What should I know about waiting lists for heart rhythm treatments in the UK? 

In the UK, the demand for heart rhythm treatments, such as catheter ablation, pacemaker fitting, and ICD implantation, is at an all-time high. While the NHS provides world-class cardiac care, many patients find themselves on a waiting list after their initial consultation. Navigating these lists can be a source of significant anxiety, especially when you are living with the symptoms of an arrhythmia every day. It is important to understand that an NHS waiting list is not a simple ‘first-come, first-served’ queue; it is a dynamic system that constantly re-prioritises patients based on their medical urgency. Knowing your rights, understanding how the system works, and knowing what to do if your symptoms change can help you feel more in control of your journey. This article provides a medically neutral guide to the reality of heart rhythm waiting lists in the UK in 2025. 

What We’ll Discuss in This Article 

• The ‘18-Week’ standard and how it applies to heart rhythm treatments. 

• How the NHS ‘triages’ cardiac waiting lists based on clinical risk. 

• Your rights under the NHS Constitution regarding long waits. 

• The difference between ‘Diagnostic’ and ‘Treatment’ waiting lists. 

• Practical steps to stay safe while waiting for a procedure. 

• How to use ‘Patient Choice’ to potentially find a shorter waiting list. 

• Emergency safety guidance for sudden or severe cardiac symptoms. 

1. The ‘18-Week’ Target (RTT) 

The primary measure used by the NHS is the Referral to Treatment (RTT) pathway. 

• The Standard: Under the NHS Constitution, you have a legal right to start your consultant-led treatment within 18 weeks of your GP referral. 

• The Reality: While this is the target, current pressures on the NHS mean that elective (non-emergency) procedures, such as ablation for Atrial Fibrillation, often exceed this timeframe. 

• The ‘Stop Clock’: The ‘clock’ starts when your GP refers you and stops when your treatment begins (e.g., the day of your surgery). Diagnostic tests like ECGs or monitors are part of this 18-week window. 

2. How Cardiac Lists are Triaged 

Clinicians categorise patients into different ‘priority bands’ to ensure those at the highest risk are treated first. 

• Priority 1 (Emergency): Patients who require life-saving treatment within 72 hours. These patients are usually already in the hospital. 

• Priority 2 (Urgent): Patients with unstable symptoms or high-risk conditions (like certain types of Heart Block) who should be treated within 4 weeks. 

• Priority 3 (Routine): Patients with stable but symptomatic conditions (like SVT or intermittent AF) where treatment is needed but the risk of immediate harm is low. 

• Priority 4: Patients whose treatment can safely wait for more than 3 months. 

3. Your Rights: The Right to Move 

If you have been waiting a long time, the NHS Constitution provides you with specific rights. 

• The 18-Week Right: If it is clear that your treatment will not start within 18 weeks, the NHS has a duty to take all reasonable steps to offer you a quicker alternative with a different provider (including private hospitals that have NHS contracts). 

• Patient Choice: At the point of referral, you have the right to choose which hospital you are sent to. Some patients choose to travel further to a hospital with a shorter waiting list. You can check wait times via the My Planned Care website. 

4. Staying Safe While on the List 

Waiting for a heart procedure does not mean you are without care. Your GP and cardiologist remain responsible for your safety during this time. 

• Medication Management: Your doctor may adjust your medication (such as beta-blockers or blood thinners) to keep your heart stable while you wait for your definitive procedure. 

• The ‘Safety Net’: If your symptoms worsen, for example, if you start fainting or your breathlessness increases, you must contact your cardiology department. They can ‘upgrade’ your priority on the list based on these new clinical findings. 

• Home Monitoring: Some trusts provide ‘patient-initiated follow-up’ (PIFU), allowing you to report symptom changes directly to the cardiac team without waiting for a new appointment. 

Differentiation: Wait Time Expectations by Treatment 

This table provides a general guide to typical NHS wait times in 2025 (note: these vary significantly by region). 

Treatment Type	Typical Priority	Estimated Wait (Routine)
Simple Pacemaker	High / Urgent.	4–8 weeks.
SVT Ablation	Routine.	12–24 weeks.
Complex AF Ablation	Routine.	18–36 weeks.
ICD (Defibrillator)	Urgent / Priority.	2–6 weeks.
Diagnostic Loop Recorder	Routine.	8–16 weeks.

5. What Should I Do If I Am Still Waiting? 

1. Contact the ‘Waiting List Coordinator’: Every cardiology department has a coordinator. You can call them to check your current position and ensure your contact details are correct. 

2. Optimise Your Health: Use the waiting time to manage ‘modifiable’ risks. Losing weight, stopping smoking, and controlling blood pressure can make your eventual procedure safer and more successful. 

3. Check for Cancellations: Ask to be put on a ‘short-notice’ list. If another patient cancels their slot, you may be offered the chance to have your procedure much sooner. 

4. Speak to Your GP: If the wait is affecting your mental health or your ability to work, your GP can write an ‘expedite letter’ to the hospital explaining the impact of the delay. 

Conclusion 

Navigating NHS waiting lists for heart rhythm treatments requires a mix of patience and proactivity. While the 18-week target is the goal, the reality of the healthcare landscape means that many ‘routine’ procedures take longer. The most important thing to remember is that you are not ‘stuck’ in a static queue; your priority is based on your clinical need. By staying in touch with your cardiology team, managing your health triggers, and knowing your rights under the NHS Constitution, you can ensure that you remain safe and informed throughout the process. The UK’s cardiac specialists are dedicated to getting you into the theatre as soon as it is clinically safe to do so, ensuring your heart rhythm is restored and your quality of life is improved. 

If you experience severe, sudden, or worsening symptoms, call 999 immediately. 

Authority Snapshot (E-E-A-T Block) 

This article was written by Dr. Stefan Petrov, a UK-trained physician with an MBBS and professional certifications in Advanced Cardiac Life Support (ACLS). Dr. Petrov has navigated the NHS system extensively, working in emergency departments and intensive care units where he has managed the prioritisation and care of patients awaiting specialist cardiac interventions. This guide follows the standards of the NHS Constitution and NICE to provide a clear, factual overview of the current state of UK cardiac waiting lists.