Haemodynamic Pacing: When Is It Selectively Indicated?

摘要

The determinant factors of cardiac output are systolic ejection volume and heart rate. Since the first pacemaker (PM) implantation in 1958, all the indications for PM implantation have been haemodynamic ones: heart rate stabilisation, exercise rate responsiveness, restoration of AV synchronisation (Table 1).The incidence of congestive heart failure (CHF) has been rising for some years, to the extent that it is set to become the "epidemic of the next millennium". Dysregulation of the cardiac pump induced by myocardial fibrosis is associated with an impairment of the electrical cardiac influx propagation and has opened the way for nonbradycardia haemodynamic pacing aimed at improving the quality of life and prognosis of patients with CHF by mean of cardiac resynchronisation therapy (CRT).