Key Points
- To review the historical development, functional capabilities, clinical indications, and technological limitations of physiological cardiac pacing systems designed to restore atrioventricular synchrony.
- Reviewed historical milestones and evaluated functional mechanisms of standard and investigational pacemaker technologies.
- Assessed device indications and technical limitations based on clinical experience in a cohort of 176 patients.
- Reliable transvenous atrial leads combined with improvements in microelectronics and battery longevity enable practical restoration of the atrioventricular sequence.
- Identified practical constraints and clinical boundaries in current pacing systems, outlining technical prerequisites needed for next-generation devices.
Structured PICO
IInterventionPhysiological cardiac pacing (pacemakers for restoration of atrioventricular sequence)
This historical review outlines the functional descriptions, indications, and limitations of physiological cardiac pacing systems based on early clinical experience.