Past and future technologic developments for rhythm and conduction disturbances.

Since the first cardiac pacemaker was implanted in 1958, continuing technologic innovations have steadily improved the therapeutic power of implantable cardiac device therapy. This evolution has benefited both patients and their physicians, expanding the conditions manageable through pacing and implantable defibrillation while streamlining implant and follow-up procedures. This progress is likely to continue unabated because (1) devices will continue to grow smaller; (2) more advanced features will be introduced, with an increased level of automaticity; and (3) the quality and quantity of telemetered diagnostic information about both patient and device will continue to expand, and device sophistication will soon reach the point at which prediction and prevention of specific events will be a reality. This article reviews historical developments and presents concepts that are guiding future technologic innovations.