[Bicavitary cardiac stimulation. Re-assessment and results]

In each indication for cardiac stimulation, dual chamber pacing must be considered if stimulation or sensing in the atrium is possible. It is of particular importance in patients with diastolic ventricular dysfunction. The Heart rate is the most important parameter in stress-adaptation; for this reason we propose to use exclusively the VVIR or DDDR stimulation mode in physically active patients. Complications of dual chamber pacing are rare. During follow-up it is important to limit the energy of impulses and so to enhance the longevity of the generator, and to verify other parameters such as adaptation of the rate adaptation sensor and the AV delay intervals for sensed and paced atrial events. Modern technology allows us to reach the two most important goals of cardiac stimulation: avoid syncopes due to excessive bradycardia or asystole and optimize the quality of life of our patients.