Pacemakers have used automated functions since the introduction of the inhibited mode more than 30 years ago. Currently, virtually all aspects of pacemaker function are subject to automated control, including automated threshold tracking and sensitivity adjustment. These features are designed to enhance patient safety and quality of life, extend battery life, and simplify pacemaker programming and follow-up for health care providers. Many of these automated algorithms are still in evolution and the clinical benefits are not clearly demonstrated for all functions. Although pacemaker function will become increasingly automated, these features should not be accepted uncritically and without demonstrating benefit to the pacemaker patient.