Concierge cardiology · UK
Pacemaker implantation - a 90-minute fix, done by the right hands.
A small incision, leads placed under X-ray, home the same day. We arrange the whole procedure with a high-volume consultant electrophysiologist - device choice argued out before the lab, not on the table.
Why patients choose us
- 01
A high-volume implanting cardiologist
A named consultant electrophysiologist or device cardiologist who implants weekly - because complication rates track operator volume, and we check the numbers.
- 02
The right device decided before the incision
Single chamber, dual chamber, leadless or conduction-system pacing - argued out from your ECG and echo before the day, not improvised in the lab.
- 03
Independent, and free
We are paid by no hospital or device company, so the recommendation - including “you can safely wait” - is impartial and costs you nothing.
Indicative pricing
What private pacemaker implantation costs in the UK.
Indicative all-in ranges - device, implanter and hospital - across our partner cardiac units. Send the details and we quote firm figures across two or three options, with cover checked.
In short
A dual-chamber implant in our network: £8,500–£15,000 all-in, home day-case or one night.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Single-chamber pacemaker implantation | £7,000–£12,000 | 45–75 min | Day-case or 1 night |
| Dual-chamber pacemaker implantation | £8,500–£15,000 | 60–90 min | Day-case or 1 night |
| Leadless pacemaker implantation | £15,000–£25,000 | 45–75 min | Day-case or 1 night |
| Conduction-system (His/LBB) pacing | £10,000–£18,000 | 90–150 min | 1 night |
| Generator replacement (battery change) | £4,500–£8,000 | 30–60 min | Day-case |
| Cardiology consultation + ECG | £250–£450 | 30–45 min | Same visit |
| Echocardiogram | £300–£600 | 30–45 min | Report in days |
Prices vary by hospital, by implanter, and above all by the device - leadless and conduction-system implants sit at the top of the range because the hardware itself costs more. Every quote we return is all-in: device, lab time, implanter and follow-up check. We come back with a firm figure within one working day.
The problem
The right implanter, the right device, and no surprises on the day.
Pacemaker implantation is routine - and still worth doing fastidiously. Operator volume, access technique and device choice all move your complication risk. We optimise all three before you consent.
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Volume is the safety feature
Implanters doing a case a week have measurably fewer pneumothoraces, displacements and infections. We check the numbers before introducing you.
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Prove the rhythm first
A pacemaker fixes bradycardia it can see. If the diagnosis rests on one dizzy spell, we arrange monitoring before anyone opens a pocket.
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Device choice is a pre-op decision
Leadless, dual-chamber or conduction-system pacing suit different hearts. The argument happens in clinic, with your ECG and echo on the screen.
The journey
From enquiry to recovery - what happens, in order.
One team from first message through work-up, the implant itself and every device clinic check.
Phase 1 · Before your implant
ECG, echo, monitoring, device choice
Phase 2 · On the day
The implant and discharge
Phase 3 · After
Wound check, device clinic, remote follow-up
- 01
Before
You tell us what is going on
A short, confidential form. Blackouts, dizzy spells or breathlessness, any ECG or monitor findings so far, your medicines and anticoagulants.
- 02
Before
We come back with a recommendation
Within one working day: whether implantation is indicated, which device type, the right implanter, and an indicative all-in price.
- 03
Before
Work-up: ECG, echo, monitoring
12-lead ECG, echocardiogram and - where the diagnosis is not yet nailed down - ambulatory monitoring to prove the rhythm problem before committing to a device.
- 04
Before
Consent and anticoagulant plan
The implanter walks through benefits, risks and device choice. Blood thinners are managed - most modern practice continues warfarin and pauses DOACs briefly.
- 05
On the day
The implant: 60–90 minutes, awake
Local anaesthetic and light sedation. A small incision below the collarbone, leads guided into the heart under X-ray, tested, then connected to the generator in a pocket under the skin.
- 06
On the day
Checks and home the same day
A device check and chest X-ray confirm lead position. Most patients go home the same day or after one night, with wound care instructions and arm-movement advice.
