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Review
. 2019 Jul;8(3):228-233.
doi: 10.15420/aer.2019.15.3.

Update in Cardiac Pacing

Nishant Verma  1 , Bradley P Knight  1
Affiliations
Review

Update in Cardiac Pacing

Nishant Verma et al. Arrhythm Electrophysiol Rev. 2019 Jul.

Abstract

Initial efforts to artificially stimulate the heart were borne out of a necessity to prevent catastrophic bradycardic events. The initial pacemaker systems were large, bulky external devices. However, advancements in technology allowed for the development of internally powered, fully implantable devices. Further advancements resulted in more complex, programmable devices, but the overall systems have remained largely unchanged for more than 50 years. The most recent advancements in the field have represented fundamental paradigm shifts in both pacemaker design and the approach to cardiac pacing. These efforts have focused on reducing and eliminating hardware to reduce the risk of complications and to focus on improving cardiac efficiency to improve clinical outcomes. In this article, the authors explore these advances including leadless pacemaker systems, permanent His bundle pacing and advances in the field of cardiac resynchronisation therapy.

Keywords: Pacemakers; bradycardia; cardiac resynchronisation therapy; leadless pacemakers; permanent His bundle pacing.

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Conflict of interest statement

Disclosure: NV receives honoraria from Medtronic and Biotronik; BPK is a consultant for and receives honoraria from Biotronik, Boston Scientific, Medtronic and Abbott.

Figures

Figure 1:
Figure 1:. Early Advancements in Cardiac Pacing
Figure 2:
Figure 2:. Modern Dual-chamber Pacemaker
Figure 3:
Figure 3:. Early Complications of Pacemaker Implantation
Figure 4:
Figure 4:. Transcatheter Delivery of a Leadless Pacemaker
Figure 5:
Figure 5:. Unipolar and Bipolar Recordings from a Permanent His Bundle Pacing Lead
Figure 6A:
Figure 6A:. Selective His Bundle Capture
Figure 6B:
Figure 6B:. Non-selective His Bundle Capture
Figure 7:
Figure 7:. Correction of Left Bundle Branch Block with Permanent His Bundle Pacing
See this image and copyright information in PMC

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