TY - CHAP M1 - Book, Section TI - PACEMAKERS AND DEFIBRILLATORS A1 - Upadhyay, Gaurav A. A1 - Singh, Jagmeet P. A2 - Fuster, Valentin A2 - Harrington, Robert A. A2 - Narula, Jagat A2 - Eapen, Zubin J. PY - 2017 T2 - Hurst's The Heart, 14e AB - Cardiac implantable electronic devices (CIEDs), notably pacemakers and implantable cardioverter-defibrillators (ICDs), represent dramatic technological advances that have become essential in addressing the problems of arrhythmia and heart failure (HF) in modern cardiovascular patients. Although similar in design, these technologies represent two distinct paradigms of treatment. Where conventional single or dual-chamber pacemakers are used to address the fundamental problem of bradyarrythmia, ICDs are designed to automatically detect and treat tachyarrhythmias, specifically hemodynamically unstable ventricular tachycardia (VT) or ventricular fibrillation (VF). In the past two decades, a third paradigm has also emerged—cardiac resynchronization therapy (CRT)—in which biventricular (BiV) pacing is used to improve left ventricular (LV) pump function in patients with intraventricular conduction delay and systolic HF. Along with developments in fundamental approaches to pacing and defibrillation, recent years have also brought about exciting advances in design, with the development of leadless pacing and subcutaneous defibrillators. The purpose of this chapter is to provide an overview on pacing, defibrillation, and the indications for specific types of devices, and to review seminal clinical trials supporting their use in clinical practice. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1161719439 ER -