Pacemaker therapies in cardiology.

BACKGROUND

Since the first cardiac pacemaker was inserted in 1958 vast changes have occurred in both the technology of the devices and their indications.

OBJECTIVE

This article discusses the indications for pacemakers, currently available devices, insertion procedure, and patient follow up.

DISCUSSION: Pacemakers have evolved from simple, single chamber devices to multichambered devices capable of treating not only bradycardias but also tachycardias and heart failure. An international classification has been developed regarding arrhythmias and the benefits of pacemakers. In class I conditions, the benefits of pacemakers are well established, decreasing symptoms and improving prognosis. The most common indications are for patients with symptomatic bradycardia associated with sick sinus syndrome and heart block. Patients need to attend for regular device follow up and be aware of precautions relating to electromagnetic radiation, but this usually involves little disruption to their day-to-day life.