DESCRIPCIÓN COMPLETA DE LOS MARCAPASOS CARDÍACOS. FUNCIÓN, TIPOS Y APLICACIONES CLÍNICAS.

Cardiac pacemakers are essential medical devices designed to manage arrhythmias by delivering electrical impulses to regulate heart rhythm. This comprehensive review explores their function, types, and clinical applications, emphasizing their role in improving patient outcomes. Modern pacemakers consist of a pulse generator and leads that transmit electrical signals to the myocardium, ensuring adequate cardiac output. The classification of pacemakers includes single-chamber, dual-chamber, and biventricular devices, each tailored to specific clinical needs. Single-chamber pacemakers stimulate either the atrium or ventricle, while dual-chamber devices coordinate atrial and ventricular contractions to mimic natural heart rhythm. Biventricular pacemakers, or cardiac resynchronization therapy (CRT) devices, are employed in patients with heart failure and ventricular dyssynchrony to improve systolic function and reduce symptoms. Indications for pacemaker implantation range from bradyarrhythmias, such as sick sinus syndrome and atrioventricular block, to advanced heart failure requiring CRT. Advances in technology have led to the development of leadless pacemakers and devices with extended battery life, offering minimally invasive options and reducing complications like lead fracture and infection. Additionally, some modern pacemakers incorporate remote monitoring capabilities, allowing clinicians to track device performance and patient status in real-time. Clinical decision-making regarding pacemaker selection and programming depends on patient- specific factors, including underlying cardiac pathology, comorbidities, and lifestyle. While the benefits of pacemakers are well-documented, potential complications, such as infection, lead dislodgement, or device malfunction, necessitate careful follow-up and management.