[Permanent cardiac pacing. Present possibilities and perspectives]

Area of Science:

• Cardiology
• Biomedical Engineering

Context:

• Cardiac pacing has evolved significantly since its inception in 1958.
• Single chamber ventricular pacing indications are now restricted, replaced by advanced modes.

Purpose:

• To review the evolution of cardiac pacing from single chamber to modern dual chamber and rate-adaptive systems.
• To highlight the benefits of physiological pacing in improving patient outcomes and expanding indications.

Summary:

• Modern pacing modes, such as dual chamber and rate-adaptive pacing, prevent bradycardia, restore atrioventricular synchronization, and ensure frequency response.
• Physiological pacing improves patient well-being and survival, extending indications to conditions like cardiomyopathies.
• Advancements like biosensors and automatic pulse energy adjustment enhance pacemaker longevity and functionality, moving towards intelligent, fully automatic devices operating in DDDR mode.

Impact:

• Improved patient quality of life and survival rates through synchronized and responsive cardiac pacing.
• Expanded therapeutic options for non-arrhythmic conditions, including cardiomyopathies.
• Development of next-generation smart pacemakers with enhanced sensing and adaptive pacing capabilities.