Fifty years of cardiac pacing: the dark side of the moon?

Fifty years after its introduction, cardiac pacing for symptomatic bradycardia can look back on its impressive past. It is one of those rare medical therapies that has changed the lives of numerous patients faced with a disease with high morbidity and mortality to a prognosis which almost equals that of the normal population. Associated with a steep increase in life expectancy in the industrial world during the last half century, the number of device implants has been steadily growing and is expected to grow even further. Because of the clear benefits of cardiac pacing in patients with symptomatic bradycardia, potential harmful effects of pacing have only recently been recognised. This commentary will discuss the evidence of the adverse effects of cardiac pacing and will provide potential future modifications. …