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Cardiac device checks, pacemaker, ICD and CRT interrogation - the standard follow-up you need.

A structured interrogation of implanted cardiac devices - pacemaker, implantable defibrillator (ICD), cardiac resynchronisation therapy (CRT) or loop recorder. Checks battery, leads, arrhythmia detections and stored electrograms - usually every 6–12 months, plus remote-monitoring alerts.

A cardiac physiologist interrogating a pacemaker in a private London clinic

Indicative pricing

What a private cardiac device check costs in London.

Indicative ranges across UK private providers.

In short

£180–£320, with findings often the same day.

Check type Indicative range
Standard pacemaker check £180–£320
ICD interrogation £240–£420
CRT device check with optimisation £320–£550
Loop recorder download and review £180–£320
Device check + electrophysiology consultation £450–£900
Remote-monitoring set-up and enrolment £150–£280

Prices vary by clinic, device type (pacemaker, ICD, CRT, loop recorder) and whether a same-visit electrophysiology opinion is included.

Key facts

What a cardiac device check actually does.

The six numbers your electrophysiology team is really looking at.

  • Definition

    In-clinic or remote interrogation of an implanted cardiac device.

  • Frequency

    Every 6–12 months in clinic, with continuous remote monitoring in between.

  • Battery and leads

    Reviews battery voltage, lead integrity, sensing and pacing thresholds.

  • Arrhythmia detection

    Quantifies AF burden, ventricular tachycardia (VT) and ventricular fibrillation (VF).

  • Therapy optimisation

    Guides medication changes and CRT programming for best clinical response.

  • Early failure detection

    Enables early identification of lead failure before clinical events occur.

The problem

A device check is only as good as who reads it.

The numbers are the answer - and the physiologist and electrophysiologist reading them decide how they translate into a programming change, medication tweak or generator swap. We route you to that team, not a generalist.

  • Remote-monitoring alert?

    We triage the alert against a clinic slot within days, not weeks.

What it shows

What a cardiac device check actually reveals.

A device interrogation answers a specific set of questions - is the hardware working, is the battery holding, and what has your heart been doing between visits.

  • Battery status (voltage, ERI)

    Battery voltage and elective replacement indicator - the earliest sign a generator swap is due.

  • Lead impedance and thresholds

    Sensing and pacing thresholds on each lead - the core check for lead integrity.

  • AF burden

    Total time in atrial fibrillation since the last check - drives anticoagulation decisions.

  • VT / VF episodes

    Any ventricular tachycardia or fibrillation events, with stored electrograms.

  • Antitachycardia pacing and shock delivery

    Whether the device treated an arrhythmia with pacing or a defibrillation shock, appropriately or not.

  • CRT biventricular pacing percentage

    The percentage of beats delivered biventricularly - the key CRT-response metric.

  • Sensing quality

    How reliably the device sees intrinsic beats - under- or over-sensing changes therapy behaviour.

  • Red flag: elective replacement indicator (ERI) or lead failure - urgent electrophysiology review

    Do not wait for a routine slot. Contact your electrophysiologist promptly.

Check types

Not all cardiac device checks are the same.

What each option on your referral is actually for.

  • Pacemaker interrogation

    Battery, leads, thresholds and sensing on a single- or dual-chamber pacemaker.

  • ICD interrogation

    Adds review of ventricular arrhythmia detections and any delivered therapies.

  • CRT device check

    Biventricular pacing percentage plus AV/VV optimisation for heart-failure patients.

  • Loop recorder download

    Implantable loop recorder read and stored ECGs reviewed for arrhythmia diagnosis.

  • Remote monitoring set-up

    Enrolment on the manufacturer’s remote platform, with alerts routed to your team.

  • Device check + EP consult

    Interrogation plus a same-visit consultant electrophysiologist opinion.

  • Pre-procedure device check

    Programming adjustments before surgery, MRI or diathermy.

  • Urgent alert review

    Same-week slot when a remote alert or symptom demands a rapid answer.

Safety and eligibility

One of the safest tests in cardiology.

Device interrogation is exceptionally safe - the practical points are when a routine slot is right, when an urgent contact is right, and how to prepare for surgery or MRI.

  • Painless, non-invasive

    A wand over your device, or a wireless link - no needles, no imaging, no discomfort.

  • Bring your device ID card

    The card carries the manufacturer, model and lead details the physiologist needs.

  • Position on the couch

    You lie or sit - that is the whole preparation. No fasting required.

