Concierge cardiac monitoring · London
Implantable loop recorder (ILR), a paper-clip-sized device that watches your heart rhythm for up to 3 years.
An implantable loop recorder (ILR) is a small, subcutaneous device inserted under local anaesthetic that continuously monitors heart rhythm for up to 3 years — for cryptogenic stroke, unexplained syncope and rare high-risk arrhythmias.
Why patients choose us
- 01
The right hands
We route you to a consultant cardiac electrophysiologist — the specialist who inserts the device and reads the rhythm data decides the answer.
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Continuous, for up to 3 years
The device watches every beat, day and night, and transmits automatically — no diary, no repeat visits for tapes.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What the implantable loop recorder actually is.
Six things worth knowing before you decide — device, insertion, monitoring model and the guidance behind it.
In short
A ten-minute insertion under local anaesthetic, then up to three years of continuous, cardiology-led rhythm surveillance.
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Subcutaneous continuous cardiac rhythm monitor
A paper-clip-sized device implanted just under the skin that records your heart rhythm around the clock.
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Battery life up to 3 years
One device, one insertion — up to three years of continuous surveillance without repeat procedures.
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Local anaesthetic insertion (10 min)
A short outpatient procedure through a small incision on the left chest wall.
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Wireless remote monitoring
A bedside transmitter uploads data automatically — no app-tapping required.
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NICE-approved for cryptogenic stroke and unexplained syncope
Recommended in national guidance where shorter monitors have failed to find the answer.
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Cardiology-led interpretation
Alerts and downloads are reviewed by consultant cardiac electrophysiologists, not algorithms alone.
The problem
Short monitors miss the arrhythmia that matters.
A 24-hour Holter or a 7-day event recorder only sees a fraction of the days that matter. Paroxysmal AF, sinus pauses and non-sustained VT hide between recordings — and an ILR is designed to catch them.
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Had a cryptogenic stroke?
We arrange an ILR to look for hidden paroxysmal AF and route findings to the stroke team.
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Unexplained blackouts?
We route you to an electrophysiologist for insertion and symptom-rhythm correlation.
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Holter and event recorder inconclusive?
We step up to three years of continuous monitoring with a defined follow-up plan.
The journey
From consultation to remote review — what happens, in order.
One cardiac electrophysiologist from first consultation through years of remote monitoring.
Phase 1 · Before insertion
Consultation and consent
Phase 2 · On the day
~10 minutes under local
Phase 3 · After
Remote monitoring
- 01
Before
Cardiology consultation
A consultant electrophysiologist reviews your history, prior ECGs and any Holter or event-recorder data before recommending an ILR.
- 02
Before
Consent and pre-op check
Bloods, blood pressure, allergies and anticoagulation status confirmed; the procedure and remote-monitoring pathway explained.
- 03
On the day
Local anaesthetic
A small area of the left chest wall is numbed. No sedation is usually required and you stay awake throughout.
- 04
On the day
Small incision, left chest wall
A single incision of roughly 1 cm is made just below the collarbone, over the fourth intercostal space.
- 05
On the day
ILR inserted subcutaneously
The paper-clip-sized device is slid into the subcutaneous pocket and the incision closed with steri-strips or a single suture.
- 06
On the day
Wireless home monitor set up
Before you leave, a bedside transmitter is paired to the device — from then on, data uploads automatically.
- 07
After
Cardiology remote review
The electrophysiology team reviews transmissions and any patient-triggered events, and calls you if action is needed.
Typical time from consultation to insertion: 1–2 weeks. Monitoring: up to 3 years.
What it shows
When an implantable loop recorder is the right test.
The ILR answers one question well — what is your heart rhythm doing at the moment something happens. These are the presentations we see most.
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Cryptogenic stroke AF detection
Uncovers paroxysmal atrial fibrillation missed by shorter monitors — the commonest hidden cause of stroke of unknown source.
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Paroxysmal AF
Captures brief, self-terminating AF episodes that never show up on a resting ECG.
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Sinus pauses
Documents pauses of the sinus node — the classic substrate for pacemaker-responsive syncope.
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Ventricular tachycardia
Records non-sustained and sustained VT, and correlates it with any symptoms you push the trigger for.
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Complete heart block
Catches intermittent high-grade AV block that shorter monitors routinely miss.
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Symptom-rhythm correlation
Pairs a palpitation, dizzy spell or blackout with the exact rhythm at that moment — the single most useful piece of data.
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Rare arrhythmia in syncope
Delivers a diagnosis in unexplained syncope where tilt testing and Holters have been inconclusive.
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Red flag: sustained VT or long pause with syncope — urgent cardiology admission
If the device transmits sustained VT or a long pause with loss of consciousness, this is an emergency — do not wait for a clinic appointment.
Next steps
What follows a positive ILR finding.
The ILR tells you what the rhythm is doing. These are the treatment options — medical, procedural or device — that follow.
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Anticoagulation for detected AF
A DOAC (or warfarin) started promptly once AF is documented, to cut the stroke-recurrence risk.
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Rate / rhythm control
Beta-blockers, calcium-channel blockers or antiarrhythmics chosen by the electrophysiologist to match the rhythm pattern.
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Cardiac ablation
Catheter ablation of AF, atrial flutter or focal VT when medical therapy is insufficient or poorly tolerated.
