Abstract The use of permanent implanted pacemakers as therapy for symptomatic bradyarrhythmias and conduction defects has shown steady growth, since the first implantation was reported in 1960.1 The early permanent pacemakers were relatively simple devices that paced the ventricle at a fixed rate but did not sense intrinsic cardiac rhythm. During the past 24 years, pacemakers have become progressively more sophisticated devices. The advent of atrioventricular (AV) sequential pacing in the late 1960s and the noninvasive multiprogrammability and dual-chamber sensing and pacing (the so-called AV universal [DDD] pacemaker) in the mid-1970s has led to a tremendous rise in the use of more sophisticated devices. At Jefferson Medical College in Philadelphia dual-chamber devices accounted for 8% of all implantations in 1980. In 1982, 50% of pacemakers were dual-chamber devices, most of which were AV universal pacemakers. These figures are representative of nationwide statistics,2 highlighting the increasing use of more versatile References 1. Chardack WM, Gage AD, Greatbatch W, et al: A transistorized, self-contained implantable pacemaker for the long-term correction of heart block. Surgery 1960;48:643-654. 2. Bilitch M, Goldman B, Hauser R, et al: Use patterns of permanent cardiac pacemakers. Pace 1983;6:311.Crossref 3. Castellanos A, Lemberg L: Electrophysiology of Pacing and Cardioversion . New York, Appleton-Century-Crofts, 1969, p 54. 4. Furman S, Fisher JD: Endless loop tachycardia in an AV universal (DDD) pacemaker. Pace 1982;5:486-489.Crossref 5. Rubin JW, Frank MJ, Boineau JP, et al: Current physiologic pacemakers: A serious problem with a new device. Am J Cardiol 1983;52:88-91.Crossref 6. Thompson R, Mitchell A, Ahmed M: Conduction defects in aortic valve disease. Am Heart J 1979;98:3-10.Crossref 7. Dhingra RC, Amat-y-Leon F, Pietras RJ, et al: Sites of conduction disease in aortic stenosis. Ann Intern Med 1977;87:275-280.Crossref 8. Goldreyer BN, Bigger JT: Ventricular atrial conduction in man. Circulation 1970;41:935-946.Crossref 9. Hayes DL, Furman S: Use of atrioventricular and ventriculo-atrial conduction times in patients receiving dual chamber sensing pacemakers. Pace 1983;6:318.Crossref 10. Ross BA, Bink-Boelkens M, Gillette PC, et al: Ventriculo-atrial conduction intervals. Pace 1983;6:319.
Archives of Internal Medicine – American Medical Association
Published: May 1, 1984