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Review
. 2025 Mar;36(3):665-672.
doi: 10.1111/jce.16559. Epub 2025 Jan 7.

Physiological Pacing: Historical Review With an Eye to the Future

Richard Sutton  1 , Atul Prakash  2
Affiliations
Review

Physiological Pacing: Historical Review With an Eye to the Future

Richard Sutton et al. J Cardiovasc Electrophysiol. 2025 Mar.

Erratum in

Abstract

This review provides a history of physiological pacing from inception to current practice and into the future. This review stems from personal experience and is not formally systematic. Physiological cardiac pacing is covered from 1960s to date. Concepts, and major milestones with their practical applications are reviewed including possible applications in the future. Huge strides have been made in the last 50 years, but consequences of developments have not always been well considered resulting in important adverse effects. The future requires deep electrophysiological thinking to achieve further benefits for our patients.

Keywords: diastolic function; physiological pacing; stimulus delivery; stimulus timing; systolic function.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Central Illustration 1
Central Illustration 1
The figure shows a diagrammatic heart with its conduction system in green on which is labelled the various sites at which physiological cardiac stimulation can be delivered via leads. AV, atrioventricular; CS, coronary sinus; HRA, high right atrial; LV, left ventricular; RV, right ventricular; Tv, tricuspid valve.
See this image and copyright information in PMC

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