Concierge electrophysiology · London
Private ICD implantation in London, by a consultant electrophysiologist.
A proper implantable cardioverter defibrillator — single‑chamber, dual‑chamber, CRT‑D or subcutaneous S‑ICD — chosen for your rhythm and your heart, implanted in a specialist EP centre and monitored remotely from day one.
Why patients choose us
- 01
A consultant electrophysiologist, in a specialist EP centre
Not a general cardiology list. A named EP consultant, a proper cath lab, and the device that actually fits your rhythm and your heart.
- 02
Subcutaneous or transvenous — a real conversation
For younger patients or those who don’t need pacing, an S‑ICD may be the right answer. We say so before you commit to a transvenous system.
- 03
Independent, and free
We are paid by no clinic, so the recommendation — device brand, single‑chamber, dual‑chamber, CRT‑D, S‑ICD — is impartial and costs you nothing.
Indicative pricing
What a private ICD implant costs in London.
Indicative ranges across our partner EP centres. Send the details and we quote firm figures across two or three device options.
In short
A single‑chamber ICD in our network: £15,000–£30,000, home the next morning.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Single‑chamber ICD | £15,000–£30,000 | 60–90 min | 1 night |
| Dual‑chamber ICD | £18,000–£35,000 | 90–120 min | 1 night |
| CRT‑D (biventricular ICD) | £25,000–£50,000 | 2–3 hours | 1–2 nights |
| Subcutaneous ICD (S‑ICD) | £20,000–£35,000 | 60–90 min | 1 night |
| Generator change (battery replacement) | £8,000–£15,000 | 45–60 min | Day case |
| EP consultation only | £250–£450 | 45 min | Same visit |
Prices vary by EP centre, by the device brand (Medtronic, Abbott, Boston Scientific, Biotronik), by whether a CRT LV lead is required, and by anaesthetic. We come back with a firm quote within one working day.
The problem
The right device, in the right centre, with the right monitoring.
ICD choice matters — single‑chamber, dual‑chamber, CRT‑D, S‑ICD — and so does the centre implanting it. We line up all three before you commit.
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Not sure it is indicated?
Optimal medical therapy first, then LVEF reassessment at 90 days may change the answer entirely. We won’t rush you into a device.
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Worried about lifelong leads?
A subcutaneous ICD may be right for you — no intravascular hardware, no long‑term SVC risk. We put it on the table.
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Want it done properly?
A named EP consultant, a specialist cath lab, and remote monitoring set up before you go home.
The journey
From enquiry to device follow‑up — what happens, in order.
One electrophysiologist from first message to your first remote check.
Phase 1 · Before your implant
Concierge, off‑stage for you
Phase 2 · On the day
In the cath lab and one night on the ward
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Diagnosis, LVEF, prior arrhythmia, current medications, whether this is primary or secondary prevention.
- 02
Before
We come back with a recommendation
Within one working day: the right device (single‑chamber, dual‑chamber, CRT‑D or S‑ICD), the right centre, an indicative price. If an ICD is not indicated, we say so.
- 03
Before
We arrange the admission
Usually within one to three weeks. Anticoagulation, antiplatelets and diabetes medication are reviewed with the EP team and you are told exactly how to prepare.
- 04
On the day
Admission and consent
Fasted admission, IV access, ECG and bloods, and a chat with the electrophysiologist and anaesthetist. Local anaesthetic with sedation for most; GA only if needed.
- 05
On the day
The implant itself
60–120 minutes in the cath lab for a single‑chamber device; longer for CRT‑D. Left subclavian or cephalic vein access, fluoroscopy‑guided lead placement, threshold testing, and a left pectoral pocket for the generator.
- 06
On the day
Overnight, then home
One night in hospital, a wound check and chest X‑ray the next morning to confirm lead position and exclude pneumothorax. Written aftercare and DVLA advice before discharge.
- 07
After
Recovery and device follow‑up
No arm‑above‑head on the implant side for 6 weeks. First device check at 4–6 weeks, then 3–6 monthly — usually via remote monitoring (Home Monitoring, MyCareLink, Merlin, LATITUDE). Generator change at 5–10 years.
Typical end‑to‑end: 2–3 weeks from enquiry to implant. First remote check: 4–6 weeks.
When it helps
When an ICD is the right step.
The indications we see most — primary and secondary prevention, aligned to NICE TA314 — plus the red flag that means same‑day cardiology, not an outpatient booking.
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Post‑MI, LVEF ≤35%
Primary prevention per NICE TA314 — at least 40 days post‑MI, NYHA II–III, on optimal medical therapy, life expectancy over 1 year.
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Non‑ischaemic dilated cardiomyopathy
LVEF ≤35% and NYHA II–III on optimal therapy — supported by the DEFINITE and SCD‑HeFT trials.
