[Which pacemaker for which patient?].

Since the early 1980's, in parallel to development of "physiological" cardiac stimulation, modalities and objectives for cardiac stimulation have been modified radically. Among the many methods of stimulation available, in practice the physician may choose from four main types: (1) single-chamber ventricular stimulation; (2) single-chamber atrial stimulation; (3) two-chamber stimulation; (4) variable rate stimulation. Three main elements determine choice of the method of stimulation: the patient's physical condition, his heart condition (nature and type of cardiopathy and hemodynamic profile) and of course, electrophysiological data and cardiac rhythm encountered. The object of this paper is to schematically describe this choice.