New concepts in pacemaker technology

Abstrod The aim of today’s pacemaker technology is to maintain a high quality of life and physical perfomace of the patient When natural sinus rhythm i s absent, a series of sensors with complex microelectronic contml circuits meets the need for rate-adaptive pacemaker systems while preserving AV synchrony. But only closed loop control has the potential to restore natural regulation. Intracardiac impedance measurements allow the monitoring of the contractile status of the heart, which depends mainly on the sympathetic drive. The ANS-contmlled pacemaker, which uses the stimulating electrode at the same time as the measuring electrode, is of special cIinical advantage The clinical evaluation of this pacing system in more than 200 patients confirmed adequate rate adaptation. Future developments are likely to make use of this possibility for eg arrhythmia prevention, intensive care monitoring o r as already implemented in conjunction with cardiomyoplasty.