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Heart failure with LBBB (CRT‑D)
HFrEF, LBBB and a wide QRS — a biventricular ICD both resynchronises and defibrillates (NICE TA314).
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Hypertrophic cardiomyopathy
Where the ESC HCM Risk‑SCD calculator predicts a 5‑year sudden‑death risk above 6%.
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Channelopathies — LQTS, Brugada, CPVT
Long QT with recurrent syncope on a beta‑blocker or a family history of sudden death; spontaneous type‑1 Brugada with syncope; CPVT failing beta‑blockade.
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Genetic and infiltrative cardiomyopathies
ARVC, cardiac sarcoid, cardiac amyloid, LMNA and Duchenne‑related cardiomyopathy — assessed individually against current guidance.
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Secondary prevention
Aborted cardiac arrest from VF/VT (not from a reversible cause), sustained VT with structural heart disease, or unexplained syncope with documented VT.
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Red flag: syncope with known heart disease
Unexplained collapse in someone with a low ejection fraction, HCM or a channelopathy is not a clinic booking — it needs same‑day cardiology assessment.
Device options
One label, four very different devices.
What each device actually does — and which fits which patient.
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Single‑chamber ICD
One lead in the right ventricle. Typical for primary prevention after MI or in channelopathies where pacing isn’t needed.
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Dual‑chamber ICD
Right atrial and right ventricular leads. Used where sinus node dysfunction or atrial pacing needs sit alongside arrhythmia risk.
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CRT‑D (biventricular ICD)
RA, RV and an LV lead via the coronary sinus. For HFrEF with LBBB and a wide QRS — resynchronisation plus defibrillation.
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Subcutaneous ICD (S‑ICD)
Boston Scientific EMBLEM — no intravascular lead. Suits younger patients, difficult venous access, or high infection risk where pacing isn’t required.
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Generator change
A short procedure to swap the pulse generator when the battery reaches end of service, typically every 5–10 years. Leads usually left in place.
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Lead revision or extraction (TLE)
For fractured leads, insulation breaks, infection or pocket erosion. Transvenous lead extraction is done in specialist centres only.
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Device optimisation
Reprogramming detection zones, therapy delays and discriminators to reduce inappropriate shocks from AF or SVT.
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EP consultation only
An honest discussion of whether a device is the right step at all — including watchful waiting and medical therapy.
Our vetted London network
A small panel of electrophysiologists, we picked them.
Consultant EP specialists across central London EP centres. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every EP consultant in our network.
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Consultant electrophysiologists, not general cardiologists
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Specialist EP centres with 24/7 device cover and TLE capability on site or by referral
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Subcutaneous ICD (S‑ICD) offered where appropriate, not only transvenous systems
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Remote monitoring set up before discharge — Home Monitoring, MyCareLink, Merlin or LATITUDE
Safety and recovery
What to expect afterwards — honestly.
ICD implantation is a well‑established, safe procedure in experienced hands. The things worth planning are your anaesthetic, the 6‑week arm restriction, DVLA rules for your licence, and what a shock actually means if you ever get one.
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LA with sedation is the norm
Most ICDs are implanted under local anaesthetic and IV sedation. GA is used only where a longer or more complex procedure — such as a difficult LV lead — is expected.
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Pneumothorax and haematoma
Pneumothorax occurs in 1–2% of subclavian punctures; pocket haematoma in 1–3%, particularly on antiplatelets or anticoagulants. Cardiac tamponade is rare but taken seriously.
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Lead dislodgement
Around 1–2% of leads need repositioning in the first weeks — the reason for the 6‑week no‑arm‑above‑head rule on the implant side.
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Late lead problems
Lead fracture or insulation breaks affect roughly 5–10% of transvenous leads by 10 years and may need revision or extraction.
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Device infection
Pocket infection or lead endocarditis occurs in 1–3%. Established infection almost always needs transvenous lead extraction and a new system on the other side.
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Inappropriate shocks
5–10% of patients get a shock they didn’t need — usually driven by AF or fast SVT. Careful programming and remote monitoring reduce this significantly.
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Tricuspid regurgitation and SVC changes
A lead crossing the tricuspid valve can worsen regurgitation; long‑standing multiple leads can narrow the superior vena cava. Both are considered when choosing between transvenous and S‑ICD.
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DVLA driving rules
Group 1 (car): 1 month off driving for primary prevention, 6 months for secondary prevention or after any shock. Group 2 (HGV/PSV) licences are usually not permitted once an ICD is implanted.
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Red flags after discharge
A shock (especially more than one), fever, spreading redness at the pocket, wound discharge, breathlessness or chest pain aren’t normal — call the device team or 999 the same day.
Reading your implant note
Your implant note in four parts. Read the last one first.
