Developing clinical indication for multisite pacing

The artificial activation of the heart modifies the mechanics of contractio n and relaxation. While only little basic research has been addressed to th is question, clinical observations showed that for hypertrophic as well as dilated cardiomyopathies appropriate pacing techniques can be useful. Pacing can influence the activation sequence. The spread out from a single site is slow, and so hypercontractility deminshed. With the use of multiple electrodes, two atrial and/or two ventricular, conduction delays in the at ria or ventricles can be eliminated. Synchronisation of the cardiac activat ion has an anti-arrhythmic and positiv inotropic effect. This may lead to n ew indications for pacemakers or better to be named cardiac synchronisers.