Cardiac pacing: the state of the art.
Permanent cardiac pacing remains the only effective treatment for chronic, symptomatic bradycardia. In recent years, the role of implantable pacing devices has expanded substantially. At the beginning of the 21st century, exciting developments in technology seem to happen at an exponential rate. Major advances have extended the use of pacing beyond the arrhythmia horizon. Such developments include dual-chamber pacers, rate-response algorithms, improved functionality of implantable cardioverter defibrillators, combinations of sensors for optimum physiological response, and advances in lead placement and extraction. Cardiac pacing is poised to help millions of patients worldwide to live better electrically. We review pacing studies of sick-sinus syndrome, neurocardiogenic syncope, hypertrophic obstructive cardiomyopathy, and cardiac resynchronisation therapy, which are common or controversial indications for cardiac pacing. We also look at the benefits and complications of implantation in specific arrhythmias, suitability of different pacing modes, and the role of permanent pacing in the management of patients with heart failure.
Trohman
Richard G
RG
Department of Medicine, Section of Cardiology, Electrophysiology, Arrhythmia, and Pacemaker Service, Rush-Presbyterian-St Luke's Medical Centre and Rush Medical College, Chicago, IL 60612, USA. rtrohman@rush.edu
Kim
Michael H
MH
Pinski
Sergio L
SL
D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D004867:Equipment Design; D006801:Humans; D010138:Pacemaker, Artificial