeat five times. This activates your vagus nerve and can slow or settle the heart.

4

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.

5

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.

6

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

  1. Check your HRV if your watch tracks it — note the number in your diary
  2. Take one resting Kardia recording — before getting up
  3. Five minutes of 4-6 breathing. In for 4, out for 6.
  4. Fill in your diary for yesterday

Every evening

  1. Five minutes of 4-6 breathing
  2. Note one thing that helped your heart today
  3. Rate your heart anxiety today (1–10) in your diary
  4. 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)

Diagram showing how to record with Kardia: place each thumb on one electrode pad, hold still for 30 seconds, single-lead ECG.

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

  1. Download the free Kardia app (App Store or Google Play)
  2. Open app, tap ‘Add a device’, follow pairing steps
  3. No paid subscription needed — free tier stores all ECGs

How to record

  1. Place each thumb on one electrode pad
  2. Hold still, breathe gently, stay for 30 seconds
  3. 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). You return it by post (a freepost envelope is provided).

If the Kardia is lost or damaged beyond reasonable wear: replacement cost £70.

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.

If you have chest pain, fainting, severe breathlessness, or feel acutely unwell, do not use this service. Seek urgent medical attention immediately — call 999 or attend A&E.

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 →
HIGH-GRADE EVIDENCE

Exercise — the strongest lifestyle evidence

0
randomised controlled trials (Cochrane review)

(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.

HIGH-GRADE EVIDENCE

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.

SAFETY WARNING

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

4-6 breathing — the most important thing you can do
Breathe in for 4, out for 6
5 breaths · morning and evening
Inhale
4
seconds in
then
Exhale
6
seconds out
How slow breathing calms the heart: slow exhale triggers vagus nerve, which slows heart rate, reduces anxiety, and reduces ectopic beats over time.

(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

The same heart, different sleep, different rhythm: disrupted sleep increases PVCs by 33%, protected sleep decreases them by 33%.

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

0
adults followed for 14 years

(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.

Explore the full evidence dashboard

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). An optional 12-lead ECG (£49) can be performed on the same visit. 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. It is loaned for one week (£70). You review the Kardia recordings yourself during that time. There is no follow-up appointment; email [email protected] with any concerns.

No. The clinic appointment is free and standalone. After your appointment, you can decide whether to add an optional 12-lead ECG (£49) or take home a KardiaMobile rhythm monitor for one week (£70). Both are 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, the replacement cost is £70.

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 Feedback

OpenPalp — For Clinicians

This page is written for healthcare professionals. If you are a patient, the information you need is on our main pages.

For Clinicians & Referrers

OpenPalp Pathway

Patients may self-refer. This page is for clinicians who wish to understand the pathway or discuss patient suitability.

Pathway focus

This pathway is designed for adults with low-risk palpitations who are otherwise well and have no high-risk features.

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

  1. 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

  1. Day 1 — Listen
  2. Day 2 — Breathe
  3. Day 3 — Discover
  4. Day 4 — Change
  5. Day 5 — Move
  6. 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, Specialist in Cardiology (SAS), MRCP(UK), GMC 6071047. Dr Ahmad practises in senior cardiology roles in NHS teaching hospitals in London. He is fully GMC-registered and fully insured for independent private practice.

Transparency: Dr Ahmad reached his Specialist grade through a career pathway different from the traditional NHS consultant training programme. He does not hold a Certificate of Completion of Training (CCT) and is not on the GMC Specialist Register.

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: referring your patient

No formal referral is required — patients can self-refer online. However, if you would like to refer directly or discuss a patient's suitability, please email [email protected] with a brief clinical summary.

After the programme, a written summary of findings is sent to the patient's GP (with consent), including any Kardia recordings of clinical significance.

Dr Mahmood Ahmad — Specialist in Cardiology (SAS grade), MRCP(UK), GMC 6071047. NHS teaching hospitals in London.

Email to book