Description
Pacing is a reliable treatment associated with major benefit in terms of quality of life and reduction in mortality. The optimal system is one that normalises heart rate and conduction. UK pacing implant rates are below the European average. There needs to be greater awareness of patients requiring pacing and the appropriate investigations to perform. Clinical indications have expanded; bradycardia based pacing technology is used in cardiac resynchronisation devices for treating heart failure and in implantable cardioverter defibrillators. Paced patients are of an age that cardiac disease unrelated to bradycardia is highly prevalent. Pacemakers require life-long follow up and adjustment alongside appropriate changes in drug therapy. Follow up is becoming more automated but clinical and technical input will always remain crucial.
