Concierge cardiac monitoring · London
Zio XT patch, FDA-cleared 14-day single-lead ambulatory ECG patch for palpitations, syncope and AF.
The Zio XT is a discreet, single-lead ECG patch worn for up to 14 days — FDA-cleared, waterproof and worn during sleep and exercise. Higher diagnostic yield than 24-hour Holter for infrequent palpitations, unexplained syncope and cryptogenic stroke.
Key facts
What the Zio XT patch is, in six lines.
The core clinical facts a patient — or a referring GP — needs before deciding whether the patch is the right next test.
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Definition
A single-lead, adhesive ambulatory ECG patch worn continuously for up to 14 days.
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Consultant cardiology-led
Applied, analysed and reported under consultant cardiologist supervision.
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Up to 14 days continuous ECG
A single recording window that captures rhythms a 24-hour Holter routinely misses.
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Waterproof, worn during sleep and exercise
Showering, sleeping and training continue as normal — the patch stays on.
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Higher diagnostic yield than 24-hour Holter
Extended monitoring materially raises the chance of catching infrequent arrhythmia.
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Complements Holter and implantable loop recorder
Sits between 24-hour Holter and long-term implantable loop recorder in the diagnostic ladder.
How it works
From consultation to report — what happens, in order.
One patch, one clinician, one structured report — usually within two to three weeks of application.
Phase 1 · Before
Consultant review
Phase 2 · Wear
Up to 14 days at home
Phase 3 · After
Analysis and report
- 01
Before
Cardiology consultation
Symptoms, history and prior ECGs reviewed by a consultant cardiologist to confirm the patch is the right test.
- 02
During wear
Patch applied in clinic
The Zio XT patch is placed on the left upper chest by a cardiac technician — a few minutes, no wires, no shaving needed.
- 03
During wear
14-day continuous recording
Single-lead ECG records every heartbeat for up to two weeks — you carry on with normal life.
- 04
During wear
Patient event marker
Press the button on the patch whenever you feel a symptom — it timestamps the recording for the analyst.
- 05
After
Patch returned by post
At the end of the wear, the patch is returned in a pre-paid envelope to the analysis lab.
- 06
After
Cardiac technician + consultant analysis
Every beat is analysed by algorithm, adjudicated by a cardiac physiologist and signed off by a consultant cardiologist.
- 07
After
Structured report + plan
A structured report with symptom-rhythm correlation and a concrete next step — rate control, rhythm control, ablation or reassurance.
Typical end-to-end: 2–3 weeks. Urgent cases: same-week fitting.
What it shows
The rhythms a 14-day patch is designed to catch.
Extended monitoring is the diagnostic sweet spot for arrhythmias that occur too infrequently for a 24-hour Holter to catch — and too often to justify an implantable loop recorder.
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Atrial fibrillation (paroxysmal)
Extended monitoring is the diagnostic sweet spot for infrequent, self-terminating AF.
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Atrial flutter
Sawtooth flutter picked up across a 14-day window even when episodes are brief.
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SVT
Supraventricular tachycardia caught in the act, with clear onset and offset.
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Non-sustained VT
Short runs of ventricular tachycardia flagged, quantified and burdened.
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Sinus node dysfunction
Pauses, sinus arrest and chronotropic incompetence characterised across two weeks.
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Heart block
First-, second- and third-degree AV block captured, including intermittent forms.
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Symptom-rhythm correlation
Patient-marked events matched to the underlying rhythm — the whole point of the test.
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Red flag: high-burden VT — urgent cardiology
Sustained or high-burden VT triggers an urgent consultant cardiology review, not a routine slot.
Treatment options
What follows a positive result.
The Zio XT is a diagnostic — treatment depends on the rhythm found, the burden, and the patient in front of the consultant.
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Rate control
Beta-blocker or rate-limiting calcium blocker to control ventricular rate in AF.
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Rhythm control
Antiarrhythmic drug therapy to maintain sinus rhythm where appropriate.
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DC cardioversion
Elective electrical cardioversion for persistent AF or flutter under sedation.
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Catheter ablation
Pulmonary-vein isolation or targeted ablation for AF, flutter or SVT.
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Anticoagulation (CHA₂DS₂-VASc)
Stroke prevention guided by CHA₂DS₂-VASc score in AF and flutter.
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Left atrial appendage occlusion
Device closure of the LAA when long-term anticoagulation is contraindicated.
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Cardiac follow-up
Structured cardiology review with repeat monitoring where indicated.
