ABSTRACT
The implantation and management of cardiac pacemakers constitute a vast subsystem within cardiology (but not a formal subspecialty) that did not exist half a century ago. The pacemaker, first fully implanted within the body in 1958, delivers pulsed stimuli to the heart so as to speed up an unduly slow heart rate and coordinate the action of the upper and lower chambers. National policies that encouraged medical research, socialized the cost of implantations through state payment schemes, and insisted that life-sustaining technologies be safe and effective have all affected the ongoing development of the pacemaker. In turn, these policies have embodied the public’s changing beliefs about needs and possibilities in medicine (1). A closer examination of the history of cardiac pacing reveals that its dominant theme has been unending innovation encouraged by medical innovators and device manufacturers.
