Multiprogrammable cardiac pacemakers. Applications, results, and follow-up.

More than 50 percent of patients with implanted pulse generators live more than 5 years and 35 percent survive beyond 10 years. For such patients, programmable pulse generators offer the flexibility to safely prolong battery life and to alter pacing function based on clinical and electrophysiologic requirements. Further, the potential to diagnose and treat pacing system malfunctions noninvasively in the future may significantly reduce the discomfort, inconvenience, and cost of reoperation. Physicians should select programmable models based on proved system reliability, clinical needs, and the availability of supervised follow-up programs. Finally, the safe and efficacious application of programmable pulse generators requires knowledge of pacing electrophysiology and techniques, and a thorough acquaintance with the operating characteristics of the systems selected for implantation.