[The best in 2000 on heart stimulation].
In the last twelve months many important articles have been published in the field of cardiac pacing. The authors analyse 5 of them in this review: the Canadian CTOPP, which compared dual and single chamber pacing in patients with a classical indication for pacing, and concluded that the results were identical in the two modes but not without serious criticism about the validity of this conclusion. A second Canadian trial analysed the effects of atrial stimulation in the prevention of atrial fibrillation but without apparent benefit. In 1999, vaso-vagal syncope had already been studied in a randomised trial; a second one was published in 2000 with concordant results in favour of pacing but reserved for a very selected population. Finally, two articles were devoted to "left heart" pacing in cardiac failure. The MUSTIC trial was the first randomised protocol and its results were favourable for this type of pacing. A physiopathological study reported by a Baltimore group, provided fundamental information: the increase of left ventricular contractility (DP/Dt) occurs without any increase in myocardial oxygen consumption.
Département de cardiologie, hôpital de la Cavale blanche, boulevard Tanguy-Prigent, 29609 Brest.
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Blanc
D001281:Atrial Fibrillation / Q000628:therapy; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D010138:Pacemaker, Artificial; D019462:Syncope, Vasovagal / Q000628:therapy