There are a number of new features in permanent pacemakers that have allowed pacing therapy to substantially improve the quality of life for people who receive pacemakers. One important feature is the ability of the artificial pacemaker to speed up the heart rate in response to activity. This happens by using motion sensors or sensors that detect breathing rate. The sensors can be turned on or off at any time in the doctor's office without any further surgical procedure. The heart rate response to exercise can be programmed to vary within a determined range (for example, from 60 to 120 beats per minute) and adjusted to speed up or slow down at different rates.

New pacemakers can detect problems with intermittent atrial fibrillation and, rather than allowing the heart to beat quite rapidly when this event occurs, the pacemaker will switch to a different mode and pace the lower chamber only. This switching of modes is very useful for people with tachy-brady syndrome who may be on certain forms of drug therapy. Also, some new pacemakers can pace the heart to try to prevent atrial fibrillation and/or to stop some forms of atrial arrhythmias.

For people who have sudden episodes of a slow heart rate that causes fainting, a pacemaker can be programmed to detect these rapid rate drops and then kick in with a fast rate (for example, 90 to 110 beats per minute) for a period of several minutes and then gradually come down to the pacing rate to support the person and prevent him or her from fainting.

The biventricular pacemaker, which synchronizes the rhythm of the heart's lower chambers (cardiac resynchronization), is another new technology. It is used in people who have damaged heart muscles and damage to the heart's electrical system. Because of the damage, the two lower chambers do not beat at the same time. These new pacemakers can pace both lower chambers at the same time by using an additional wire to the left lower chamber, which "resynchronizes" the lower chambers.