Pacing and cardiac failure

Conventional dual-chamber cardiac pacing with the right ventricular pacing catheter positioned at the apex of the right ventricle was proposed eight y ears ago by Hochleitner as primary treatment of refractory cardiac failure. Although the preliminary results were encouraging, those at long-term and s ubsequent studies were less favourable in this indication. Biventricular pacing is now a technical possibility and allows at least par tial correction of the electromechanical abnormalities observed in dilated cardiomyopathy. The preliminary results of biventricular pacing in patients with refractory cardiac failure due to dilated cardiomyopathy with major i ntraventricular conduction defects are Very encouraging. This new therapeut ic approach should now be validated by controlled, randomised therapeutic t rials.