[Multi-programmed pacemakers: one more gadget or practical usefulness?].

More than 60% of pacemakers presently implanted are programmable. Their parameters (rate, power, sensitivity, etc.) can be non-invasively modified by a "programmer" transmitting a coded signal to the pacemaker's circuit. It may be useful to select a high or low rate to achieve a normal cardiac output or to prevent arrhythmias. Output programmability may avoid reoperations and, if the threshold is low, decrease the current drain through low output programming. Clinical or technical indications for programming exist but this is frequently an unnecessary gimmick: many programmable pacemakers are never programmed. The absence of standardization decreases the advantages of the system. The trend will obviously be towards the routine implantation of programmable models, particularly for initial implant, but it is surely unnecessary to condemn the non-programmable models, particularly for replacements.