[Evidence-based medicine. Indications for cardiac pacemakers]

Recently published international recommendations classify indications for permanent cardiac pacing according to their level of evidence of clinical benefit. Sick sinus syndrome, AV conduction disturbances, carotid sinus hypersensitivity and congestive heart failure are successively discussed. Good quality practice not only includes careful indication analysis but also a rational choice of pacemaker type. In sick sinus syndrome, the clinical interest of physiological pacing modes clearly appears, particularly in the prevention of atrial fibrillation.