The heart is stimulated to contract via an internal electrical pathway. An impulse is normally generated from the sinoatrial node (the hearts internal ‘pacemaker’) and travels from the atria (tops chambers) to the ventricles (bottom chambers).

An interruption in the electrical pathway may cause the heart to miss beats, if several beats are missed in a row, the frequency of heart contraction may be so low that the brain does not get enough blood supply and the patient may blackout – this is usually quite sudden and can even occur whilst driving

Dizziness, excess fatigue and black-outs are the most common symptoms

Occasionally, heart block may be identified incidentally, such as during an ECG or Holter recording

Stopping the offending medications (if relevant)

Insertion of a pacemaker