Cardiac pacing has been used in the treatment of bradyarrhythmias for more than 50 years and during that time both clinical practice and an impressive body of research have proved its effectiveness objectively, in terms of parameters that includes the patient's quality of life, morbidity, and mortality. There can also be no doubt that the related technology has made great strides over the same period. The guidelines for the appropriate use of pacemaker devices presented in this document, a joint European Society of Cardiology (ESC) and EHRA initiative, aim to provide for the first time in Europe an up-to-date specialists’ view of the field. The guidelines cover two main areas: the first includes permanent pacing in bradyarrhythmias, syncope, and other specific conditions, whereas the second refers to ventricular resynchronization as an adjunct therapy in patients with heart failure.
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