Since the introduction of the implantable pacemaker in 1958 and the
implantable cardioverter defibrillator (ICD) in 1980, implantable devices
for rhythm control are now commonly used for treating bradycardia and certain
types of ventricular arrhythmias. The first pacemakers and ICDs were large
devices (40-200 cm3) that required a prolonged hospitalization
for implantation and postoperative recovery, and had few programmable features.
In contrast, the current devices are significantly smaller (9-45 cm3), can be implanted on an outpatient basis, and provide a myriad of
programming options to optimize therapy. During the last several years, the
actual and potential indications for pacemaker and ICD implantation have expanded
significantly as results from several large clinical trials have become available.
These advances have led to increased patient and physician acceptance and
a steady increase in implantation rates. In 1997, 153 000 new pacemakers
and 29 000 ICDs were implanted in the United States.1
We summarize the function of and current indications for pacemakers and ICDs.
More comprehensive discussions can be found elsewhere.2- 5
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