  • Threshold testing sensations

    Brief pacing tests may feel like a mild flutter for a few seconds - expected and safe.

  • ICD shocks are a medical emergency

    If your ICD has delivered a shock, contact your electrophysiology team the same day.

  • MRI-conditional devices

    Most modern devices are MRI-conditional. A device check is required before and after the scan.

  • Diathermy and surgery

    Surgical diathermy can interfere with devices - programming changes may be needed pre-op.

  • Remote monitoring is not a shortcut

    Remote alerts complement, not replace, scheduled in-clinic interrogation.

  • Bring prior device reports

    Trend data across visits is what turns a snapshot into a decision - bring what you have.

Red flags

When a device check demands urgent action.

These findings on interrogation - or symptoms between checks - should trigger a same-week electrophysiology review.

  • Lead failure or dislodgement

  • Elective replacement indicator (ERI)

  • High-risk arrhythmia detection

  • Inappropriate ICD shocks

  • Battery depletion earlier than expected

  • Twiddler syndrome

  • Device infection (endocarditis)

  • Twiddler or lead migration

  • CRT non-response

After the check

What happens next.

The interrogation is the input - these are the concrete next steps a device check drives.

  • Reprogramming for optimisation

  • Medication review for arrhythmia burden

  • Lead revision for lead failure

  • Generator replacement at ERI

  • Remote-monitoring set-up

  • Electrophysiology consultation

  • Structured 6–12 monthly follow-up

  • Advanced heart-failure referral for CRT non-responders

Reading your report

A device report can look intimidating. It isn’t.

Whatever the finding, the report keeps to the same four parts.

A cardiac physiologist reviewing a device interrogation report on a clinical workstation at a UK private clinic

A quiet reminder

The report is written for your doctor, not for you - and that’s normal.

If you would like us to talk you through it before your follow-up, just ask.

  1. 01 Header

    Device details and indication

    Your details, the device manufacturer, model, implant date and the reason for the check.

  2. 02 Technique

    Programmer and interrogation method

    Which programmer was used, wand or wireless, and which parameters were tested.

  3. 03 Findings

    Battery, leads, arrhythmias, therapies

    Battery voltage and longevity, lead impedance and thresholds, AF burden, VT/VF episodes and any delivered therapies.

  4. 04 Impression

    The conclusion: read this first

    Normal, programming change, generator replacement due, or urgent electrophysiology review - read this first.

Recognised by major UK insurers

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Frequently asked

Everything we get asked about cardiac device checks.

Quick answers on how often, cost, remote monitoring, differences between pacemaker, ICD and CRT, and when to contact your team urgently.

  • How often should my cardiac device be checked?

    In-clinic interrogation is typically every 6–12 months, with continuous remote monitoring in between. Loop recorders and ICDs generally sit at the more frequent end of that range.

  • What is the difference between a pacemaker, ICD and CRT?

    A pacemaker treats bradycardia by pacing the heart when it is too slow. An ICD (implantable cardioverter-defibrillator) additionally detects and treats life-threatening ventricular arrhythmias with pacing or a shock. A CRT (cardiac resynchronisation therapy) device paces both ventricles together in selected heart-failure patients.

  • Do I need a referral?

    Most clinics accept self-referral for a device check.

  • What is remote monitoring and do I need it?

    Remote monitoring uses a bedside or bedside-app transmitter to send device data to your team overnight - often daily. It shortens the time between an event (a lead problem, an arrhythmia, low battery) and clinical action, and it is now standard for ICD and CRT devices.

  • When should I contact my team urgently?

    Any ICD shock, new palpitations with dizziness or blackout, a remote-monitoring alert flagged as urgent, or symptoms suggestive of device infection (fever, redness or discharge at the pocket site). If you have chest pain or lose consciousness, call 999.

Sources

Guidelines and evidence behind this page.

Last reviewed 2026-07-30. Next scheduled review 2027-07-30.

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In practice, in London

What cardiac device checks looks like on the ground in London

With cardiac device checks, the London question is usually about report turnaround and the radiologist reading it - not whether the scan is available. On the NHS, cardiac device checks typically sits behind a triage step and a wait that can stretch from a few weeks into months. In London’s private sector, the same appointment often lands within days. That speed matters when symptoms are disrupting work, sleep, or a plan you’d already committed to - and it’s the single most common reason people call us in the first place.

In practice, a private cardiac device checks appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For cardiac device checks specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.