On Oct. 8, 1958, Arne Larsson became the first to receive an implantable pacemaker. Actually, the ‘definitive’ unit placed in the abdominal wall of the pacemaker recipient, Arne Larsson, fired for only three hours. The first replacement, done the following morning, was followed by more than 22 units and numerous surgical interventions until Mr. Larsson died in 2001.

Despite all the initial technical and medical failures, the daily resuscitations of this patient caused by recurrent AV block were over and Mr Larsson could be discharged after several months of hospitalisation to resume his daily life and activities. For the Netherlands, the D Day of this cardiac electrotherapy was 3 January 1962 when the cardiac surgeon Professor G. Brom of the University Hospital Leiden implanted the first permanent epicardial pacemaker, soon followed by implantations by Professor Homan van der Heide in the University Hospital Groningen and afterwards in many general hospitals.

The impressive progress of chronic cardiac pacing is embodied by the normalised life expectancy of most pacemaker recipients and also, very importantly, a much better quality of life than before pacing.2 In the early days, nobody could foresee that besides pacing for slow cardiac rhythms, biventricular pacing could support medical treatment of congestive heart failure.