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November 1985

Progress in Cardiac Pacing: Part I

Author Affiliations

From the Division of Cardiology, San Francisco General Hospital, and the Departments of Medicine, San Francisco General Hospital and University of California, San Francisco.

Arch Intern Med. 1985;145(11):2103-2106. doi:10.1001/archinte.1985.00360110179035

Cardiac pacing therapy has evolved rapidly since the first device was implanted 26 years ago.1 Technologic progress has provided the clinician with microprocessor-based multiprogrammable pulse generators, long-lived power sources, and reliable atrial and ventricular lead systems. Along with these developments, the indications for singleand dual-chamber pacing have broadened considerably since the early pacemakers were implanted for complete heart block. They now include the bradyarrhythmic manifestations of the sick sinus syndrome and some types of tachycardias.2-4 As a result, the number of patients in the United States with pacemakers is over 500,000 and growing.5 The practicing physician is thus very likely to encounter patients who either have or need a pacing system.

In the past, the physician caring for a patient was concerned primarily with establishing the indications for pacemaker implantation. Now pacing therapy must be individualized to match the patient's needs with the most suitable pacing mode

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