**1. Introduction**

Cardiovascular disease (CVD), which refers to interdependently related heart and blood vessel problems, is currently known to be one of the leading causes of death in the world. The World Health Organization (WHO) reported that CVD is responsible for one-third of all deaths globally. The annual cost of CVD to the economy is estimated about £25 billion in the UK and over \$500 billion in the USA. The prevalence and cost of CVD raise an urgent need for solutions to elevate standards of care and improve patient outcomes.

A significant proportion of CVD is associated with heart rhythm problems, which means that the rhythm responds poorly or not at all to the physiological needs of the body. There are both an excessively slow rhythm (bradycardia) and an excessively high rhythm (tachycardia) or an unstable rhythm (arrhythmia, rhythm disturbances). All these incorrect rhythm phenomena are life-threatening. Fortunately, many methods, techniques, and tools have been developed and successfully applied today to stabilize and control the heart rate (HR). Modern implantable devices and treatment methods, including minimally invasive surgery, have been developed for cardiac rhythm management and avoiding heart failure. These measures benefit many millions of people every year [1].

Not only electrical pacing [1–3], but also ablation is an effective minimally invasive surgical method for reducing and blocking arrhythmic phenomena [4, 5], both as an independent treatment method and in conjunction with pacing therapy. In the following, we will look at modern cardiac rhythm management methods and devices in more detail together with some important medical aspects of their use.
