Guidelines of the Spanish Society of Cardiology on Pacemakers

Following a brief introduction on the history and generic codification of t he different cardiac stimulation methods available, the implantation techni ques are described and the requisites, such as human resources, their quali fications and the materials required, which are essential in the organizati on of a Pacemaker Unit are discussed. The current indications for permanent cardiac stimulation are reported and are classified by sections in tales following the 1998 norms of the ACC/AHA . In another section, the indications in special situations such as hypertr ophic or dilated cardiomyopathy are described. Stimulation frequency modula tion with the incorporation of biodetectors in modern pacemakers or in the probes are commented upon as is atriosynchronic ventricular stimulation wit h a single electrode (VDD). The recent automatisms which have been implemented in the current pacemaker s are discussed and the most adequate selection of the stimulation mode for each patient is analyzed and demonstrated in a table which may be easily i nterpreted. On establishing the recommendable protocol for undertaking the follow up of the patient with a pacemaker, the criteria accepted as replacement indicat ors are discussed. In a brief section some legal aspects (drivers license, informed consent) are commented upon and the possible sources of interferen ce with the function of the system implanted, whether medical or environmen tal or laboral, have been analyzed more in depth. The chapter ends with a brief discussion on the survival of patients with p acemakers.