Which Pacemaker?

Abstract

INTRODUCTION The first fully implantable cardiac pacemaker was inserted by Elmqvist and Senning in 19591 into an electrical engineer suffering from complete atrioventricular (AV) block. He is still alive today. Since then, and more specifically in the last decade, cardiac pacing has been transformed by technological innovation, and has resulted in devices that no longer merely prevent the incidence of syncope and sudden death in patients with complete heart block, but actually restore appropriate chronotropic response to exercise, and maintain normal conduction between, and contraction of, the cardiac chambers. Modern ‘physiological’ pacemakers are thus designed to restore a normal quality of life to patients requiring cardiac pacing.