The pacemaker therapy is undoubtedly one of the significant advances in medical knowledge over the past thirty years. People whose lives were limited to just a few years have been given a new lease on life. Their life expectancy has been sustainably extended, and their quality of life has been significantly improved. However, the development of pacemakers has not stagnated. In recent years, substantial progress has been made specifically to enhance quality of life. The original therapy concept aimed to prevent Adams-Stokes attacks, initially in cases of complete AV block, but very quickly it was applied to all bradycardic arrhythmias. A significant advancement in this regard was the introduction of the demand function, which activates only when needed, that is, in the event of a sudden rhythmogenic failure of heart activity.