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MDT review
Complex or borderline cases discussed at an electrophysiology MDT.
Red flags
When a Zio XT finding is not routine.
Findings that trigger urgent consultant cardiology review — not a routine follow-up slot.
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Sustained VT
Sustained ventricular tachycardia — a medical emergency requiring urgent cardiology assessment.
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Torsades de pointes
Polymorphic VT on a long QT background — stop QT-prolonging drugs and admit.
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Complete heart block
Third-degree AV block — urgent pacing assessment.
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Wide-complex tachycardia
Any wide-complex tachycardia treated as VT until proven otherwise.
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Pre-excited AF
AF in Wolff-Parkinson-White — avoid AV-nodal blockers, urgent electrophysiology input.
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Long QT with syncope
Long QT interval with syncope — high risk of sudden cardiac death.
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Brugada pattern
Type-1 Brugada ECG pattern — inherited arrhythmia clinic referral.
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Post-ablation atrial tachycardia
Organised atrial tachycardia after ablation — repeat electrophysiology review.
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Symptomatic bradycardia < 40 bpm
Symptomatic bradycardia below 40 bpm — pacing assessment.
Sources
The guidelines this page is written against.
Every clinical statement here is checked against current specialty-society guidance and NICE.
Reviewed by
Pulse Atlas Editorial Board,
Last reviewed 2026-07-30. Next review 2027-07-30.
- 01 Reference
European Society of Cardiology. 2024 ESC Guidelines for the management of atrial fibrillation.
European Society of Cardiology. 2024 ESC Guidelines for the management of atrial fibrillation. - 02 Reference
NICE. Atrial fibrillation: diagnosis and management (NG196).
NICE. Atrial fibrillation: diagnosis and management (NG196). - 03 Reference
Heart Rhythm Society. Clinical documents on ambulatory ECG monitoring.
Heart Rhythm Society. Clinical documents on ambulatory ECG monitoring. - 04 Reference
American Heart Association. Scientific statements on ambulatory rhythm monitoring.
American Heart Association. Scientific statements on ambulatory rhythm monitoring.
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 Zio XT patch.
Quick answers on how the patch compares to Holter and implantable loop recorders, everyday wear, and when to skip the private route and call 999.
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What is a Zio XT patch?
The Zio XT is a small, single-lead adhesive ECG patch worn on the left upper chest that records every heartbeat continuously for up to 14 days. It is FDA-cleared, waterproof and worn during sleep and exercise, with no wires and no separate recorder.
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How is the Zio XT patch different from a 24-hour Holter monitor?
A Holter records for 24–48 hours through multiple leads and wires; the Zio XT records through a single adhesive patch for up to 14 days. The longer window materially raises the diagnostic yield for infrequent palpitations, syncope and paroxysmal atrial fibrillation.
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Can I shower and exercise with it on?
Yes — the patch is waterproof and designed to stay in place through showering, sleeping and exercise. Baths and swimming are typically avoided but everyday life carries on as normal.
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When would a cardiologist choose a Zio XT patch over an implantable loop recorder?
The Zio XT is a first-line extended-monitoring test — 14 days without a procedure. An implantable loop recorder is reserved for very infrequent, high-risk symptoms (such as unexplained syncope with a normal Zio XT) where monitoring over months or years is needed.
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How is the recording analysed?
Every beat is analysed by algorithm, adjudicated by a cardiac physiologist and signed off by a consultant cardiologist. Patient-marked events are matched against the underlying rhythm to produce a structured, symptom-rhythm-correlated report.
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When should I go to A&E instead of waiting for a patch?
Chest pain, collapse with injury, sustained fast palpitations that do not settle, breathlessness at rest, or one-sided weakness or slurred speech — 999, not a private appointment. The Zio XT is for investigation of stable, recurrent symptoms.
Related tests
Looking for a different test?
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Holter monitor
24–48 hour multi-lead ambulatory ECG for frequent symptoms.
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Remote heart rhythm monitoring
Cloud-connected long-term rhythm monitoring with clinician review.
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Implantable loop recorder
Subcutaneous long-term monitor for very infrequent or high-risk symptoms.
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All tests
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Hypertension
Related condition guide.
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Atrial Fibrillation
Related condition guide.
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Coronary Angioplasty
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Coronary Artery Disease Treatment
Related treatment option.
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In practice, in London
Why private zio xt patch moves differently in London
With zio xt patch, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for zio xt patch is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
A typical private booking for zio xt patch in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For zio xt patch specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
There are a lot of consultants in London who can technically handle zio xt patch. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.