- 07
After
Wound check, device clinic, remote follow-up
Wound review at 1–2 weeks, first device clinic check at 4–6 weeks, then remote monitoring with annual in-person checks.
Typical end-to-end: 1–2 weeks from enquiry to implant. Back to normal life: days, with arm precautions for 4–6 weeks.
When it helps
When pacemaker implantation is the right step.
The situations we see most, plus the one red flag that means urgent cardiology rather than a routine booking.
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Complete or high-grade heart block
The clearest indication - the electrical signal fails between the atria and ventricles, and pacing is the definitive fix.
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Blackouts from a slow heart
Syncope with documented pauses or profound bradycardia - implantation prevents the next collapse.
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Sick sinus syndrome
A worn-out natural pacemaker causing fatigue, dizziness and pauses - dual-chamber pacing restores a normal rate response.
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AF with a slow ventricular response
Atrial fibrillation with long pauses or symptomatic bradycardia - often a single-chamber or leadless device.
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Drug-induced bradycardia you cannot avoid
When rate-slowing drugs (beta-blockers for angina or AF) are essential but your heart cannot tolerate them, pacing squares the circle.
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After TAVI or cardiac surgery
Heart block after valve intervention is common and sometimes permanent - a planned implant rather than an emergency one.
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Carotid sinus syndrome and reflex syncope
Selected older patients with pauses on carotid sinus massage and recurrent falls benefit from pacing.
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Red flag: blackout with injury, or at the wheel
Unexplained syncope causing injury - or while driving - needs urgent cardiology and a driving pause, not a routine booking.
Procedure options
What actually happens in the lab.
The implant, step by step - access, leads, pocket, testing - and the modern variations worth knowing about before you consent.
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The venous route
Access via the axillary or cephalic vein beneath the collarbone. Ultrasound-guided axillary puncture has largely replaced blind subclavian sticks - fewer lung and lead complications.
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Lead placement and testing
Leads are steered into the right atrium and/or ventricle under X-ray, then tested electrically - sensing, capture threshold and impedance - before anything is sewn in.
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The pocket
The generator sits in a small pocket under the skin (or under the muscle in slim patients) below the collarbone, usually on your non-dominant side.
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Local anaesthetic and sedation
Almost all implants are done awake with local anaesthetic and light sedation. General anaesthesia is the exception, not the rule.
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Leadless implantation
A capsule-sized device delivered through the femoral vein straight into the right ventricle - no chest incision, no pocket, no leads to fracture.
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Conduction-system pacing
Pacing the His bundle or left bundle branch recruits the heart’s own wiring - increasingly chosen when a high burden of ventricular pacing is expected.
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Antibiotics and infection control
A single pre-incision antibiotic dose, meticulous skin prep, and in higher-risk cases an antibacterial envelope around the generator.
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Generator replacement, years later
When the battery runs down after 8–15 years, only the generator is exchanged through the old scar - a shorter, simpler day-case.
Our vetted UK network
A small panel of implanting cardiologists, we picked them.
Consultant electrophysiologists and device cardiologists across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every implanter in our network.
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Consultant electrophysiologists and device cardiologists with high annual implant volumes
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Ultrasound-guided axillary access and same-day discharge as routine practice
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Leadless and conduction-system pacing available where conventional leads are the wrong answer
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Remote monitoring enrolment and a named device clinic for every patient
Safety and recovery
What to expect afterwards - honestly.
Pacemaker implantation is one of cardiology’s safest procedures. The things worth planning are the anticoagulant strategy, the access technique, and knowing the red flags for the first six weeks.
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A safe, short procedure - with honest numbers
Implantation takes 45–90 minutes under local anaesthetic. Serious complications are uncommon: overall significant complication rates run at roughly 3–5 percent, most of them fixable.
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Bleeding and pocket haematoma
Bruising is near-universal; a tense haematoma needing intervention affects 1–2 percent, more on anticoagulants - which is why the blood-thinner plan is agreed in advance.
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Pneumothorax and lead displacement
A dropped lung occurs in under 1 percent with modern ultrasound-guided access. Lead displacement needing repositioning affects about 1–2 percent, usually in the first weeks.
