Cardiac Pacing

Approximately 1 million people in the United States have permanent pacemakers, and 426 new pacemakers were implanted per million members of the population in 19931,2 (and Bernstein AD, Parsonnet V: personal communication). Since the late 1950s, when the first asynchronous single-chamber permanent pacemakers were placed in patients,35 cardiac pacing has become a complex and self-contained subspecialty within cardiology that requires special training.6 However, primary care providers commonly encounter patients in whom permanent pacemakers have been implanted and evaluate patients to determine the need for permanent pacing. For this reason, it is essential that all physicians understand how pacemakers . . .