title: Advances and Future Directions in Cardiac Pacemakers: Part 2 of a 2-Part Series.
abstract: In the second part of this 2-part series on pacemakers, we present recent advances in pacemakers and preview future developments. Cardiac resynchronization therapy (CRT) is a potent treatment for heart failure in the setting of ventricular dyssynchrony. Successful CRT using coronary venous pacing depends on appropriate patient selection, lead implantation, and device programming. Despite optimization of these factors, nonresponse to CRT may occur in one-third of patients, which has led to a search for alternative techniques such as multisite pacing, His bundle pacing, and endocardial left ventricular pacing. A paradigm shift in pacemaker technology has been the development of leadless pacemaker devices, and on the horizon is the development of batteryless devices. Remote monitoring has ushered in an era of greater safety and the ability to respond to device malfunction in a timely fashion, improving outcomes.
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Malini
authors.initials: M
authors.lastname: Madhavan
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Siva K
authors.initials: SK
authors.lastname: Mulpuru
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McLeod
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: pfriedman@mayo.edu.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
mesh_terms: D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000639:trends; D004452:Echocardiography; D005544:Forecasting; D006327:Heart Block / Q000628:therapy; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000639:trends*; D011474:Prosthesis Design / Q000639:trends*; D011475:Prosthesis Failure; D058998:Remote Sensing Technology / Q000639:trends
keywords: His bundle pacing; leadless pacing; remote monitoring; resynchronization