Improving the beat for heart failure

Adding a special pacemaker that coordinates the beat of the heart's lower chambers to state-of-the-art drug therapy helps some people with heart failure live longer and better.

The first artificial pacemaker was a boxy device too big to be implanted in the chest. It ran on AC power, which tethered its user to an extension cord and prayers against power failures. Today's pacemakers, some the size of a silver dollar, fit neatly in the chest and run on their embedded batteries for years.

Pacemakers have changed in other ways as well. Modern ones are safer, better protected against microwaves and other stray electromagnetic radiation, and smarter. While early pacemakers delivered tiny "beat now" shocks to just one chamber of the heart, some now come close to mimicking the complex electrical system of the heart.

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