Abstract
The second half of the 20th century witnessed a revolution in electronic medicine similar to that in pharmacology in the decades before. The advent of the implantable pacemaker, implantable cardioverter-defibrillators, cardiac resynchronisation therapies, insertable loop recorders and more, have improved diagnoses and reduced mortality and morbidity in millions of patients suffering from cardiac disease. The possibility to monitor patients continually without need for frequent office visits has the potential to reduce follow-up burden on physicians, facilitate increased use of home-based care and further improve the safety for patients. This review summarises the role of cardiac device therapies today and some of the developments which we can hope for in the nearest future.
Highlights
In the last 50 years, electronic cardiac medicine witnessed an impressive technological and miniaturisation development which resulted in an enormous positive impact on our healthcare
One of the best tested algorithms developed for this purpose is the Managed Ventricular Pacing (MVP), data from the SavePace trial, which followed 1065 patients for a mean of 1.7 ± 1 years and showed that MVP reduced the relative risk of developing persistent atrial fibrillation (AF) by 40% (p = 0.009) compared with conventional dual-chamber pacing
On the related question of whether implantable cardioverter-defibrillator (ICD) patients might benefit from cardiac resynchronisation therapy (CRT)-D, the results of REVERSE and MADIT-CRT seem reassuring to physicians who have opted for this therapy in ICD-indicated patients with wide QRS interval, and most likely updates in guideline recommendations will come soon
Summary
The second half of the 20th century witnessed a revolution in electronic medicine similar to that in pharmacology in the decades before. The advent of the implantable pacemaker, implantable cardioverter-defibrillators, cardiac resynchronisation therapies, insertable loop recorders and more, have improved diagnoses and reduced mortality and morbidity in millions of patients suffering from cardiac disease. The possibility to monitor patients continually without need for frequent office visits has the potential to reduce follow-up burden on physicians, facilitate increased use of home-based care and further improve the safety for patients. This review summarises the role of cardiac device therapies today and some of the developments which we can hope for in the nearest future
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