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Device infection
Around 1 percent, and taken very seriously - an infected system usually must be removed entirely. Redness, discharge or fever near the wound needs same-day review, never a wait-and-see.
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Arm movement after the implant
Keep the elbow below shoulder height on the implant side for 4–6 weeks, but do keep the arm moving gently - a frozen shoulder is a real and avoidable complication.
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Red flags after implantation
Fever, a hot or leaking wound, worsening breathlessness, hiccup-like twitching of the chest wall, or the return of blackouts - same-day device clinic or A&E.
Reading your implant report
Your implant report in four parts. Read the last one first.
Whichever system you received - conventional, leadless or conduction-system - the report your implanter sends keeps to the same shape.
A quiet reminder
Pacing reports are dense with modes and millivolts - we translate them for you.
If you would like us to talk you through the settings, the thresholds and the driving rules before your device clinic visit, just ask.
- 01 Header
Indication and device implanted
Why you were paced - heart block, sick sinus, AF with pauses - plus the exact generator and lead models and their serial numbers.
- 02 Technique
Access, lead positions, measurements
The vein used, where each lead sits, and the electrical numbers at implant - thresholds, sensing, impedance - your baseline for every future check.
- 03 Findings
Settings and pacing mode
The programmed mode (DDD, VVI and friends), base rate, and any special features switched on - rate response, AF suppression, MRI-conditional status.
- 04 Impression
Follow-up, driving and restrictions
Read this first: wound care, the arm-movement rules, when you may drive again (usually one week for private licences, with DVLA criteria met), and your device clinic dates.
Recognised by major UK insurers
Pacemaker implantation is usually covered when medically indicated, including the device itself. Pre-authorisation is standard for the hardware cost. We confirm cover before booking.
Frequently asked
Everything we get asked about pacemaker implantation.
Quick answers on the procedure, pain, recovery, complications, cost and NHS waits.
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How is a pacemaker implanted?
Through a 4–5 cm incision below the collarbone under local anaesthetic and light sedation. One or two leads are guided through a vein into the heart under X-ray, tested, and connected to a matchbox-sized generator placed in a pocket under the skin. The procedure typically takes 60–90 minutes and most people go home the same day.
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Is the implantation painful?
You will feel pressure and tugging but not sharp pain - the area is numbed and sedation keeps you relaxed. The pocket site aches for a week or two afterwards; simple painkillers are almost always enough.
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How long is recovery after pacemaker implantation?
Most people are back to normal daily life within a few days. Keep the implant-side elbow below shoulder height for 4–6 weeks while the leads bed in, avoid heavy lifting on that side, and keep the wound dry for about a week. Group 1 (car) driving usually resumes after one week if DVLA criteria are met.
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What can go wrong?
Significant complications affect roughly 3–5 percent of implants: pocket bruising or haematoma, lead displacement needing repositioning (1–2 percent), pneumothorax (under 1 percent with ultrasound-guided access) and device infection (around 1 percent). Choosing a high-volume implanter measurably lowers all of these - which is precisely what we vet for.
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How much does private pacemaker implantation cost in the UK?
Typically £7,000–£12,000 for a single-chamber system, £8,500–£15,000 for dual-chamber, and £15,000–£25,000 for a leadless device, including the device, implanter and hospital fees. Generator replacements run £4,500–£8,000. We confirm a firm all-in figure within one working day.
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How long will I wait on the NHS, and is private faster?
Urgent cases - complete heart block, syncope with pauses - are done promptly on the NHS, often during the same admission. Routine and elective implants can wait weeks to a few months depending on the trust. Privately, work-up to implant is typically one to two weeks with your choice of implanter.
Related treatments
Looking for something else?
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Pacemakers
The devices themselves - types, batteries, living with one.
Learn more -
Pacemakers + defibrillators
Pacemaker, ICD or CRT - which device does what.
Learn more -
Conduction system pacing
His-bundle and left-bundle pacing in detail.
Learn more -
Atrial fibrillation
The rhythm problem behind many implants.
Learn more -
Echocardiogram
The heart scan that guides device choice.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more