Cardiac implantable electronic devices: An update.

Background: Cardiac implantable electronic devices (CIEDs) are a core component in the management of heart rhythm disorders. The complexity of devices, the information gathered and therapy delivered by CIEDs continues to advance at pace.

Objective: The aim of this paper is to provide an update on advances in CIED technology and how this applies to managing patients with CIEDs in general practice.

Discussion: In recent years, there have been notable advances in CIED technology. These include widespread magnetic resonance imaging compatibility and automated algorithms to assist in the clinical management of patients. There is the ability for clinicians and pacemaker clinics to monitor devices remotely, avoiding in-clinic visits. Options are now available for leadless pacemakers and subcutaneous defibrillators as an alternative to indwelling leads and associated infection and vascular issues. Techniques have been developed to allow leads to capture the native conduction system, providing physiological cardiac activation (conduction system pacing) for treatment and prevention of heart failure.