9 Widening Indications

Apart from support of heart rate in patients of symptomatic bradycardia, in the last two decades, the indications of pacemakers have widened to prevent arrhythmias, optimise hemodynamic functions and suppress tachyarrhythmias. Pacemakers have been successfully used in Hypertrophic Obstructive Cardiomyopathy (HOCM) to reduce LVOT gradient and in improving cardiac output in patients of dilated cardio myopathy (DCM) with class III/class IV heart failure (Cardiac Resynchronization Therapy). Nowadays, different pacemakers are being routinely used to treat Sick Sinus Syndrome, Neurocardiogenic Syncope, Heart Transplant patients and to prevent atrial arrhythmias. They are used to prevent fatal ventricular arrhythmias and to prevent bradycardia in patients of long QT syndromes. In future genetically engineered pacemakers could be a possible alternative to implantable electronic devices for the treatment of brady arrhythmias. This article briefly discusses these expanding indications of pacemakers.