Whichever device was used, the note the electrophysiologist sends you keeps to the same shape.
A quiet reminder
EP language is precise and can read densely — we translate it for you.
If you would like us to talk you through the note before your device clinic, just ask.
- 01 Header
Indication and device chosen
Why the device was implanted — primary or secondary prevention — and which system was agreed: single‑chamber, dual‑chamber, CRT‑D or S‑ICD.
- 02 Technique
Access, leads and generator
Which vein was used (subclavian, cephalic, axillary), where each lead was fixed (RV apex or septum, RA appendage, LV branch of the coronary sinus), and where the generator sits.
- 03 Findings
Thresholds, sensing and programming
R‑wave amplitude, pacing thresholds and lead impedance at implant, the detection zones and therapies programmed, and any DFT (defibrillation threshold) test done.
- 04 Impression
Recovery, driving and follow‑up
Read this first: activity restrictions for 6 weeks, DVLA advice for your licence class, remote monitoring set‑up, and when your first device clinic is booked.
Recognised by major UK insurers
Cover for ICD implantation varies by insurer and by indication — usually funded where NICE TA314 criteria are met. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about ICDs.
Quick answers on indications, device choice, cost, driving and remote monitoring.
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Who needs an implantable cardioverter defibrillator (ICD)?
Broadly two groups. Primary prevention: people at high risk of sudden cardiac death but who haven’t yet had a dangerous arrhythmia — most often HFrEF with LVEF ≤35% on optimal therapy, high‑risk HCM, or channelopathies such as long QT or Brugada. Secondary prevention: people who have survived VF/VT arrest, sustained VT with structural heart disease, or unexplained syncope with documented VT. NICE TA314 sets the NHS thresholds and we work to the same standards privately.
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What is the difference between a single‑chamber, dual‑chamber and CRT‑D ICD?
A single‑chamber ICD has one lead in the right ventricle and is used when only ventricular sensing and defibrillation are needed. A dual‑chamber ICD adds a right atrial lead — useful where sinus node dysfunction or atrial pacing needs are present. A CRT‑D (biventricular ICD) adds a third lead in a branch of the coronary sinus to pace the left ventricle, and is used in HFrEF with LBBB and a wide QRS to resynchronise the heart and defibrillate.
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What is a subcutaneous ICD (S‑ICD) and who is it for?
The subcutaneous ICD (Boston Scientific EMBLEM) sits under the skin on the left side of the chest with a lead tunnelled beside the breastbone — nothing goes inside the heart or veins. It suits younger patients who want to avoid decades of transvenous leads, people with difficult venous access, those at high infection risk, and primary‑prevention patients who don’t need pacing. It cannot pace for bradycardia and cannot deliver anti‑tachycardia pacing, so it’s not right for everyone.
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How much does a private ICD implant cost in London?
Roughly £15,000–£30,000 for a single‑chamber ICD, £18,000–£35,000 for a dual‑chamber, £25,000–£50,000 for a CRT‑D and £20,000–£35,000 for an S‑ICD. A generator change alone is usually £8,000–£15,000. Prices vary by device brand, EP centre and anaesthetic — we confirm a firm quote within one working day.
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How long does the procedure take and how long will I be in hospital?
A single‑chamber ICD typically takes 60–90 minutes; a dual‑chamber 90–120 minutes; a CRT‑D two to three hours because the LV lead can be technical. Most patients stay one night and go home the next morning after a wound check and chest X‑ray.
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Can I drive after an ICD implant?
For Group 1 licences (car and motorcycle) the DVLA requires 1 month off driving after a primary‑prevention implant, and 6 months after a secondary‑prevention implant or after any shock. Group 2 licences (HGV, PSV) are usually revoked once an ICD is implanted. Your EP consultant will give written advice specific to your case.
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What are the main risks and complications?
Early risks include pneumothorax (1–2% with subclavian access), pocket haematoma (1–3%), lead dislodgement needing revision (1–2%) and — rarely — cardiac tamponade. Later problems include lead fracture or insulation breaks (5–10% at 10 years), device infection (1–3%) which usually requires transvenous lead extraction, inappropriate shocks (5–10%, often from AF or SVT), tricuspid regurgitation from the RV lead and, over decades, superior vena cava narrowing.
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What is remote monitoring and do I still need clinic visits?
Every major manufacturer provides remote monitoring — Biotronik Home Monitoring, Medtronic MyCareLink, Abbott Merlin and Boston Scientific LATITUDE. A small bedside transmitter sends device data to your EP team overnight, picking up arrhythmias, lead issues and battery status earlier than clinic visits ever could. It reduces in‑person visits to roughly once a year, with everything else handled remotely.
Related treatments
Looking for something else?
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All tests
Every test and procedure we arrange.
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