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Pacemaker for symptomatic bradycardia
Permanent pacing when the ILR documents symptomatic sinus pauses or high-grade AV block.
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ICD for VT
An implantable cardioverter-defibrillator when the ILR documents sustained VT or you meet primary-prevention criteria.
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Explant at end-of-life
A short outpatient procedure to remove the device once its job is done or the battery is depleted.
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Cardiology follow-up
Structured remote review with periodic in-person clinics to correlate device data with how you feel.
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Structured stroke-clinic pathway
A defined route back into the TIA or stroke clinic when the ILR uncovers AF after a cryptogenic event.
Our vetted London network
A small panel of electrophysiologists, we picked them.
Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant cardiac electrophysiologists performing insertions
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Same-day insertion in a dedicated cardiac procedure room
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24/7 remote-monitoring service with rapid triage of alerts
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Onward pathway into stroke-clinic or device (pacemaker/ICD) teams if needed
Safety and eligibility
A small procedure, and then it just runs.
ILR insertion is one of the safest cardiac procedures in routine practice. The practical points are wound care, MRI conditions, and knowing when a transmission is an emergency.
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Local anaesthetic only
Insertion takes about ten minutes under local anaesthetic — no general anaesthetic and, usually, no sedation.
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Small, discreet device
The device is roughly the size of a paper clip and sits just under the skin — most patients cannot see it after healing.
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MRI-conditional
Modern ILRs are MRI-conditional; the device card confirms the exact scanner limits.
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Continuous, hands-off
You do not need to remember to press anything for the device to record — automatic algorithms flag arrhythmia around the clock.
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Wound care
Keep the incision dry for 48 hours; a small bruise is normal and settles within a fortnight.
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Sustained VT or syncope is urgent
A transmission of sustained VT, or a blackout with a documented long pause, is a 999 or same-day admission — not a routine clinic appointment.
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Battery life up to 3 years
The device is monitored throughout; you are told well in advance when the battery approaches end-of-life.
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Explant when the job is done
Removal is a short local-anaesthetic procedure once a diagnosis is reached or the battery is spent.
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Bring your device card and prior ECGs
Your device identity card plus any Holter, event-recorder or resting ECG reports materially sharpens interpretation.
Red flags for ILR referral
Presentations where an ILR is often the right call.
Not exhaustive, and always a consultant electrophysiologist’s decision — but any of these usually warrants that conversation.
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Cryptogenic stroke
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Recurrent syncope
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Sustained VT
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Complete heart block
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Long QT with syncope
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Wolff-Parkinson-White
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Brugada
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Family SCD
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Post-cardiac-arrest survivor
Reading your report
An ILR report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
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.
- 01 Header
Indication and device details
Your details, the reason for the ILR, and the device make, model and implant date.
- 02 Technique
Insertion and monitoring set-up
Where and when the device was inserted, and the remote-monitoring platform and transmission schedule in use.
- 03 Findings
Rhythm events and symptom correlation
Automatic and patient-triggered events, with the rhythm strip at each event and any symptom log entries.
- 04 Impression
The conclusion: read this first
Diagnosis (AF, pause, VT, block, or no arrhythmia), and the concrete next step — read this first.
Sources
What this page is based on.
- NICE. Atrial fibrillation: diagnosis and management (NG196).
- NICE. Implantable cardiac monitors to detect atrial fibrillation after cryptogenic stroke (IPG634).
- European Society of Cardiology. Clinical practice guidelines.
- Heart Rhythm Society. Clinical resources and guidelines.
Last reviewed 2026-07-30. Next review 2027-07-30. Reading time approximately 6 minutes.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about the implantable loop recorder.
Quick answers on who needs one, the insertion, recovery, battery life and what happens when the device flags something.
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What is an implantable loop recorder?
An implantable loop recorder (ILR), also called an insertable cardiac monitor, is a paper-clip-sized device implanted just under the skin of the left chest wall. It records your heart rhythm continuously for up to three years and transmits the data wirelessly to a cardiology team.
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Who needs an ILR?
The two main groups are patients who have had a cryptogenic stroke (a stroke of unknown source, where hidden paroxysmal atrial fibrillation is suspected) and patients with unexplained syncope after shorter monitors and tilt testing have been inconclusive. It is also used in selected patients with rare, high-risk arrhythmias.
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How is it inserted?
Under local anaesthetic, through a single incision of roughly 1 cm on the left chest wall. The whole procedure takes about ten minutes and does not usually require sedation. You go home the same day.
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Does it hurt, and how long is recovery?
You feel the local anaesthetic sting, then a pushing sensation as the device is inserted. Most patients need only paracetamol afterwards. Keep the incision dry for 48 hours and avoid heavy lifting for a week; a small bruise is normal and settles within a fortnight.
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How long does the battery last?
Up to three years, depending on the device and how much data it transmits. Battery status is checked at every remote transmission, and you are told well in advance when replacement or explant is due.
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What happens when the device detects something?
The bedside transmitter uploads data automatically. Alerts are triaged by the electrophysiology team, and you are contacted if action is needed. If the device records sustained ventricular tachycardia or a long pause with syncope, this is treated as an emergency.
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In practice, in London
Getting implantable loop recorder sorted in London, without the guesswork
With implantable loop recorder, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. On the NHS, implantable loop recorder 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.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For implantable loop recorder specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Fit matters more than people expect. For implantable loop recorder, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.
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