[New pacemaker functions: which ones represent real progress and which are only gadgets?].

Modern pacemakers, and particularly dual chamber models, include a broad array of therapeutic and diagnostic features. Some are designed to increase safety, whereas others are either designed to avoid unnecessary pacing, reduce the current drain and increase the pacemaker longevity, or to improve the hemodynamics. Diagnostic features are more elaborate, more or less automatic, and easier to extract from the pacemaker memory. Some of these new algorithms represent a real advantage, while others appear to be more like gadgets than real advances. Several new algorithms should be improved in order to avoid possibly dangerous side effects. Most of these new features are of little value in the absence of postoperative programming by a well trained physician.