Document Detail

Benefits of the advances in cardiac pacemaker technology.
MedLine Citation:
PMID:  1499189     Owner:  NLM     Status:  MEDLINE    
Pacemaker technology has expanded rapidly in the last thirty years. Each phase of development has been marked by both improvements in clinical benefit and disadvantageous interactions of physiology and technology. Each phase of development has led to smaller, more reliable devices with greater programmability. Advances in generator technology and battery design have increased longevity of devices. The first devices used asynchronous pacing which had a significant effect in reducing the mortality of surgically induced complete heart block. Ventricular demand pacemakers overcame the problems of asynchronous competitive pacing, but exposed the pacemaker syndrome. Atrioventricular sequential pacing restored atrioventricular synchrony, resulting in hemodynamic improvement, but created the phenomenon of pacemaker-mediated tachycardia. Alternative dual chamber modes and algorithms have largely resolved this. Adaptive-rate devices have been of benefit to patients with chronotropic incompetence, and are now incorporating an increasing variety of biosensors. Almost all the problems of pacing have been overcome, but the increasing complexity of pacemaker technology is now a major limitation to its proper use.
C F Shakespeare; A J Camm
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical cardiology     Volume:  15     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-17     Completed Date:  1992-09-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  601-6     Citation Subset:  IM    
Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.
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MeSH Terms
Arrhythmias, Cardiac / physiopathology,  therapy*
Equipment Design
Heart Atria / physiopathology
Heart Rate / physiology
Heart Ventricles / physiopathology
Pacemaker, Artificial*

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