[Current pacemaker treatment and technology]

The increasing use of microprocessor technology in pacemaker devices results, by multiple programmability, in a more reliable follow-up of pacemaker systems and accounts for individual patient program settings. Rate-adaptive and AV-sequential pacing allows physiologic pacing. The implantation of dual-chamber pacemakers is no longer precluded in patients with atrial tachyarrhythmias with the availability of pacemakers with automatic mode switching (DDD[R] to DDI[R]). The actual vast variability of pacemaker treatment modalities requires a careful evaluation of the indication for pacemaker implantation, with international guidelines being helpful in decision-making. Besides frequent pacemaker indications, the occasional patient with hypersensitive carotid sinus syndrome, neurocardiogenic syncope and hypertrophic cardiomyopathy may benefit from pacemaker treatment. Temporary pacemaker functions with programmable stimulation extend the diagnostic and therapeutic horizon of various arrhythmia treatments.