Juraj Bodnár, Peter Kalist
Since 1958, when cardiostimulation (cardiac pacing) was clinically used for the first time, the development of cardiostimulation (cardiac pacing) has recorded significant changes. In resuscitation of asystolic heart, present cardiostimulators (pace-makers) (CS) are able to monitor heart activity and, if needed, reliably regulate electrical stimulation. By timing and producing impulses they can substitute a physiological activity of the heart, involving coordination of atrioventricular contraction with frequention corresponding metabolic needs of organism. Indications for cardiostimulators (pace-makers) and criteria for selection of a proper type of the cardiostimulator have recently recorded cardinal changes. Progress in production technology of cardiostimulators and electrodes has also significantly contributed to changes. Quality of used electrodes has been improved. Originally used epimyocardial electrodes have been substituted by qualitative and functionally more reliable electrodes used for intravenous stimulation. A significant role has been assigned to improved atrioventricular electrodes with the possibility of active fixation that has enabled the introduction of bilocular stimulation into the practice. Most of patients with implanted pace-makers in 90s can use the advantage of stimulation in DDD or DDDR regime with no respect whether dysfunction of atrioventricular or sinoatrial node dominates with the exception of chronic atrial arrhythmia.