Abstract
This review provides a history of physiological pacing from inception to current practice and into the future. This review stems from personal experience and is not formally systematic. Physiological cardiac pacing is covered from 1960s to date. Concepts, and major milestones with their practical applications are reviewed including possible applications in the future. Huge strides have been made in the last 50 years, but consequences of developments have not always been well considered resulting in important adverse effects. The future requires deep electrophysiological thinking to achieve further benefits for our patients.