Abstract
Since the first permanent cardiac pacemaker was successfully implanted in 1958 there has been a vast improvement in pacemaker technology and reliability. This has been accompanied by a broadening of indications for pacemaker implantation. The initial emphasis was placed on pacemaker implantation as a life saving procedure in patients with complete heart block whose prognosis without treatment was very poor and had a mortality rate of up to 30% per year. Today the emphasis has shifted towards improving quality of life and allowing a normal lifestyle in patients whose endogenous cardiac rhythm impairs their ability to cope with the demands of day-to-day life. This article is in two major parts. The first part will introduce the pacemaker technology available, the types of pacemakers and NBG code, the indications for pacemaker treatment and the British Pacing and Electrophysiology Group (BPEG) recommendations for the selection of pacing modes for individual conditions. The second part will deal with patient management and causes of pacemaker malfunctions.
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