Cardiac pacing. An alternative treatment for selected patients with hypertrophic cardiomyopathy and adjunctive therapy for certain patients with dilated cardiomyopathy.

The use of pacemaker technology for treating cardiomyopathies has provoked keen interest and enthusiastic support in the past decade.1–9 Often, the hemodynamic abnormalities associated with heart disease can be modified, at least for the short term, by altering the timing, sequence, and site of cardiac electrical activation. In both hypertrophic cardiomyopathy and dilated cardiomyopathy, dual-chamber pacing has relieved symptoms and improved hemodynamics in certain patients. However, pacing techniques should be used as a therapeutic approach to individual patients rather than as routine therapy for most patients with cardiomyopathies. Only recently have controlled, randomized studies assessed the usefulness of dual-chamber (VDD and DDD) pacing in patients with hypertrophic or dilated cardiomyopathies.10,11