[Advances in the technology of pacing]

Abstract

It has been nearly four decades since the first asynchronous simple-chamber permanent pacemaker was implanted. At this time the only indication for pacemaker implantation was heart block associated with syncope. Since then, pacemaker technology has improved. In this article we provide an overview of recent technological advances in cardiac pacing. Those related to both generators (dimensions, multiprogrammability, protecting algorithms, automatization, sensors and others) and leads (polarity, dual chamber pacing with a single lead and others). With all these improvements in pacemaker technology, we now witness a relative simplification in the implantation procedures and in the follow-up evaluation of new systems. Due to all these improvements, current indications for cardiac pacing were expanded (non conventional indications). Despite all these recent engineering improvements, formal monitoring of the pacemaker system is still warranted to detect, pacemaker malfunctions as soon as possible.