Pacemakers of the 1980s

Today's pacing techniques and technologies have gone a long way toward the ideal and in the 1980s will make further strides toward a possible universally responsive, sophisticated, single instrument. These advances include the use of programmability of at least mode, rate, output, sensitivity, and refractory period; dual-chamber as well as single-chamber pacing; CMOS and LSI circuits; lithium batteries and possibly a limited revival of plutonium batteries; new lighter, longer-lasting, positive attachment leads; and new methods of triggering pacing. However, the increase in complexity and expense of the new devices has led to a question of their need, to a disputed question as to the possibility of overuse of pacing in general, and a need to reconcile government-mandated cost containment with medical as well as socioeconomic reality.