Cardiac Pacing Update-I.

Abstract

The field of cardiac pacing has grown extensively over the last 25 years. Permanent cardiac pacemaker implantation has become the established treatment for management of heart block and brad arrhythmias. The oldest pacemakers were large, bulky units. Since then both the indications and the technology have changed considerably.

A physician, in deciding to implant a permanent pacemaker, has to consider factors other than just statistical numbers. These may include for example, the general condition of the patient and the presence of associated illness and the specific constraints imposed by patient and his or her family.

However, an optimal lead position sometimes cannot be found, especially if there is diffuse myocardial fibrosis. In these cases, the higher threshold or poor signal amplitude may have to be accepted. Difficult cases might require specially made high-output or high-sensitivity pulse generators to prevent pacing failure.