[The physiopathology of dual-chamber cardiac stimulation. Apropos a case with a dual-chamber pacemaker, left atrial standstill and heart decompensation].

The paper describes the clinical case of an elderly patient with heart failure, the possessor of a dual-chamber pacemaker programmed in DDD mode, in whom a complete interatrial block with left atrial standstill was diagnosed. The authors discuss the physiopathological aspect of the case which is a paradigmatic example of the problems related to dual-chamber pacing. In particular, the utility of an echo-Doppler assessment of the mechanical activity of the atria is emphasized together with a careful choice of the optimal atrioventricular delay in programming and the follow-up of dual-chamber pacing.