[Indications for implantation of pacemakers and their ambulatory follow-up]

In 1983 the indications for cardiac pacing to be considered by the physician are still the symptomatic sinus node dysfunctions ("maladie du sinus" and "maladie rythmique de l'oreillette") and the symptomatic or potentially symptomatic AV blocks (complete AV block, either permanent or intermittent, second-degree infranodal AV block, and even symptomatic Wenckebach type second-degree AV block). The choice of the type of cardiac pacemaker and of the pacing mode depends mainly on the implanting center. In the author's opinion the choice of multiprogrammable VVI models is justifiable in most cases. The increased price and fragility of the DDD models still seem to limit their use to particular cases involving about 10% of all implanted pacemakers. The selection of patients who could benefit most from the DDD mode of pacing is not always easy. Pacemaker follow-up should be performed in three stages: by the patient, by the physician and by the cardiologist specializing in cardiac pacing. The principles of this follow-up mode are reviewed.