The path of medical development in the treatment of arrhythmias is very rich, it includes a large number of discoveries that currently make it possible to successfully treat thousands of patients, while improving their quality of life or fully restoring their physical activity. However, to this day, there are cases that expand the boundaries of the use of electrocardiostimulation. There has been an increasing interest in minimizing the risk and complications associated with the implantation procedure, in monitoring patients with implanted pacemaker and remote monitoring devices. Accordingly, the models of the pacemaker, which acts as an artificial heart rhythm driver, as well as its technical support, are rapidly changing and improving. This review will cover both the historical aspects of the development of electrocardiostimulation, as well as the most important and most modern technical achievements and concepts of electrotherapy.