Implantable pacemakers for management of tachyarrhythmias

Attempts have been made to control tachyarrhythmias with implantable pacemakers since the late 1960's. The basic approaches considered were: a) maintenance of a basic rate following surgical division of the conducting system, b) pacing to prevent onset of tachyarrhythmias, and c) pacing to terminate episodes of tachyarrhythmias. The earliest approaches required conscious patient interaction in effecting therapy. Emergence of newer technologies has allowed development of flexible, automatic pacing systems which overcome some of the limitations of earlier approaches.