title: Are electronic cardiac devices still evolving?
abstract: OBJECTIVE
  The goal of this paper is to review some important issues occurring during the past year in Implantable devices.
  
  
  METHODS
  First cardiac implantable device was proposed to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or there is a block in the heart's electrical conduction system. During the last forty years, pacemakers have evolved considerably and become programmable and allow to configure specific patient optimum pacing modes. Various technological aspects (electrodes, connectors, algorithms diagnosis, therapies, ...) have been progressed and cardiac implants address several clinical applications: management of arrhythmias, cardioversion / defibrillation and cardiac resynchronization therapy.
  
  
  RESULTS
  Observed progress was the miniaturization of device, increased longevity, coupled with efficient pacing functions, multisite pacing modes, leadless pacing and also a better recognition of supraventricular or ventricular tachycardia's in order to deliver appropriate therapy. Subcutaneous implant, new modes of stimulation (leadless implant or ultrasound lead), quadripolar lead and new sensor or new algorithm for the hemodynamic management are introduced and briefly described. Each times, the main result occurring during the two past years are underlined and repositioned from the history, remaining limitations are also addressed.
  
  
  CONCLUSIONS
  Some important technological improvements were described. Nevertheless, news trends for the future are also considered in a specific session such as the remote follow-up of the patient or the treatment of heart failure by neuromodulation.
authors.affiliation: Guy Carrault, Laboratoire de Traitement du Signal et de l'Image, (LTSI) - INSERM UMR 1099, Campus de Beaulieu, Bâtiment 22, F-35042 RENNES CEDEX, France, E-mail: guy.carrault@univ-rennes1.fr, http://www.ltsi.univ-rennes1.fr.
authors.forename: G
authors.initials: G
authors.lastname: Carrault
authors.forename: P
authors.initials: P
authors.lastname: Mabo
mesh_terms: D001145:Arrhythmias, Cardiac / Q000628:therapy; D017147:Defibrillators, Implantable / Q000639:trends*; D006333:Heart Failure / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D010138:Pacemaker, Artificial / Q000639:trends*
keywords: Implantable device; leadless sensor; management of hemodynamic; quadripolar lead; subcutaneous implantable device