[Physiologic stimulation: the future or a passing phase?].

Abstract

Pacing techniques achieving normal AV synchrony are termed "physiologic". All rely on an atrial pacing or/and pacing system usually coupled with ventricular pacing. The major advantage is haemodynamic, usually related to the varying ventricular pacing rate obtained with atrial sensing systems only. Problems related to the more complex implantation technique, the cost of this system, its limited lifetime, more frequent iatrogenic complications and in particular the risk of reentry electronic "tachycardias" with the presently available models including an atrial sensing function, should limit the use of these devices to patients who really need AV synchrony if the implantation is technically possible, i.e., in our opinion, 10 to 15% of patients.