Objective: Specialist nursing services focused on delivering care to patients with a suspected arrhythmia are evolving. An audit was undertaken to characterize the population of patients referred to a nurse-facilitated suspected arrhythmia outpatient clinic during the fi rst year of its operation, to assess effectiveness of the clinic in identifying those requiring further treatment, organizational implications of such a clinic and to form a baseline against which future audits can be compared. Methods: Retrospective data were collected from all patients newly referred and assessed in a nurse-facilitated suspected arrhythmia from July 2006 to July 2007. Results: 192 patients were referred to this clinic. New referrals were predominantly female (60%); an age range of 19–91 years and were largely Caucasian (88%). The most common symptom prompting referral was palpitations (71%). Depending on clinical history, 82% of referred patients had cardiac monitoring. Following investigation atrial fi brillation (persistent or paroxysmal) was identifi ed in 26% of the referred patients and signifi cant paroxysmal supra-ventricular tachycardia in 5%. The remainder demonstrated atrial ectopy (17%), ventricular ectopy (13%), other arrhythmias (1%), with no arrhythmias identifi ed in 38% of the cohort. Conclusions: This audit demonstrates that a nurse-facilitated suspected arrhythmia clinic is an effective way of identifying patients with suspected heart rhythm abnormalities. From an organizational standpoint this clinic helps to reduce the burden on general cardiology clinics and helps meet NHS targets. A clear need for further published evidence is highlighted.