Pacemaker and Defibrillator Care in London
Assessment before implantation, explanation of device choices, complex device care and follow-up for people with pacemakers, defibrillators and cardiac resynchronisation devices.
A device decision should be understandable.
People are referred because of a slow heart rate, conduction disease, unexplained blackouts, heart failure, a risk of dangerous ventricular rhythms, or a problem with an existing device. The decision to implant—or not implant—depends on the rhythm evidence, symptoms, heart function, wider health and personal priorities.
Dr Bhuva routinely implants pacemakers and defibrillators and leads a major pacing clinic. He can explain the indication, alternatives, expected benefits, procedure, recovery, restrictions and follow-up in practical terms.
Reasons for consultation
- A new recommendation for a pacemaker or defibrillator
- Symptoms despite an existing device
- Questions about remote monitoring or battery replacement
- Cardiac resynchronisation or conduction-system pacing
- MRI access with a pacemaker, ICD or implanted monitor
Care before, during and after a cardiac-device procedure.
Pacemaker or defibrillator implantation
The indication, alternatives and device type are reviewed before the procedure. Implantation is commonly performed using local anaesthetic with sedation where appropriate, with leads introduced through a vein and the generator placed beneath the skin.
Generator replacement
Battery status is monitored during follow-up. When replacement becomes appropriate, the existing leads are assessed and are often retained if they remain suitable. Timing and procedural planning are individual.
Device management and follow-up
Checks review battery, leads, settings and recorded rhythm events. Results are interpreted with symptoms, heart function and treatment. Remote monitoring supports care but does not replace all in-person or urgent assessment.
MRI and other procedures
Many people with implanted cardiac devices can undergo MRI through an appropriate protocol. Device information also matters before surgery, radiotherapy and selected treatments.
MRI with a pacemaker or defibrillator →Cardiac-device questions.
Can I have an MRI with a pacemaker or defibrillator?
Many patients can, including some with older or non-standard systems, but the device, leads, clinical need and local pathway must be reviewed. Do not assume either that MRI is impossible or automatically safe.
How long does a pacemaker battery last?
Longevity varies with device type, settings and how much pacing is required. The estimated remaining life is reviewed during device checks.
Evidence and review.
General information on pacemaker implantation is available from the NHS. The device-MRI pathway is supported by the Joint British Society consensus recommendations in Heart, led by Dr Bhuva as first author.
Written and reviewed by Dr Anish Bhuva, Consultant Cardiologist. Last reviewed 2 September 2026. This page provides general information and does not replace an individual medical assessment.
Arrange a cardiac-device consultation.
If you already have a device, bring the implant card and latest follow-up report.